title: Midwives' perspectives of their ability to promote the oral health of pregnant women in Victoria, Australia.
abstract: BACKGROUND
  Midwives have a potential role in promoting the oral health of pregnant women although they have little formal training in this area. The aim of this study was to explore the perspectives of midwives in Victoria towards incorporating oral health promotion into their antenatal practice after undergoing training through the Midwifery Initiated Oral Health (MIOH) online education program.
  
  
  METHODS
  A purposive sample of thirty-nine midwives from maternity services across Victoria, Australia were invited to participate in an online MIOH education program in October 2012. The program included three self-paced modules covering oral health screening, referral processes, and theoretical and practical skill assessments. A mixed methods design was used to capture midwives perspectives. Evaluation questionnaires, completed pre- and post-training, captured knowledge and confidence (confidence likert scale), and also included five opened-ended questions post-training. Open-ended questions, feedback forms and unsolicited emails formed the data for qualitative analysis. Data were analysed using content and thematic analysis and descriptive statistics.
  
  
  RESULTS
  Thirty-three midwives completed the MIOH education program and demonstrated a significant increase (51.5%) in their confidence to promote oral health. All participants viewed the program as suitable, acceptable and useful for their practice and were happy to recommend the course to other Victorian midwives. Participants indicated that it would be feasible to incorporate oral health into the first antenatal booking visit and recognised that oral health promotion was within their scope of practice.
  
  
  CONCLUSIONS
  This study has shown that the MIOH education program is a valued resource that can assist midwives to increase their confidence and skills to incorporate oral health promotion into their practice. A key barrier identified was time constraints during antenatal care booking visits. However, it is evident that with relevant training it would be feasible and acceptable for Victorian midwives to incorporate oral health promotion within their practice. The current engagement with midwives in Victoria and other parts of Australia provides an opportunity to continue to explore and define the role of antenatal health care professionals in oral health promotion at a state and national level.
authors.affiliation: Centre for Applied Oral Health Research, Dental Health Services Victoria, Melbourne, Australia. Adina.Heilbrunn@dhsv.org.au.
authors.forename: Adina Y
authors.initials: AY
authors.lastname: Heilbrunn-Lang
authors.affiliation: Centre for Applied Oral Health Research, Dental Health Services Victoria, Melbourne, Australia. Andrea.deSilva@dhsv.org.au.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: de Silva
authors.affiliation: Health Promotion, Dental Health Services Victoria, Melbourne, Australia. Gillian.Lang@dhsv.org.au.
authors.forename: Gillian
authors.initials: G
authors.lastname: Lang
authors.affiliation: Centre for Applied Nursing Research, University of Western Sydney/ South Western Sydney Local Health District, Sydney, Australia. A.George@uws.edu.au.|Ingham Institute Applied Medical Research, Sydney, Australia. A.George@uws.edu.au.|Faculty of Dentistry, University of Sydney, Sydney, Australia. A.George@uws.edu.au.
authors.forename: Ajesh
authors.initials: A
authors.lastname: George
authors.affiliation: Health Promotion, Dental Health Services Victoria, Melbourne, Australia. Allison.Ridge@dhsv.org.au.
authors.forename: Allison
authors.initials: A
authors.lastname: Ridge
authors.affiliation: Faculty of Health Sciences, Australian Catholic University, Sydney, Australia. Maree.Johnson@acu.edu.au.
authors.forename: Maree
authors.initials: M
authors.lastname: Johnson
authors.affiliation: Faculty of Dentistry, University of Sydney, Sydney, Australia. Sameer.Bhole@sswahs.nsw.gov.au.|Sydney Local Health District Oral Health Services and Sydney Dental Hospital, Sydney, Australia. Sameer.Bhole@sswahs.nsw.gov.au.
authors.forename: Sameer
authors.initials: S
authors.lastname: Bhole
authors.affiliation: Australian College of Midwifery Victorian Branch, Melbourne, Australia. carolegilmour@bigpond.com.|Monash University, Melbourne, Australia. carolegilmour@bigpond.com.
authors.forename: Carole
authors.initials: C
authors.lastname: Gilmour
mesh_terms: D002983:Clinical Competence; D005260:Female; D006293:Health Promotion; D006801:Humans; D008880:Midwifery / Q000193:education* / Q000379:methods; D009721:Nurse Midwives / Q000193:education / Q000523:psychology*; D009723:Nurse-Patient Relations; D009909:Oral Health; D011247:Pregnancy; D037841:Pregnant People; D011295:Prenatal Care / Q000379:methods; D015397:Program Evaluation; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D014739:Victoria