Improving Health for Vulnerable Urban Elderly Americans through Community Partnerships and Community Oral Health Workers: Assessing Community-based Intervention Approaches

The “Take Charge of Your Oral Health” project aims to identify theory-driven, culturally-appropriate, evidence-based strategies and risk-reduction interventions targeted to elderly Americans. Phase I of the project developed health promotion materials in a cartoon slide and video formats. Evaluations in cross-sectional studies among African American elders that attended senior centers in urban Philadelphia showed significant improvement (p<0.001) in mean number of correct responses in dental knowledge (pre-test mean = 4.7 and post-test mean = 5.4) for both presentation formats, cartoon slide (n=111) and video ( n=161) . Phase 2 designed skill and knowledge building activities for inclusion in the intervention based on the materials developed in Phase 1. Community collaborations were established with Project O.R.A.L., a non-profit organization that trained oral community health workers and with the Philadelphia Housing Authority (PHA). Phase 3 recruited twelve elders residing in a PHA low-income senior's complex, African American (n = 10); Puerto Rican (n= 1); Hatian (n=1), that participated in focus group discussions and a questionnaire to assess individual, community, and family-level influences of oral health. These assessments were utilized to refine the intervention activities. Phase 4 pilot tested intervention role playing and game activities. Overall, the activities rated as being excellent and relevant to reinforcing the content included in the cartoon slide and video presentations. Phase 5 trained two community health workers to facilitate the intervention. The intervention is innovative and the public health community-participatory approaches are rational and feasible towards contributing to addressing oral health disparities among vulnerable elder Americans.