Advancing a program theory for community-level oral health promotion programs for humanitarian migrants: A realist review protocol

Abstract

Introduction:

Humanitarian migrants often experience oral diseases such as toothache and dental cavities. While community-level oral health promotion programs have been implemented in host countries and in refugee camps, there is scant literature that evaluates their effectiveness or transferability. Given that oral health promotion programs will yield unique context-specific outcomes, oral health planners need to better understand how contextual factors affect program participants’ reasoning, causing both intended and unintended outcomes.

Methods:

Realist review is a theory-driven program evaluation methodology incorporating a causal heuristic called context-mechanism-outcome configurations (CMOCs) to develop such an understanding. Using Pawson’s realist review steps (clarifying scope and drafting an initial program theory; identifying relevant studies; study appraisal and data extraction; data synthesis; and dissemination of findings.), we begin by developing an initial program theory from the references collected in a scoping review on oral health of refugees and asylum seekers. Following stakeholder validation, we will identify additional evidence through searching four databases (Ovid Medline, Ovid EMBASE, CINAHL and Cochrane library) to refine our theory into a middle-range program theory. The resultant theory will explain how community-level oral health promotion programs work for humanitarian migrant populations, in which contexts and why.

Discussion:

This study will be among the first to use the realist methodology in the field of oral health. The middle-range program theory resulting from this study will serve as a framework for designing and implementing effective and context-specific community-level oral health promotion programs for humanitarian migrants.

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