title: A bi-level intervention to improve oral hygiene of older and disabled adults in low-income housing: results of a pilot study.
abstract: OBJECTIVE
  This paper describes the results of a bi-level intervention, using a cognitive-behavioral theoretical approach, to improve the oral hygiene of older adults and the disabled in community-based low income senior housing.
  
  
  METHODS
  The bi-level pilot intervention consisted of an on-site tailored adapted motivational interviewing (AMI) session and two oral health fairs, supported by a resident campaign committee, to change community norms. All materials were available in English and Spanish. Participants completed a survey consisting of 12 domains that provided the basis for tailoring the AMI and shaping the campaigns. The domains were activities of daily living (ADLs), access to oral health information, oral hygiene status, dental knowledge, hygiene behaviors, importance of oral hygiene, self-efficacy/locus of control, diet, intentions, self-management worries/fears, perceived risk and dry mouth.
  
  
  METHODS
  Each participant received clinical assessments consisting of full-mouth plaque score (PS) and gingival index (GI) before the intervention and at three months.
  
  
  RESULTS
  Twenty-seven residents with at least one tooth completed all phases of the study. The mean number of domains requiring attention was 4.5 (SD 1.6) with a range of one to seven. Mean baseline PS was 83% (SD 16%) which improved significantly to 58% (SD 31%); mean baseline GI was 1.15 (SD 0.61) and improved significantly to 0.49 (SD 0.46).
  
  
  CONCLUSIONS
  This pilot study supports the feasibility and acceptability of a tailored oral hygiene intervention among older and disabled adults living in low income senior housing. Although a small sample, the study demonstrated significant improvements in both plaque and gingival scores three months after the bi-level intervention.
authors.forename: S
authors.initials: S
authors.lastname: Reisine
authors.forename: J J
authors.initials: JJ
authors.lastname: Schensul
authors.forename: R
authors.initials: R
authors.lastname: Goldblatt
authors.forename: K
authors.initials: K
authors.lastname: Radda
authors.forename: C
authors.initials: C
authors.lastname: Foster-Bey
authors.forename: C
authors.initials: C
authors.lastname: Acosta-Glynn
authors.forename: L
authors.initials: L
authors.lastname: Miron-Carcamo
authors.forename: E
authors.initials: E
authors.lastname: Ioannidou
mesh_terms: D022126:Access to Information; D000203:Activities of Daily Living; D000368:Aged; D001007:Anxiety / Q000523:psychology; D054626:Consumer Health Information; D003774:Dental Plaque Index; D006233:Persons with Disabilities; D005240:Feasibility Studies; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006267:Health Education, Dental / Q000379:methods; D006277:Health Fairs / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing / Q000379:methods; D009910:Oral Hygiene / Q000193:education*; D010512:Periodontal Index; D010865:Pilot Projects; D011638:Public Housing; D020377:Self Efficacy; D014987:Xerostomia / Q000145:classification