Changing Oral Health Norms and Hygiene Practices among Vulnerable Older Adults

描述（由申请人提供）：减少弱势低收入老年人和残疾成年人之间持续的口腔健康差距是2020年健康人的中心目标，也是州卫生部门和地区机构对老龄化的优先事项。对口腔健康及预防和治疗方法的了解有限，语言和口腔健康问题认知方面的文化差异，以及结构性障碍，这些联合收割机共同增加了弱势群体的口腔健康差距。这项名为“改变脆弱老年人的口腔健康规范和卫生习惯”的提案旨在通过开发和试点测试一种双水平的（建筑和个人）认知/行为干预（GOH议员：Pro-Good Oral Health），以减少弱势老年人和低收入人群在口腔健康方面的显著和持续差异，居住在康涅狄格州中部公共资助的高级住房的少数民族和残疾成年人。建议的干预模式是基于Fishbein的修改后的理论，合理的行动，称为综合模型（IM）的行为预测操作通过适应动机面试和实践掌握（AMI-PM）。社区居住的62岁及以上的低收入、残疾和少数民族成年人中有相当大的比例住在低收入老年人住房中。众所周知，他们是最容易患抑郁症、慢性病、初级保健不足以及口腔和其他健康差距的群体。一个成功的试点干预将提供一个更大的疗效试验的基础上，在其他建筑物的RE-AIM方法住房脆弱的老年人和残疾人在康涅狄格州中部地区。拟议试验研究的目的是：1）进行形成性研究，2）在典型的低收入老年人住宅中进行个人和建筑物层面的干预试点，3）评估试点个人层面和建筑物层面干预过程的可行性，可接受性和保真度，4）使用干预前和两次干预后评估，进行个体水平的结果评估，将治疗大楼中的参与者与匹配的对照大楼进行比较，和5）准备标准操作程序（SOP），评估措施和干预手册，用于康涅狄格州的广泛临床试验。

DESCRIPTION (provided by applicant): Reducing persistent oral health disparities among vulnerable low income older adults and adults with disabilities is a central objective in Healthy People 2020 and is a priority of state health departments and area agencies on aging. Limited knowledge of oral health and prevention and treatment alternatives, cultural differences in language and perception of oral health problems, and structural barriers combine to increase oral health disparities in vulnerable populations. This proposal, entitled "Changing Oral Health Norms and Hygiene Practices among Vulnerable Older Adults" aims to address these issues by developing and pilot testing a bi-level (building and individual) cognitive/behavioral intervention (Pro-GOH: Pro-Good Oral Health) to reduce significant and persistent disparities in oral health among vulnerable older low income, minority and disabled adults residing in publicly funded senior housing in Central Connecticut. The proposed intervention model is based on Fishbein's modified theory of reasoned action called Integrated Model (IM) of Behavioral Prediction operationalized through Adapted Motivational Interviewing and Practice-to-Mastery (AMI-PM). A substantial percentage of community-residing low income, disabled and minority adults aged 62 and over live in low income senior housing. They are known to be among those most vulnerable to depression, chronic diseases, inadequate primary care, and oral and other health disparities. A successful pilot intervention will provide the basis for a larger efficacy trial based on the RE-AIM approach in other buildings housing vulnerable older adults and adults with disabilities in the Central Connecticut area. The aims of the proposed pilot study are to: 1) Conduct formative research, 2) Conduct a pilot of the intervention at the individual and building level in a typical low income senior residence, 3) Evaluate the pilot individual-level and building-level intervention processes for feasibility, acceptability and fidelity, 4) Conduct an individual level outcome evaluation comparing participants in the treatment building with a matched control building, using a pre and two post intervention assessments, and 5) Prepare Standard Operating Procedures (SOP), evaluation measures and intervention manuals for use in a broad clinical trial in Connecticut.