Oral health promotion for rural adolescents: A process evaluation of a co-designed pilot program

Adolescents living in rural areas are more likely to have poorer oral health compared with their metropolitan counterparts. Co-design is emerging as an effective method for developing health promotion programs that meets the needs of stakeholders; however, little evidence exists to inform successful co-designed oral health promotion programs for rural adolescents.

The aim of this study is to understand the value of a co-designed oral health promotion program undertaken with rural adolescents in northeast Victoria with objectives to: Co-design an oral health promotion program with rural adolescents. Evaluate the program for appropriateness, acceptability, and feasibility. Make recommendations for program refinement and scalability.

Study participants included year 11 and 12 students in a rural secondary school in Northern Victoria (n=2), who collaboratively along with schoolteachers, and the local health service staff led by an oral health therapist, co-designed, and delivered an oral gealth promotion program in their schools. This qualitative study used semi-structured group interviews (n = 8) to evaluate the co-design process and impact. Audio-recorded interviews were transcribed and thematically analysed using a co-design evaluation toolkit as a framework for analysis.

Qualitative inductive analysis revealed three main thematic categories around participant benefits (intended and unintended learning outcomes; interpersonal skills), the quality of the process (value of co-design, qualities of facilitators, and engagement); and scalability and replicability.

The study indicates that co-design was both acceptable and appropriate for designing an oral health promotion program for rural adolescents delivering unexpected benefits. Building the capacity of schoolteachers could offer sustainable and cost-effective solutions for scalability.