the use of oral health services, oral health knowledge, attitudes, and practices of older Greek and Italian adults attending community clubs and living in ...
Original article
Oral health promotion programme for older migrant adults Rodrigo Marin˜o1, Hanny Calache2, Clive Wright3, Margot Schofield1 and Victor Minichiello1 1
School of Health, The University of New England, Armidale, NSW 2351, Australia; 2School of Dental Sciences, University of Melbourne, Melbourne, Victoria, Australia; 3Ministry of Health, Wellington, New Zealand
Gerodontology 2004; 21; 216–225 Oral health promotion programme for older migrant adults Objectives: This study evaluated the impact of a community-based oral health promotion programme on the use of oral health services, oral health knowledge, attitudes, and practices of older Greek and Italian adults attending community clubs and living in Melbourne, Australia. Methods: The oral health promotion intervention consisted of three components: a series of oral health seminars, held at the clubs in the participants’ native languages, the provision of oral health care products, and the production of oral health information sheets. The intervention programme was known as the Oral Health Information Seminars/Sheets (ORHIS). The content of each session was determined following suggestions and findings from the data collected. A pre-test–post-test non-equivalent control group quasi-experimental design was chosen to evaluate the intervention. A total of 520 independent-living older adults, members of Greek or Italian social clubs participated in this evaluation. Results: Participants who took part in the intervention responded with higher levels of achievement than those in the control groups. After controlling for baseline variables, experimental groups were significantly more likely than the control groups at post-test to have improved oral health attitudes, oral health knowledge, and self-assessed physical health status, as well as, self-reported oral hygiene practices and use of oral health services. Discussion: The ORHIS approach was successful within the setting of social clubs, and highly acceptable to these communities. As such, it represents a helpful approach for the design of (oral) health interventions in older adults. Further research is required to test the long-tem impact including the economic evaluation of the ORHIS approach. Keywords: older adults, oral health, health promotion, migrant groups. Accepted 30 July 2004
Introduction Despite the well-documented ethnic and ageing profile of the Australian population and repeated calls for comprehensive geriatric assessment1–4, the oral health status and needs of migrant older adults have been poorly researched and there are few, if any, health promotion programmes designed to improve the oral health status of these communities. Traditionally, oral health services for older adults have been treatment based. Nonetheless, the need to educate older adults to enable them to modify their oral health practices is evident. Goals in dentistry cannot be achieved solely by providing treatment. Contrary to the myth that it is too late 216
for older adults to benefit from changes to their lifelong habits5, health promotion intervention could be a key to improving oral health status in later life as it encourages older adults to be proactive in regard to their health. The importance of lifelong learning is well established in the literature and it is receiving increased attention5,6. Lifestyle modifications have been successfully implemented even in the very old or older old, provided that co-morbidities are not overwhelming6–9. Failure to achieve change in behaviours or poor health performance might be related to other non-cognitive factors10. For example, Resnick11 studying health promotion activities in older adults, reported that the most
Ó 2004 The Gerodontology Association and Blackwell Munksgaard Ltd, Gerodontology 2004; 21: 216–225
Oral health promotion programme for older migrant adults
commonly cited reason for not performing health promoting and disease prevention measures (e.g. diet, exercise, stress management, tobacco avoidance, etc) was ‘not being told to’ by the primary health care provider. However, the literature does not give sufficient direction on how best to provide health promotion and disease prevention services to older adult populations12–15. Two recent reviews indicated that while programmes in oral health education and oral health promotion have expanded in the last two decades13,16, evidence-based oral health promotion research in this area has been limited. This arises from (i) research methodology limitations, (ii) lack of an equivalent control group, (iii) small sample size (
