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| Key issue/challenges | Associated issues/barriers identified |
|
| Difficulty contacting patients | Frequent change of address |
| Irregular use of letterboxes |
| Appointment cards returned to sender |
| Patients moving towns at a high rate, sometimes leaving Pt Augusta and returning months later—clinic not notified |
| Patients not on telephone or frequent change of number |
| Children changing schools |
| Nonattendance at school |
| Schools unable to release contact details |
| Patients may use more than one surname |
|
| High rate of failure to attend appointments | Difficulties with transport |
| Priority placed on oral health in combination with other physical, social, and emotional well-being issues of individuals and families |
| Wednesdays and Thursdays are “money days” when pensions are paid, bringing with it other priorities for adults |
| Lack of understanding of the importance of dental care |
|
| Attendance patterns | Attend for relief of pain |
| Nonattendance for routine and preventative care |
| Lack of understanding of the importance of preventative care in contrast to relief of pain |
|
| Consent issues | Patient may be residing with someone who is not parent or legal guardian |
| Difficulty contacting parent or guardian when treatment decision needs to be made |
| Cultural differences and rules in regard to consent not understood and accepted by mainstream policies |
|
| Difficulty communicating with parents and guardians | Parents and guardians often seem uncomfortable in the dental clinic |
| Parents seem uncomfortable communicating with dental service staff |
| Lack of understanding of dental disease, prevention and importance of dental care |
| Different approach to and understandings of treatment decision making (different between staff and patients/parents) |
| Lack of Aboriginal staff in the mainstream dental clinic |
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