Health Smart Deadly Art
Greater Southern Area Health Service
Abstract
Health Smart Deadly Art was an innovative project, which utilised the medium of visual art to develop Aboriginal culturally appropriate education resources. The program developed partnerships with:
- Department of Education and Training (DET) Aboriginal Education unit and Narooma Primary school
- Katungul Aboriginal Medical Service
- Department of Community Services (DOC's) Schools as Community Centres
- NSW Centre for Oral Health Strategy, Eurobodalla Dental Clinic and Health Development teams
- Narrama Aboriginal community elders.
After attending an Oral Health lesson conducted with all classes in the school, Aboriginal students underwent a creative development process facilitated by an indigenous community artist. Students created visual art products representing the key messages within the NSW Messages for a Healthy Mouth Strategy, Eat Well, Drink Well, Clean Well, Play Well, Stay Well (NSW Centre For Oral Health Strategy, May 2007)1.
Aim
To increase the importance of good Oral Health through development of effective partnerships, providing culturally appropriate Oral Health information, and building significant relationships with Aboriginal and Torres Strait Islander communities.
Nature of the Problem
Aboriginal and Torres Strait Islander people have poorer Oral Health than non-indigenous people.
One quarter of the population has a preference for visual-spatial learning and Aboriginality is a racial difference that predisposes children to this style (Silverman, 2005)2. In order to provide effective Oral Health education for indigenous children programs need to be tailored to their learning style.
Partnerships with Indigenous organisations need to be developed to promote the importance of good Oral Health within the community.
This is acknowledged in Healthy mouths, Healthy lives: Australia’s National Oral Health Plan 2004-2013 (National Advisory Committee on Oral Health, July 2004)3 which states that there is a strong connection between the Oral Health Status of Indigenous peoples and their historical, cultural, socio-economic and environmental backgrounds.
Extent of the Problem
Studies in South Australia assessed the Oral health of Indigenous children and found that they have more than double the national decay rate in their deciduous teeth at 6 years and almost double in the permanent dentition of 12 year olds (National Advisory Committee on Oral Health, 2004.)
Anecdotal information from local clinicians indicated that early childhood caries seems to be more prevalent, with a large number of children being referred for general anaesthetic. Oral hygiene is generally poor and some children state they don’t have toothbrushes or toothpaste at home.
Healthy for Life assessments in Moruya 2007 indicated that more than 50% of those assessed required dental treatment.
Pre-knowledge tests identified misconceptions about good Oral Health Messages.
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Figure 1: Sample of results from Health Smart Deadly Art 2007, Pre and Post Knowledge Tests
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Strategic Importance
The project is in line with the National and NSW Oral Health strategies for Aboriginals and Torres Strait islanders (NSW Oral Health Promotion Audit Dec 2006)4 and is consistent with the following strategies of the NSW Oral Health Promotion Framework for Action 2010 ‘Aboriginal & Torres Strait Islanders (NSW Department of Health, 2004)5.
- Include oral health as primary health care provision in an equitable manner.
- Promote oral health through a wide range of communication mediums that focus on Aboriginal and Torres Strait Islander peoples.
- Build significant relationships with Aboriginal and Torres Strait Islander communities.
- Provide culturally appropriate oral health information.
- Increase partnerships with appropriate stakeholders.
The project is also in line with the NSW State Health Plan (NSW Department of Health, 2007, p22)6, Strategic Direction 3, strengthen primary health and continuing care in the community.
Planning and Implementing Solutions
Health Smart Deadly Art was written as a demonstration project and was funded by the NSW Centre for Oral Health Strategy. After discussion with representatives of the Department of Education (DET), Narooma Primary School was chosen to participate in the program.
The project management team involved representatives from the following organizations:
- Department of Education and Training (DET) Aboriginal Education unit
- Narooma Primary school
- Katungul Aboriginal Medical Service
- Department of Community Services (DOC’s) Schools as Community Centres
- NSW Centre for Oral Health Strategy
- Eurobodalla Community Dental Clinic
- Eurobodalla Health Promotion team
The Dental staff from GSAHS and Katungul developed an Oral Health education session that was adaptable for students of all ages and in keeping with the programs emphasis on visual- spatial learning styles. With the school’s assistance all students completed a pre-knowledge test and then attended the education session.
Visual art is a highly acceptable and culturally appropriate medium for learning within the Aboriginal culture. To facilitate the learning process an indigenous artist known to the community worked with dental staff, Aboriginal Education Assistants and the indigenous students to create culturally appropriate posters demonstrating the 5 Key Messages for a Healthy Mouth.
Students then completed a post- knowledge test.
The program culminated in a launch day where the students and artists involved presented the finished product to their school. Those present at the launch included Narramar Aboriginal community elders, dignitaries and representatives of all organizations involved.
A key to the success of the project was giving the school ownership of the project with health staff acting as resources for its facilitation. The construction of effective partnerships resulted in impassioned involvement from the representatives of the other stakeholders and immense pride for the indigenous community and the school as a whole.
Outcomes and Evaluation
The project was evaluated at process and impact levels.
At the process level a questionnaire was developed to assess participant satisfaction by the key stakeholders in the program. A focussed discussion was conducted with a group of children who participated in the art program. The results for both were highly positive and suggestions made for improvement will be useful for others who wish to embark on a similar program.
A comment from a member of the school team:
"The project has been a wonderful experience for all the children. The message that had been brought to the forefront about the 5 messages had an enormous impact on the students and some of the messages were filtered to the parents."
At the impact evaluation level the evidence from the post -tests showed significant changes in knowledge.
| Table 1. Pre and post test results for the question- Indicate the foods which are healthy | ||
| Pre | Post | |
| Strawberries | 85.95% | 92.90% |
| Coca Cola | 7.86% | 2.50% |
| Sandwiches | 91% | 92.90% |
| Lollies | 8.90% | 1.20% |
| Potato Chips | 10.60% | 1.90% |
| Water | 89.80% | 97.40% |
| Table 2. Pre and post test results for the question- What is the best drink to choose everyday | ||
| Pre | Post | |
| Milk | 39.80% | 38.80% |
| Water | 84.20% | 88.50% |
| Coca Cola | 7.30% | 1.20% |
| Cordial | 27.50% | 17.80% |
| Table 3.Pre and post test results for the question- Which items help keep out teeth clean and safe? | ||
| Pre | Post | |
| Coca Cola | 11.79% | 0.63% |
| Face Shield | 56.74% | 92.99% |
| Toothpaste | 95% | 96.17% |
| Tooth brushing | 85.95% | 94.90% |
| Lollies | 10.67% | 0.63% |
Anecdotally, the responses form the students were enthusiastic and encouraging. At a health check day where they each received a show-bag containing roll up’s, the students from Narooma School were heard saying that they wouldn’t eat them as the dental therapist had said they were bad for their teeth.
Sustaining Change
Eurobodalla Dental Service is committed to providing ongoing Oral Health promotion and clinical services to Narooma Primary School. The distribution of additional resources such as tooth-brushing models and toothpaste, floss and toothbrushes for student’s, reinforces the Key Messages, Stay Well and Clean Well.
Narooma Primary School is committed to promotion of healthy eating through participation in the Fresh Tastes @ School Healthy Canteen. The DOC’s Schools as Community Centres promotes healthy eating through Breakfast Club’s and playgroups. This reinforces the messages of Eat Well and Drink Well throughout the community.
The continuous display of the art works produced by students and indigenous artists in the main function auditorium of the school allows them to be viewed by the community and fosters the partnership between the indigenous community, school and dental services.
Future Scope
NSW Centre for Oral Health Strategy plans to distribute the Health Smart Deadly Art poster set statewide. They are also making available copies of the Pre and Post knowledge tests and the interactive lesson plan based on the 5 Key messages for a Healthy Mouth as tools for other oral health promotion projects.
Health Smart Deadly Art was recently included as a poster presentation at the NSW Turning the Tides Oral Health Conference, which has resulted in requests from other area health services for information regarding the development of partnerships and the implementation of the project.
References
- NSW Centre For Oral Health Strategy, NSW Messages for a Healthy Mouth 2nd edition, 01 May 2007.
- Silverman, Upside-down Brilliance: The Visual Spatial Learner, 2005.
- National Advisory Committee on Oral Health, Healthy mouths, Healthy lives: Australia’s National Oral Health Plan 2004-2013, July 2004.
- NSW Oral Health Promotion Audit Dec 2006.
- NSW Department of Health 2004, NSW OHP, Framework for Action 2010 ‘Aboriginal & Torres Strait Islander Peoples'.
- NSW Department of Health, NSW State Health Plan Towards 2010, 2007.
Contact
Project Manager, NSW Centre for Oral Health Strategy
Phone: 02 8821 4321
This project was entered in the 2008 NSW Health Awards, Build regional and other partnerships for health category.
