Good Oral Health: A Bi-Level Intervention to Improve Older Adult Oral Health

Good Oral Health: A bilingual Intervention to improve oral hygiene of older adults and vulnerable populations is a five year clinical trial funded by NIH/NIDCR to evaluate the impact of an individual and a norms change intervention on oral hygiene of adults 18 and above living in publicly supported senior housing.  Residents of subsidized housing for older adults and people with disabilities often have more health and mental health problems than those living in community settings stemming from racial/ethnic discrimination, social isolation and a lifetime of experiencing health and other inequities.

Dental treatment is unequally distributed in this population but many people with disabilities including those 62 and over do have some dental care. However dental treatment for caries, dentures, periodontal disease and even annual cleanings does not guarantee that they will be able to maintain good oral hygiene. One way to prevent the advance of oral disease is to improve people’s ability to take proper care of their own teeth, dentures and mouth.

Good oral health offers a two pronged theoretically driven and tailored approach to assist diverse older adults and people with disabilities to improve their oral hygiene. The approach is based on a theoretical framework that combines social norms about oral hygiene, beliefs about oral health and oral health practice, worries and fears about the consequences of poor oral health, self efficacy and intentions to practice and proper oral hygiene practices.

The approach is translated into a face to face one hour long intervention tailored to the needs of each participant, and oral health fairs that reinforce messages delivered in the face to face intervention. The face to face intervention is delivered by trained health educators; the oral health fairs are delivered by a team of residents and health educators. The interventions are sequenced differently in two groups of three buildings each randomized to each condition.

The evaluation assesses each enrolled participant before and after the first intervention, after the second intervention and six months later to see whether the results of the interventions have been sustained.

The processes of recruitment, enrollment, consenting, intervention implementation, and evaluation are described on subsequent pages with links to relevant materials, survey, data collection tools, and clinical protocol for the study. 

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