Online Program

Developing an oral health intervention for implementation with diverse older adults that addresses tailoring, fidelity, and fit

Monday, November 4, 2013

Jean Schensul, PhD, Institute for Community Research, Hartford, CT
Susan Reisine, PhD, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT
Kim Radda, RN, MA, Institute for Community Research, Hartford, CT
Colleen Foster-Bey, MEd, Institute for Community Research, Hartford, CT
Emil Coman, PhD, Ethel Donaghue Tripp Center, University of Connecticut Health Center, Farmington, CT
Clara Acosta-Glynn, MSW, Institute for Community Research, Hartford, CT
Ruth Goldblatt, DMD, Dental Medicine, Univ of Ct, Farmington, CT
Introduction. This paper describes tailoring of a theoretically driven pilot intervention to a diverse population of older adults/adults with disabilities in one senior housing building designed to be implemented with fidelity and fit in multiple additional buildings. Methods. Theoretical domains (knowledge, beliefs, intention, self-efficacy, self-management fears, skills) were derived from Fishbein's Integrated Model of Behavioral Prediction and others added included ADLs and self-management fears. Domains were operationalized and measured in a baseline survey and cutoff points for 19 domains were specified for tailoring. With an adapted motivational interview technique (AMI), bilingual facilitators used talking points, prioritization, elicitation and specification to address participant domain needs, witha checklist of focal points, behavioral skills assessment form, and personal GOH plan as recording forms. Results. 31 individuals completed the AMI. Mean number of domains requiring attention was 6.4 and median of 7. High priority areas (55% - 81% of participants) were oral health social support, oral health self assessment, oral health efficacy, self management concerns, dry mouth; lower priority areas (18-25% of participants) were oral health intentions, beliefs, knowledge and not brushing at night. Conclusion: A theoretically specified oral health intervention for older adults provided by culturally matched facilitators using adapted motivational interviewing and interactive media, administered with fidelity using a standardized recording protocol, identified high salience areas for fine tuning the theoretical framework and a protocol for ensuring individualized tailoring, fidelity and fit.

Learning Areas:

Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe an approach that integrates tailored intervention with fidelity and fit List key oral health intervention domains applicable to diverse older adults

Keyword(s): Intervention, Oral Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an established researcher with more than 20 years of community based research and intervention studies on and with diverse older adults and adults with disabilities. Among my interests is the development of engaged tailored interventions with older adults living in senior housing. I current have funding to develop such interventions and hope to establish and implementation study in the future that can improve oral health in this underserved and marginalized population.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.