Clinical Associate Professor, University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI, USA.
Assistant Research Scientist, University of Michigan Medical School, Department of Internal Medicine, Ann Arbor, MI, USA.
JDR Clin Trans Res. 2024 Oct;9(1_suppl):59S-69S. doi: 10.1177/23800844241273829.
This study implemented a single-session oral health education and referral program in behavioral health settings serving people with psychiatric disabilities. The program was led by peer specialists ("peers")-lay community behavioral health workers with personal experience of mental health challenges who are trained and certified to support others.
Investigators collaborated with peers, state government, and clinical leadership to design and implement the program. Randomized parallel assignment was used to compare 2 arms: (1) group viewing of an oral health educational video (VC) and (2) a peer-led 1-time class providing education and motivation to access dental care (the Oral Health Recovery Group; OHRG). In both arms, peers followed up with participants to encourage accessing dental care and reinforce at-home care goals. Oral health knowledge, at-home care, motivation, appointment scheduling, and utilization were assessed at baseline, postintervention, and 2 mo. Qualitative interviews assessed barriers and facilitators.
More than half of participants reported oral pain in the previous year. Pre-/postintervention survey results did not significantly improve in either arm or differ between arms. At follow-up, 25 (68%) in OHRG and 14 (56%) in VC reported meeting a dental at-home care goal because of the program. Ten (27%) in OHRG and 9 (36%) in VC reported making a dental appointment because of the program. Most were satisfied with the program. Interviewed participants were comfortable with peers in this role, yet access barriers remained.
Single-session oral health interventions were implemented in behavioral health settings. The fact that surveys did not significantly improve suggests that more intensive interventions may be needed. Nevertheless, peers successfully scheduled dental appointments for vulnerable patients. Given that dental appointments were scheduled after only a 1-time class and light-touch peer navigation, oral health integration in behavioral health settings shows promise as a financially sustainable approach that merits further research.
The results of this study can be used by staff in behavioral health settings who wish to consider peer-led financially sustainable approaches to providing oral health education and linkages to dental care for their clients.
本研究在为精神残疾人士提供服务的行为健康环境中实施了单次口腔健康教育和转诊计划。该计划由同伴专家（“同伴”）领导，他们是经过培训和认证的、有过心理健康挑战个人经历的非专业社区行为健康工作者，以支持他人。
调查人员与同伴、州政府和临床领导层合作设计和实施该计划。采用随机平行分配的方法比较了两个组：（1）观看口腔健康教育视频（VC）的小组，以及（2）同伴领导的一次性课程，为获取牙科护理提供教育和动力（口腔健康恢复组；OHRG）。在这两个组中，同伴都会与参与者联系，以鼓励他们接受牙科护理并加强家庭护理目标。在基线、干预后和 2 个月时评估口腔健康知识、家庭护理、动机、预约安排和利用情况。定性访谈评估了障碍和促进因素。
超过一半的参与者报告在过去一年中存在口腔疼痛。在任何一组或两组之间，干预前后的调查结果都没有显著改善。在随访中，OHRG 中有 25 人（68%）和 VC 中有 14 人（56%）因该计划实现了家庭口腔护理目标。OHRG 中有 10 人（27%）和 VC 中有 9 人（36%）因该计划预约了牙科。大多数人对该计划表示满意。接受采访的参与者对同伴在这一角色中感到满意，但仍然存在获得服务的障碍。
单次口腔健康干预措施已在行为健康环境中实施。调查结果没有显著改善表明可能需要更密集的干预措施。然而，同伴成功地为弱势患者安排了牙科预约。鉴于仅进行了一次课程和轻度同伴导航后就安排了牙科预约，因此，将口腔健康融入行为健康环境中作为一种具有成本效益的可持续方法具有前景，值得进一步研究。
希望为其客户提供口腔健康教育和与牙科护理联系的具有成本效益的可持续方法的行为健康环境中的工作人员可以使用本研究的结果。
