An Oral Health Promotion Strategy for Persons With Intellectual and Developmental Disability: An Exploratory Randomized Trial Comparing Intervention and Control Group Homes

Introduction

Individuals with intellectual or developmental disabilities (IDD) often experience more negative oral health outcomes.

Methods

We implemented and tested a comprehensive strategy in 39 IDD group homes to examine whether skills-based training for direct support professionals (DSP) and individualized oral health planning for residents could improve DSP assistance and provision of oral health care for residents and oral health status. Our sample comprised 19 intervention homes and 20 control group homes, with 61 residents with IDD and 77 DSP. The strategy involved providing didactic and experiential skills-based training, combined with in-home coaching to DSP with resident participation over the course of 16 weeks. DSP in control homes received educational brochures. DSP attitudes, skills, and behaviors; and resident oral health outcomes were measured at baseline, 4 months later (post-intervention), and 12 months after baseline. Analyses compared the intervention and control conditions at 4-months and 12-months.

Results

Results suggest that the intervention influenced DSP skills and behaviors. Among residents, results showed improved outcomes for teeth in the lower anterior sextant only; intervention effects largely abated by 12-month follow-up.

Discussion

Findings demonstrate that skills-based, experiential training with coaching can be effective in enhancing skill sets and increasing behaviors about oral health among DSP. In addition, results showed that the strategy used can improve oral health outcomes for residents. However, given that there were only improved outcomes in residents' lower anterior sextant, more research is needed to determine how to adequately assess and improve resident outcomes.