Co-creating Solutions to Oral Healthcare Issues in Vulnerable Communities in Denmark

Aim(s): Access to affordable and high-quality oral healthcare remains limited for many EU residents. This study focuses on two communities with unmet needs: asylum seekers and individuals with limited financial resources. The aim is to identify key issues and co-create solutions to improve their oral healthcare in Denmark. <br/> <br/>Methods: Two community-based multistakeholder teams (MSTs) were formed, involving residents, healthcare professionals, social workers, and policymakers. The territory based MST at rural asylum centres, targeting asylum seekers, involved 30 residents and 11 professionals. The territory-free urban MST in Copenhagen, targeting individuals with limited financial resources, included eight residents and five professionals. Co-creation was applied throughout the project, from recruitment to analysis and implementation, following the Community Health Improvement Process. The study began in the autumn of 2023 with the design phase and is now in the evaluation phase. Qualitative methods were employed, such as semi-structured interviews, focus group discussions, and workshops. An inductive thematic analysis was conducted collaboratively within multistakeholder teams. All co-creators provided written consent, and ethical approval was obtained. The Ethics Committee of the Heidelberg University Medical Faculty approved this study. <br/> <br/>Results: Besides financial issues, the MSTs identified challenges such as difficulties understanding and navigating the dental care system, including applying for subsidies; dental anxiety related to social judgment; and lack of preventive knowledge and self-care practices. The asylum seekers emphasised the need for increased access to dental treatments. In addition to developing an educational preventive programme, the MSTs' efforts led to a ripple effect, giving rise to other improvement initiatives. <br/> <br/>Conclusions: In the population studied, issues related to oral healthcare required both community-based and policy-level solutions. The co-creation process revealed the importance of community-based collaboration in generating context-specific solutions. These insights will guide the DELIVER project in improving access to high-quality oral healthcare. <br/>Keywords: Solutions, Oral Healthcare Issues, Vulnerable Communities, Denmark <br/> <br/>Acknowledgement: This study was performed as part of the DELIVER project <br/>(DELiberative ImproVEment of oRal care quality) funded by the EU Horizon Europe program. The authors thank all the co-creators for their time and commitment to this study.