Objective: Evaluate the clinical and behavioral effects of personalized prevention plans (PPP) in a cohort of HIV+ individuals.
Methods: 22 HIV+ people were recalled from an earlier study to qualitatively and quantitatively assess changes occurring after delivery of PPP. At recall, subjects were asked what they remembered and what oral hygiene behavior (OHB) changes they made since baseline. Probing depths ³ 4.0 mm at baseline were assessed on an average of 38 sites per subject. All subjects received a hands-on coaching session focusing on targeted OHB techniques. Subjects self-rated their motivation and confidence to make future OHB changes using a 10-point Likert scale.
Results: On average, subjects reported making 3.5 specific OHB changes since written and spoken exposure to a baseline PPP. Elements of knowledge, optimism, interest, and concern about oral health increased in 20 of 22 subjects. Enhancements were reported in frequency of flossing (50%) and tooth-brushing (45%); tooth-brushing technique (50%); and eating habits (27%). 95% attributed OHB changes to PPP. 41% of sites improved; 26% worsened, 33% were unchanged. Compared to smokers, non-smokers were more optimistic about their oral health (c2=.024) and more likely to change their OHB (p=.009). On the Structured Behavior Change Scale, ratings of motivation and confidence were highest for brushing (9.56; 10.0) and flossing (7.7; 8.32) and lowest for use of a proxy brush (5.0; 4.0). All subjects reported increased knowledge with hands-on OHB coaching at recall. 91% of subjects reported that hands-on coaching was more helpful than the baseline visit.
Conclusions: In an HIV-1 cohort, PPP effectively enhanced oral health related knowledge and improved OHB¢s. This study suggests that the use of PPP and OHB coaching can be effective tools to enhance oral home care; providers should encourage incremental change in an ongoing, targeted and personalized manner.
Supported by NIDCR, DE15746-01A1.