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. 2019 May 31;14(5):e0217658. doi: 10.1371/journal.pone.0217658

Table 5. Summary of published research articles identified in the scoping review (2011 onward).

Author; Year/ Country University/ Institution Type of publications Program description Outcome variable/ Measurement instrument Results
Bhayat A, et al.; 2011/ South Africa [67] University of Witwatersrand Original research project report Final year dental students were enrolled in two groups for outreach:
  1. Phelophepa train, a mobile primary health care

  2. Public oral health facility

  • Dental students’ competencies/ Mixed method (qualitative and quantitative questionnaires)

  • Improved clinical skills and efficiency and understanding of the community needs

  • Problems: High patient input and long working hours on the train, and inadequate and non-functioning equipment in public oral health facility

Summerfelt FF; 2011/ USA [64] University of Northern Arizona Original research Pilot teledentistry program having dental hygiene students as mid-level practitioners in rural areas
  • Pedodontist’s acceptance during initial field trial/Opinion

  • Evaluation of diagnostic efficacy of patients’ digital X-rays taken by dental hygiene students at two remote locations/ Descriptive measurement

  • Faculty and students’ opinion/Survey questionnaires

  • Pedodontist identified project as successful

  • No significant difference between diagnostic efficacy at two remote sites

  • Hygiene students rated digital X-ray training as ‘excellent’

  • Hygiene students and faculty members rated value of inclusion of teledentistry skills into dental hygiene curriculum as ‘excellent’

Martinez-Mier, et al.; 2011/ USA [43] Indiana University Original research Hidalgo International Service-learning programme with multidisciplinary students and faculty- dental, medical, nursing, public health and social work
  • Students’ and faculty opinion about program development/ Questionnaires and SWOT analysis

  • Students acquired better clinical skills and appreciated rural culture and barriers to access to care

  • Faculty reported better understanding of students’ learning and better communication skills among team members

Parlani S, et al; 2011/ India [71] Chhatrapati Sahuji Maharaj Medical University Original research Awareness programs of prosthodontics among aging rural population
  • Evaluate awareness among study population/Interview and quantitative assessment

  • Increased awareness of ageing population

Bulgarelli AF, et al.; 2012/ Brazil [50] University of São Paulo Original Research Huka-Katu (beautiful smile) culturally adapted outreach programs in an Indigenous community for final year dental students
  • Dental students’ competencies and experiences/Qualitative interview

  • Improved students’ understanding of primary oral health care

  • Students developed sense of cultural respect and social perspective

Glassman P, et al.; 2012/ USA [85] University of Pacific Original research (First phase of demonstration project) Virtual Dental Home program (Expansion of dental home concept with use of advanced telehealth technology by teamwork between registered dental auxiliaries and distant dentists
  • Impact of implementation of project’s first phase/Descriptive analysis and feedback

  • 750 patients received preventive and early intervention dental treatments

  • Staff, caregiver, and parent education led to increased dental literacy and compliance with daily oral health practices, treatments, and referrals

Author; Year/ Country University/ Institution Type of publications Program description Outcome variable/ Measurement instrument Results
Macnab A, et al., 2012/ Uganda [72] Joint Ugandan/ Canadian university (University of British Columbia and Makerere University) Original research intervention study (project report) ‘Many voices, one song’: oral health model of health promoting schools based on Brighter Smiles program for the Aboriginal community in Canada. It included health education by local teachers and the university team and daily in-school tooth brushing
  • Change in oral health knowledge and oral health status after four years’ evaluation/Qualitative and quantitative methods (questionnaire and interviews of teachers)

  • Improved oral health and health-related knowledge among children

  • Positively influenced university faculty and students

Parker EJ, et al.; 2012/ Australia [63] University of Adelaide Original research evaluation study Aboriginal children’s Dental Program in Port Augusta by dental therapists and dentists; Integrated health project involving health promotion by conducting a workshop for Aboriginal health workers by dental students with key role of local primary health care provider (in collaboration with Pika Wiya Aboriginal Health Service)
  • Change in participation rate after 3.5 years and identified challenges/Documented data and interviews

  • Increased rate of participation for dental care for Aboriginal children from 53% to 70%.

  • Main challenges: Difficult to contact patients, communicate with parents or guardians, missed appointments, and consent-related issues

Tandon S, et al.; 2012/ India [73] Manipal College of Dental Sciences Original research Mobile dental health care services in rural areas
  • Knowledge, attitude, practice, and satisfaction among rural people after three months/Questionnaire

  • Improved oral health knowledge, attitude, and practices

  • High patient satisfaction

Vashisth S, et al.; 2012/ India [77] Swami Devi Dayal Dental College Original research (retrospective study) Various outreach programs in rural areas
  • Type of patients, diseases, and services at outreach for three months/Descriptive measurement

  • Dental caries was prevalent

  • mostly curative services were provided

  • recommended development of need-based programs

Johnson G, et al.; 2011/ Australia [27] University of Sydney Original research 1-month duration of Rural Placement Program was initiated for 4th-year dental students.
  • Students’ competencies and experience/Pre-and post-questionnaires

  • Positive rural experience

  • Improved clinical skills

  • Increased chances for considering rural practice after graduation

Johnson G, et al.; 2012/ Australia [1]
  • Competencies of placement students compared to non-placement students/Pre-and post-questionnaires

  • Positive attitude and improved clinical skills compared to non-placement group

Johnson G, et al.; 2013/ Australia [28]
  • Staff and supervisors’ attitude/Interviews

  • Supervisors recognized students’ positive clinical and personal development and identified the program as feasible

Johnson G, et al.; 2013/ Australia [29]
  • Follow up for rural recruitment after three years/Descriptive measurement

  • Higher proportion of graduates worked in rural location compared to non-placement group

Author; Year/ Country University/ Institution Type of publications Program description Outcome variable/ Measurement instrument Results
Dawkins E, et al.; 2013/ USA [86] University of Western Kentucky Original research Free dental sealant and oral examination program through mobile dental unit for school children since 2001[86].
  • Compare sociodemographic characteristics between caries and non-caries group and explore factors responsible for non-treated caries in children from 2006-2011/Descriptive measurement

  • More non-treated caries were observed in children living in rural areas, without private insurance and having older ages

Ibiyemi O, et al.; 2013/ Nigeria [40] University of Ibadan Original research project report Ibarapa Community Oral Health Programme: 6-week rural posting program for fifth-year dental students at Igboora
  • Dental students’ attitude/Reports

  • Students’ expectations from the program were fulfilled

  • Students became sensitized to community needs

  • Enhanced teamwork skills

Lalloo R, et al.; 2013/ Australia [30] Griffith University Original Research Remote rural clinical placement in Indigenous Community over three years from 2009 to 2011
  • Audited reports of services provided/Descriptive measurement

  • Primarily offered clinical examination, restorative, and oral surgical services and provided fewer preventive and periodontal services

Lalloo R, et al; 2013/ Australia [31]
  • Students’ perception and competencies/Online questionnaire survey

  • Students had positive experience, improved clinical competencies, gained knowledge and developed cultural sensitivity

Lalloo R, et al.; 2013/ Australia [32]
  • Auditing of expenditure/ Cost analysis

  • Factors related to financial support overshadowed benefits to students and local community, e.g. additional cost for salary incentives, travel, accommodation and meals

Chandrashekar B, et al.; 2014/ India [70] Kamineni Institute of Dental Sciences Original research (intervention study) Oral health promotion intervention study for six months with children divided into four groups:
1: Control group: no subsequent education
2: Education by a qualified dentist at every three months
3: Education by the trained school teachers with oral hygiene screening
4: Intervention 3 + children were given the oral hygiene aids
  • Pre- and post-oral health status using oral health indices/Descriptive measurement

  • Improvement in children’s’ oral hygiene status in oral hygiene aids group

  • Regular dental education sessions by school teachers were more efficient compared to an occasional meeting by dentists

Goel P, et al.; 2014/ India [92] Rajasthan Dental College Original research Indigenously fabricated mobile portable dental unit
  • Measurement of cost efficiency after seven years’ evaluation/ Descriptive method

  • Cost-effective, easy to transport and feasible

  • Required additional space and time for set up

Author; Year/ Country University/ Institution Type of publications Program description Outcome variable/ Measurement instrument Results
Naidu A, et al.; 2014/ Canada [80] McGill University Original research Community-based participatory research to promote oral health of school children in a rural Aboriginal community
  • Explore oral health practices and development of oral health promotion activities/Semi-structured interviews

  • Successfully developed culturally appropriate methods for oral health promotion by engaging children with their parents

Nayar P, et al.; 2014/ US [46] University of Nebraska Original research Rural community- based dental education program for dental students to improve their competencies.
  • Attitude of supervising dentists regarding program effectiveness for improving student’s competencies/ Electronic survey questionnaire

  • Enhanced dental students’ skills while experiencing the real-world situations

  • Supervising dentists considered program as successful and rated it as ‘excellent’ or ‘very good’

Anderson VR, et al.; 2015/ New Zealand [34] University of Otago, New Zealand Original research report Oranga Niho dental student outplacement project for final year dental students
  • Attitude of students, supervisors and clients and their caregivers/Mixed method (quantitative by pre- and post-questionnaires for dental students and qualitative by paper questionnaire for adult’s clients and caregivers)

  • Students showed readiness for the outplacement and willingness to work for Maori communities

  • Majority of supervisors expressed students’ readiness for working in remote areas

  • Most patients and their caregivers had positive attitudes about students’ care

Asawa K, et al.; 2015/ India [87] Pacific Dental College and Hospital Original research (retrospective study) Dental outreach programs for rural population through mobile dental units
  • Number of patients, diseases, services in outreach as well as the effectiveness of referral from 2 years’ data/Descriptive measurement

  • Dental caries, periodontal disease, and dental fluorosis were prevalent

  • Generally curative services were provided

  • Increased effectiveness of referral system

Okeigbemen SA, et al.; 2015/ Nigeria [78] University of Benin Original research (retrospective study) Rural outreach dental clinic
  • Dental service utilization and trends of patients attending this program/Descriptive measurement

  • Lower utilization of dental services

  • Recommended the need for oral health promotion and preventive services through frequent outreach activities

Vashishtha V, et al.; 2015/ India [76] D.J. College of Dental Sciences and Research Original research (cross-sectional study) Community dental outreach programs for the 1-month duration
  • Patient satisfaction/ Questionnaire

  • High patient satisfaction

Abuzar MA, et al.; 2016/ Australia [26] University of Melbourne Original research (case study) Aboriginal community oral health placement for final year DDS and BOH (Bachelor of Oral Health)
  • Students’ experience towards program from 2008-2014/Questionnaire survey

  • Students valued Aboriginal culture

  • Increased chances for recruitment

  • Students appreciated clinical supervisors and staff

Author; Year/ Country University/ Institution Type of publications Program description Outcome variable/ Measurement instrument Results
Okeigbemen SA; 2016/ Nigeria [48] University of Benin Case study Clinic-based curriculum for the dental students
  • Effect of community- based services on rural dental services/Quantitative and qualitative methods

  • Improvement in community-based dental services for rural residents such as awareness, screening, and referral services.

Shannon CK, et al.; 2016/USA [36] University of West Virginia Original research (survey) 6-week community-based rotations for senior dental students from 2001–2012
  • Students’ assessment of predictors for practicing in rural areas and intention for rural recruitment/Online pre- and post-survey questionnaires

  • Students identified significant predictors before rotations: expectations for rural practice, rural hometown, and more practice accessibility to poor patients

  • Increased likelihood of rural practice after rural rotations

Verma A, et al.; 2016/ India [39] M.R. Ambedkar Dental College, V.S. Dental College, and M.S. Ramaiah Dental College Original research (Non-randomized trial) Outreach program where dental interns were divided into outreach group and dental school-based group
  • Pre-and post-evaluation of students’ confidence and communication skills/Questionnaire

Higher confidence and communication skills among outreach group students