title: Train the trainer? A randomized controlled trial of a multi-tiered oral health education programme in community-based residential services for adults with intellectual disability.
abstract: OBJECTIVE
  To assess the impact of a multi-tiered oral health education programme on care staff caring for people with intellectual disability (ID).
  
  
  METHODS
  Postal questionnaires were sent to all care staff of a community-based residential care service for adults, randomly assigned to control and intervention groups. A specifically developed training programme was delivered to residential staff nominees, who then trained all staff within the intervention group. The control group received no training. Post-test questionnaires were sent to both groups. Paired-samples t-test was used to compare oral health-related knowledge (K) and behaviour, attitude and self-efficacy (BAS) scores.
  
  
  RESULTS
  Of the initial 219 respondents, 154 (response rate between 40% and 35.8%, with attrition rate of 29.7% from baseline to repeat) returned completed questionnaires at post-test (M=8.5 months, range=6.5-11 months). Control and intervention groups were comparable for general training, employment and demographic variables. In the intervention group, mean Knowledge Index score rose from K=7.2 to K=7.9 (P<0.001) and mean BAS scale score rose from BAS=4.7 to BAS=5.4 (P<0.001). There was no statistically significant increase in mean scores from test (K=7.0, BAS=4.7) to post-test (K=7.2, BAS=4.9) for the control group.
  
  
  CONCLUSIONS
  Mean scores regarding knowledge, attitude, self-efficacy and reported behaviour increased significantly at 8.5 months in staff where training was provided. The results indicate that a multi-tiered training programme improved knowledge, attitude, self-efficacy and reported behaviour amongst staff caring for people with ID.
authors.affiliation: Department of Child and Public Dental Health, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland. macgiolla@dental.tcd.ie
authors.forename: Caoimhin
authors.initials: C
authors.lastname: Mac Giolla Phadraig
authors.forename: Suzanne
authors.initials: S
authors.lastname: Guerin
authors.forename: June
authors.initials: J
authors.lastname: Nunn
mesh_terms: D000328:Adult; D001294:Attitude to Health; D017028:Caregivers / Q000193:education*; D003778:Dentures; D004032:Diet; D015438:Health Behavior; D006267:Health Education, Dental / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008607:Intellectual Disability; D009042:Motivation; D019212:Multimedia; D009909:Oral Health; D009910:Oral Hygiene / Q000193:education; D017063:Outcome Assessment, Health Care; D011340:Problem Solving; D011369:Professional-Patient Relations; D012112:Residential Facilities; D012381:Role Playing; D020377:Self Efficacy; D013663:Teaching / Q000379:methods*; D014099:Toothbrushing / Q000379:methods; D000078329:Workforce