Implementation of an oral health intervention for adults with intellectual and developmental disabilities.

Often oral care is overlooked during the daily care of adults with intellectual and developmental disabilities (IDD). Due to the integration of adults with IDD from institutions into group homes and private homes, caregivers need to be taught to implement daily oral hygiene protocols. The purpose of this pilot study, conducted by the University of Louisville and the Pacific Institute for Research and Evaluation, was to develop an oral hygiene plan for adults with IDD residing in group homes in the Louisville, Kentucky area that would ultimately improve their oral health and quality of life. This thesis focuses on the quality of implementation of the oral health intervention strategy based on the results from the pilot study. Additionally, this thesis sheds light on the level of implementation quality as measured by dosage, fidelity, and caregiver reactions

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

AbstractThis 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