title: 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 1 week before and 1 week after implementing a 1-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.
authors.affiliation: Department of Surgical & Hospital Dentistry, School of Dentistry, University of Louisville, Louisville, KY 40292, United States. Electronic address: cjbink01@louisville.edu.
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Binkley
authors.affiliation: Pacific Institute for Research & Evaluation, 1300 S 4th Street, Louisville, KY 40208, United States. Electronic address: kwjohnson@PIRE.org.
authors.forename: Knowlton W
authors.initials: KW
authors.lastname: Johnson
authors.affiliation: Pacific Institute for Research & Evaluation, 1300 S 4th Street, Louisville, KY 40208, United States. Electronic address: mabadi@PIRE.org.
authors.forename: Melissa
authors.initials: M
authors.lastname: Abadi
authors.affiliation: Pacific Institute for Research & Evaluation, 1300 S 4th Street, Louisville, KY 40208, United States. Electronic address: kthompson@PIRE.org.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Thompson
authors.affiliation: Pacific Institute for Research & Evaluation, 1300 S 4th Street, Louisville, KY 40208, United States. Electronic address: sshamblen@PIRE.org.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Shamblen
authors.affiliation: Pacific Institute for Research & Evaluation, 1300 S 4th Street, Louisville, KY 40208, United States. Electronic address: young@PIRE.org.
authors.forename: Linda
authors.initials: L
authors.lastname: Young
authors.affiliation: Department of Surgical & Hospital Dentistry, School of Dentistry, University of Louisville, Louisville, KY 40292, United States. Electronic address: brzaks01@gmail.com.
authors.forename: Brigit
authors.initials: B
authors.lastname: Zaksek
mesh_terms: D017028:Caregivers; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities; D016352:Group Homes / Q000458:organization & administration*; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D008607:Intellectual Disability; D009909:Oral Health; D009910:Oral Hygiene / Q000379:methods*; D010865:Pilot Projects; D015397:Program Evaluation / Q000379:methods*; D012107:Research Design; D020377:Self Efficacy
keywords: Health disparities; Intellectual and developmental disability; Intervention design; Oral health; Process and outcome evaluation