Oral health care education and its effect on caregivers' knowledge and attitudes: a randomised controlled trial

Objectives: The effect of an oral health care education programme (OHCE) upon nursing home caregivers was assessed in a randomised controlled trial. Methods: A self-administered questionnaire assessed oral health care knowledge and attitudes at baseline among 369 caregivers working in 22 nursing homes. Homes were randomly allocated to two groups. The intervention was a work-place OHCE. Caregivers assessed the value of the presentations. Questionnaires were re-administered 1 month (time 2) and 6 months (time 3) after the OHCE was delivered. The knowledge and attitude score means of the groups were compared. Open-ended questions solicited qualitative data. Results: Questionnaire response rates at the three time points ranged from 76.3% to 85.4%. Two-thirds of caregivers employed at the time of the intervention attended the presentations. The OHCE was favourably assessed in 79% of responses. The intervention group significantly improved their scores over the control group at times 2 and 3 for knowledge (P<0.003) and attitude (P<0.001). Analysed across both arms at baseline, the main predictors for knowledge and attitude scores were age and dental attendance pattern. Qualitative responses showed an acceptance of caregivers' roles in oral health care and criticism of existing provision within homes. Conclusions: The OHCE was well received and resulted in improved oral health care knowledge and attitudes. When viewed with separately reported trial results of clients' oral health status, knowledge and attitude score improvements coincided with improved delivery of oral health care.