title: The early childhood oral health program: a qualitative study of the perceptions of child and family health nurses in South Western Sydney, Australia.
abstract: BACKGROUND
  Early childhood caries affects nearly half the population of Australian children aged 5 years and has the potential to negatively impact their growth and development. To address this issue, an Early Childhood Oral Health (ECOH) program, facilitated by Child and Family Health Nurses (CFHNs), commenced in 2007 in New South Wales, Australia. This study builds on the previous evaluation of the program. It aims to explore the perceptions of CFHNs regarding the implementation of the ECOH program in South Western Sydney and the challenges and barriers related to its sustainability.
  
  
  METHODS
  A descriptive qualitative design was used in this study. Two focus groups were conducted with 22 CFHNs who were sampled from two Community Health Centres in South Western Sydney, Australia. Data were transcribed verbatim and thematic analysis was undertaken.
  
  
  RESULTS
  Most CFHNs acknowledged the importance of early childhood oral health promotion and were providing education, oral assessments and referrals during child health checks. Many stressed the need for collaboration with other health professionals to help broaden the scope of the program. Some barriers to implementing the program included confusion regarding the correct referral process, limited feedback from dental services and the lack of oral health awareness among parents.
  
  
  CONCLUSIONS
  The study findings suggest that the ECOH program is being sustained and effectively implemented into practice by CFHNs. Improvement in the referral and feedback process as well as enhancing parental knowledge of the importance of infant and child oral health could further strengthen the effectiveness of the program. Expanding oral health education opportunities into general practice is advocated, while regular on-line training for CFHNs is preferred. Future research should include strategies to reduce non-attendances, and an assessment of the impact on the prevalence of childhood caries of the ECOH program.
authors.affiliation: School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
authors.forename: Maxine
authors.initials: M
authors.lastname: Veale
authors.affiliation: Sydney Local Health District Oral Health Services/ Sydney Dental Hospital/ University of Sydney, Sydney, Australia.
authors.forename: Shilpi
authors.initials: S
authors.lastname: Ajwani
authors.affiliation: Faculty of Health Sciences, Australian Catholic University/Ingham Institute Applied Medical Research, Sydney, Australia.
authors.forename: Maree
authors.initials: M
authors.lastname: Johnson
authors.affiliation: Marrickville Community Oral Health Clinic, Sydney Local Health District Oral Health Services, Sydney, Australia.
authors.forename: Linda
authors.initials: L
authors.lastname: Nash
authors.affiliation: Centre for Applied Nursing Research, Western Sydney University/ South Western Sydney Local Health District/ Ingham Institute Applied Medical Research , Sydney, Australia.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Patterson
authors.affiliation: Collaboration for Oral Health Outcomes, Research, Translation and Evaluation (COHORTE) Research Group/Western Sydney University/South Western Sydney Local Health District Oral Health Services/University of Sydney/Ingham Institute Applied Medical Research, Sydney, Australia. a.george@westernsydney.edu.au.
authors.forename: Ajesh
authors.initials: A
authors.lastname: George
mesh_terms: D001315:Australia; D002648:Child; D002675:Child, Preschool; D005192:Family Health; D006267:Health Education, Dental; D006801:Humans; D009517:New South Wales; D009909:Oral Health
keywords: Child and family health nurses; Early childhood; Oral health; Postnatal; Qualitative study