Evidence-based health promotion in nursing homes: A pilot intervention to improve oral health

Nursing home residents over the age of 65 years are at high risk for poor oral health and related complications such as pneumonia and adverse diabetes outcomes. A preliminary study found that Massachusetts’s nursing homes generally lack the training and resources needed to provide adequate oral health care to residents. In the study reported here, an intervention targeting Certified Nurses’ Aides (CNA’s) was developed and tested. We hypothesized that following the training, CNA’s would have increased knowledge and self-efficacy, toward providing oral health care to the residents in their charge.

The pilot study used a one-group pretest-posttest design to test the effectiveness of a psycho-educational training intervention. Utilizing the constructs of knowledge and self-efficacy, from the Theory of Planned Behavior and the Social Cognitive Theory, we framed the content of a training intervention and administered a 21-item survey to the CNA staff of a single mid-size nursing home immediately prior to and after the intervention.  The one-hour training intervention was empirically supported by formative data and delivered by dental faculty researchers. 

Findings indicate significant increases in two areas of oral health knowledge: toothbrush position and frequency of brushing. Findings; however, did not indicate a significant increase in self-efficacy.  Although the results marginally supported our hypothesis, the pilot study demonstrates the feasibility of delivering interventions to populations of CNAs who have direct and daily responsibility for promoting the oral health of residents in long-term care facilities.