Co-creating a toothbrushing intervention for adults with severe mental illness

Area of Science:

• Oral health research
• Mental health interventions
• Behavioral science

Background:

• Individuals with severe mental illness (SMI) experience high rates of periodontal disease.
• Poor oral hygiene exacerbates existing mental and physical health issues in the SMI population.
• Effective oral hygiene is critical for managing overall health in people with SMI.

Purpose of the Study:

• To collaboratively develop a theory-informed oral hygiene intervention tailored for people with SMI.
• To address the specific needs and challenges faced by individuals with SMI in maintaining oral hygiene.
• To integrate oral health promotion into existing healthcare frameworks for SMI.

Main Methods:

• A two-stage, eight-step approach using the Behaviour Change Wheel framework.
• Stakeholder consultations and evidence reviews to understand oral hygiene challenges in SMI.
• Semi-structured interviews (n=20) and co-design workshops with people with SMI, carers, and professionals.
• Analysis of interview data using framework analysis and mapping to behavioral models (COM-B, TDF).

Main Results:

• The intervention targets twice-daily toothbrushing, considering habit formation, cognitive capacity, and support needs.
• Recommendations include integrating oral hygiene into SMI physical health checks.
• Training and remuneration for primary care and mental health professionals are suggested for intervention delivery.
• Personalized care approaches and follow-up appointments are key for sustained engagement.

Conclusions:

• This study represents the first co-creation of a theory-driven toothbrushing intervention for people with SMI.
• The intervention is designed for delivery by primary care and mental health professionals.
• This initiative aims to improve oral health outcomes and overall well-being for individuals with SMI.