Improving the oral health of residents with intellectual and developmental disabilities: An oral health strategy and pilot study

Abstract

This article presents an oral health (OH) strategy and pilot study focusing on individuals with intellectual and/or developmental disabilities (IDD) living in group homes. The strategy consists of four components: (1) planned action in the form of the behavioral contract and caregiver OH action planning; (2) capacity building through didactic and observation learning training; (3) environmental adaptations consisting of additional oral heath devices and strategies to create a calm atmosphere; and (4) reinforcement by post-training coaching. A pilot study was conducted consisting of pre- and post-assessment data collected one week before and one week after implementing a one-month OH strategy. The study sample comprised 11 group homes with 21 caregivers and 25 residents with IDD from one service organization in a Midwestern city. A process evaluation found high-quality implementation of the OH strategy as measured by dosage, fidelity, and caregiver reactions to implementing the strategy. Using repeated cross-sectional and repeated measures analyses, we found statistically significant positive changes in OH status and oral hygiene practices of residents. Caregiver self-efficacy as a mechanism of change was not adequately evaluated; however, positive change was found in some but not all types of caregiver OH support that were assessed. Lessons learned from implementing the pilot study intervention and evaluation are discussed, as are the next steps in conducting an efficacy study of the OH strategy.

Oral health-related quality of life improves in employees with disabilities following a workplace dental intervention

“…However, there was anecdotal evidence of some improvements. Other studies have highlighted the challenges in changing oral health behaviours for this subpopulation (Binkley, Johnson, Abadi, Thompson, Shamblen et al, 2014;Pradhan, Keuskamp & Brennan, 2015), and more intensive efforts would likely be required than were employed in this study. For the general population, systematic reviews of the evidence for oral health promotion effectiveness have not been definitive.…”

Pre- and post-training evaluation of dental efficacy and activation measures in carers of adults with disabilities in South Australia - a pilot study

“…() and Binkley et al . (). While behavioural issues among people with disabilities remain a challenging problem for carers and dental professionals, disability organisations and researchers could explore the reasons for the high turnover and mobility of carers.…”

“…() in Ireland and Binkley et al . () in the United States, who found that their training had varied impacts on carers. In this pilot study, training methods from these two studies have been combined for a more effective intervention.…”

“…A similar suite of data was collected in a pilot study by Binkley et al . (), and they added a daily checklist of oral hygiene care completed by the carer for each resident, and video camera observation of oral hygiene practices, but failed to find an impact on carer self‐efficacy.…”

“…As carers' own dental care practices tend to be reflected in the care they provide for their care recipients (Pradhan 2008), training in oral care should also address the dental behaviours of carers and associated psychosocial factors (Pradhan 2012a, Binkley et al 2014. Pradhan (2012a) evaluated the behaviours of carers by the introduction of two measures: carer dental efficacy (CDE) and carer activation measure (CAM).…”