{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T18:55:13Z","timestamp":1781722513942,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T00:00:00Z","timestamp":1634169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Comm Dent Oral Epid"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To understand why, how and under what circumstances interventions lead to improved access of young adults with experience of homelessness (YAEH) to primary care dental services in the UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We followed a realist, theory\u2010driven methodology. It involved locating existing theories, searching for evidence, document selection, data extraction\/appraisal and evidence synthesis. We searched scientific databases and grey literature sources. We used these data and relevant substantive theories to develop explanations of how, why and under what circumstances interventions lead to desired outcomes. We presented these explanations in the form of context\u2010mechanism\u2010outcome configurations (CMOCs). The CMOCs were incorporated in an overarching programme theory, which was iteratively developed and refined throughout the realist synthesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We used 106\u00a0scientific and 18\u00a0grey literature records to synthesize 61 CMOCs. Our revised programme theory highlights the importance of four main considerations: \u2018preparing a service\u2019, \u2018producing and disseminating information\u2019, \u2018outreach activities\u2019 and \u2018facilitating interactions\u2019. When designing dental programmes for YAEH, we recommend considering the importance of prior service planning (including resourcing of emergency dental care, training staff and incorporating safety measures), creating positive experiences, flexibility, patient\u2010centeredness, being informative and reassuring, creating an enabling environment (including strong communication, building rapport and avoiding negative judgements), having realistic expectations and designing services that empower patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Improving dental access of YAEH requires attention to multiple levels. Services can achieve positive outcomes by understanding the complexity of YAEH lives, and creating contextual circumstances that encourage their attendance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cdoe.12695","type":"journal-article","created":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T21:39:34Z","timestamp":1634679574000},"page":"437-444","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Improving access of young adults with experience of homelessness to primary care dental services in the UK: A realist synthesis"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4501-1163","authenticated-orcid":false,"given":"Maryam","family":"Ahmadyar","sequence":"first","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanvi","family":"Rai","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanaid","family":"Daly","sequence":"additional","affiliation":[{"name":"Dublin Dental University Hospital Trinity College Dublin  Dublin 2 Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Wong","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,14]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"This is England: a picture of homelessness in 2019. The numbers behind the story. Shelter 2019. (Available online):https:\/\/assets.ctfassets.net\/6sxvmndnpn0s\/1QzOPPJc0PD2R5OzhUNJUo\/cbe3cc028eaed31d333645d892006b3c\/This_is_England_A_picture_of_homelessness_in_2019.pdf"},{"key":"e_1_2_11_3_1","unstructured":"Statutory Homelessness Annual Report 2019\u201020 England.https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/923123\/Annual_Statutory_Homelessness_Release_2019\u201020.pdf"},{"key":"e_1_2_11_4_1","unstructured":"Homelessness: applying all our health. 2019.https:\/\/www.gov.uk\/government\/publications\/homelessness\u2010applying\u2010all\u2010our\u2010health\/homelessness\u2010applying\u2010all\u2010our\u2010health"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-10-92"},{"key":"e_1_2_11_6_1","unstructured":"Homelessness: Rapid Evidence Assessment. 2019.https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/793471\/Homelessness_\u2010_REA.pdf"},{"key":"e_1_2_11_7_1","unstructured":"Centrepoint charity databank of youth homelessness.https:\/\/centrepoint.org.uk\/databank\/"},{"key":"e_1_2_11_8_1","first-page":"141p","volume-title":"Youth homelessness in the UK: A review of the OVO Foundation","author":"Watts EE","year":"2015"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.2012.891"},{"key":"e_1_2_11_10_1","unstructured":"British Dental Association.Dental care for homeless people. BDA London. 2003.https:\/\/bda.org\/dentists\/policy\u2010campaigns\/research\/patient\u2010care\/Documents\/homeless_dec20_2003.pdf"},{"key":"e_1_2_11_11_1","unstructured":"A. Healthy Mouths: A peer\u2010led health audit on the oral health of people experiencing homelessness. Groundswell. 2017.https:\/\/groundswell.org.uk\/wp\u2010content\/uploads\/2018\/10\/Groundswell\u2010Healthy\u2010Mouths\u2010Report\u2010Full\u2010Report\u2010Web.pdf"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12444"},{"key":"e_1_2_11_13_1","unstructured":"PawsonR GreenhalghT HarveyG WalsheK.Realist synthesis: an introduction. RMP Methods Paper 2\/2004."},{"key":"e_1_2_11_14_1","unstructured":"RAMESES Project.Realist synthesis: RAMESES Training Materials. 2013.https:\/\/www.ramesesproject.org\/media\/Realist_reviews_training_materials.pdf"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-11-21"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1071\/PY17178"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2021.103606"},{"key":"e_1_2_11_18_1","first-page":"1273","article-title":"The Behavioral Model for Vulnerable Populations: application to medical care use and outcomes for homeless people","volume":"34","author":"Gelberg L","year":"2000","journal-title":"Health Serv Res"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-9276-12-18"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.12644"},{"key":"e_1_2_11_21_1","unstructured":"World Economic Situation and Prospects. United Nations New York 2020.https:\/\/www.un.org\/development\/desa\/dpad\/wp\u2010content\/uploads\/sites\/45\/WESP2020_Annex.pdf"},{"key":"e_1_2_11_22_1","volume-title":"Doing Realist Research","author":"Wong G","year":"2019"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx194"}],"container-title":["Community Dentistry and Oral Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cdoe.12695","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cdoe.12695","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cdoe.12695","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T14:39:30Z","timestamp":1692715170000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cdoe.12695"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,14]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1111\/cdoe.12695"],"URL":"https:\/\/doi.org\/10.1111\/cdoe.12695","archive":["Portico"],"relation":{},"ISSN":["0301-5661","1600-0528"],"issn-type":[{"value":"0301-5661","type":"print"},{"value":"1600-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,14]]},"assertion":[{"value":"2021-05-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}