Hendry Annie, Baker Sarah R, Tsakos Georgios, McKenna Gerald, Jenkins Alison, Syed Saif Sayeed, Harvey Michelle, Mirza Afshan, Morgan Lorraine, Brocklehurst Paul R
Bangor Institute of Health and Medical Research, Bangor University, Bangor, UK.
Unit of Oral Health, Dentistry and Society, University of Sheffield, Sheffield, UK.
Gerodontology. 2024 Mar;41(1):159-168. doi: 10.1111/ger.12705. Epub 2023 Jul 26.
Poor oral health is common among older adults residing in care homes impacting their diet, quality of life, self-esteem, general health and well-being. The care home setting is complex and many factors may affect the successful implementation of oral care interventions. Exploring these factors and their embedded context is key to understanding how and why interventions may or may not be successfully implemented within their intended setting.
This methodology paper describes the approach to a theoretically informed process evaluation alongside a pragmatic randomised controlled trial, so as to understand contextual factors, how the intervention was implemented and important elements that may influence the pathways to impact.
SENIOR is a pragmatic randomised controlled trial designed to improve the oral health of care home residents in the United Kingdom. The trial uses a complex intervention to promote and provide oral care for residents, including education and training for staff.
An embedded, theoretically informed process evaluation, drawing on the PAHRIS framework and utilising a qualitative approach, will help to understand the important contextual factors within the care home that influence both the trial processes and the implementation of the intervention.
Utilising an implementation framework as the basis for a theoretically informed process evaluation provides an approach that specifically focuses on the contextual factors that may influence and shape the pathways to impact a given complex intervention a priori, while also providing an understanding of how and why an intervention may be effective. This contrasts with the more common post hoc approach that only focuses on implementation after the empirical results have emerged.
口腔健康状况不佳在养老院老年人中很常见，这会影响他们的饮食、生活质量、自尊、总体健康和幸福感。养老院环境复杂，许多因素可能会影响口腔护理干预措施的成功实施。探索这些因素及其内在背景是理解干预措施在预期环境中如何以及为何可能成功或无法成功实施的关键。
本方法学论文描述了一种理论导向的过程评估方法，该评估与一项实用的随机对照试验同时进行，以便了解背景因素、干预措施的实施方式以及可能影响影响途径的重要因素。
SENIOR是一项实用的随机对照试验，旨在改善英国养老院居民的口腔健康。该试验采用复杂的干预措施为居民促进和提供口腔护理，包括对工作人员的教育和培训。
基于PAHRIS框架并采用定性方法进行的嵌入式、理论导向的过程评估，将有助于了解养老院中影响试验过程和干预措施实施的重要背景因素。
利用实施框架作为理论导向的过程评估的基础，提供了一种方法，该方法特别关注可能先验地影响和塑造给定复杂干预措施影响途径的背景因素，同时还能理解干预措施如何以及为何可能有效。这与更常见的事后方法形成对比，后者仅在实证结果出现后才关注实施情况。
