Efficacy of Oral Health Motivational Interviewing among Elderly Patients

Objectives: Older adults have been described as one of the most underserved groups at the highest risk for oral diseases. A Randomized Clinical Trial is being conducted to assess the efficacy of a group-based oral health education activity versus an individual-based activity utilizing motivational interviewing (MI) in terms of changes in oral health related quality of life (OHRQoL), oral health self-efficacy and oral health knowledge. The present study examines the treatment fidelity of the MI intervention, and tests its effects on oral health outcomes.
Methods: One hundred and twenty patients were randomly allocated to traditional education (n=60) and MI education (n= 60) groups. Treatment fidelity was measured in sixteen random patients. The intervention was administered by a public health dental hygienist who attended a 1-day MI training. All interviews were audio-recorded and coded by an expert using the Motivational Interviewing Treatment Integrity (MITI) Code. Global scores in four MI areas for each intervention and average use of MI consistent behaviors during five minute increments were calculated. In addition, multivariable linear regression was used to test an effect of the MI intervention on outcomes after 6 months, controlling for baseline demographics.
Results: Basic proficiency or higher was achieved in all global areas during all sixteen interventions. Average scores in the global areas indicated basic proficiency or higher (M_empathy =3.75, M_{collaboration} =3.56, M_{change talk} =3.62, M_sustain =3.75). Open-ended questions and reflections were used in all interventions. Self-efficacy score change between baseline and follow-up was 3.1±4.9 for the MI group and 0.9±3.2 for the traditional group. OHRQoL score change was -3.9±5.6 for the MI group and -0.3±4.7 for the traditional group. Greater change in these scores among the MI vs. traditional group was statistically significant (p<0.01).
Conclusions: Findings from the study support fidelity of this MI intervention for conducting oral health education among seniors. Data support improvement of oral health self-efficacy and oral health related quality of life after 6 months among the MI intervention group.