Supervised versus non-supervised implementation of an oral health care guideline in (residential) care homes: a cluster randomized controlled clinical trial
Identifieur interne : 002F24 ( Ncbi/Merge ); précédent : 002F23; suivant : 002F25Supervised versus non-supervised implementation of an oral health care guideline in (residential) care homes: a cluster randomized controlled clinical trial
Auteurs : Gert-Jan Van Der Putten [Pays-Bas] ; Luc De Visschere [Belgique] ; Jos Schols [Pays-Bas] ; Cees De Baat [Pays-Bas] ; Jacques Vanobbergen [Belgique]Source :
- BMC Oral Health [ 1472-6831 ] ; 2010.
Abstract
The increase of the proportion of elderly people has implications for health care services. Advances in oral health care and treatment have resulted in a reduced number of edentulous individuals. An increasing number of dentate elderly people have tooth wear, periodontal disease, oral implants, and sophisticated restorations and prostheses. Hence, they are in need of both preventive and curative oral health care continuously. Weakened oral health due to neglect of self care and professional care and due to reduced oral health care utilization is already present when elderly people are still community-dwelling. At the moment of (residential) care home admittance, many elderly people are in need of oral health care urgently. The key factor in realizing and maintaining good oral health is daily oral hygiene care. For proper daily oral hygiene care, many residents are dependent on nurses and nurse aides. In 2007, the Dutch guideline "Oral health care in (residential) care homes for elderly people" was developed. Previous implementation research studies have revealed that implementation of a guideline is very complicated. The overall aim of this study is to compare a supervised versus a non-supervised implementation of the guideline in The Netherlands and Flanders (Belgium).
The study is a cluster randomized intervention trial with an institution as unit of randomization. A random sample of 12 (residential) care homes accommodating somatic as well as psycho-geriatric residents in The Netherlands as well as in Flanders (Belgium) are randomly allocated to an intervention or control group. Representative samples of 30 residents in each of the 24 (residential) care homes are monitored during a 6-months period. The intervention consists of supervised implementation of the guideline and a daily oral health care protocol. Primary outcome variable is the oral hygiene level of the participating residents. To determine the stimulating or inhibiting factors of the implementation project and the nurses' and nurse aides' compliance and perceived barriers, a process evaluation is carried out.
The method of cluster randomization may result in a random effect and cluster selection bias, which has to be taken into account when analyzing and interpreting the results.
Current Controlled Trials ISRCTN86156614
Url:
DOI: 10.1186/1472-6831-10-17
PubMed: 20598123
PubMed Central: 2912776
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PMC:2912776Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Supervised versus non-supervised implementation of an oral health care guideline in (residential) care homes: a cluster randomized controlled clinical trial</title>
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<author><name sortKey="Schols, Jos" sort="Schols, Jos" uniqKey="Schols J" first="Jos" last="Schols">Jos Schols</name>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The increase of the proportion of elderly people has implications for health care services. Advances in oral health care and treatment have resulted in a reduced number of edentulous individuals. An increasing number of dentate elderly people have tooth wear, periodontal disease, oral implants, and sophisticated restorations and prostheses. Hence, they are in need of both preventive and curative oral health care continuously. Weakened oral health due to neglect of self care and professional care and due to reduced oral health care utilization is already present when elderly people are still community-dwelling. At the moment of (residential) care home admittance, many elderly people are in need of oral health care urgently. The key factor in realizing and maintaining good oral health is daily oral hygiene care. For proper daily oral hygiene care, many residents are dependent on nurses and nurse aides. In 2007, the Dutch guideline "Oral health care in (residential) care homes for elderly people" was developed. Previous implementation research studies have revealed that implementation of a guideline is very complicated. The overall aim of this study is to compare a supervised versus a non-supervised implementation of the guideline in The Netherlands and Flanders (Belgium).</p>
</sec>
<sec><title>Methods/Design</title>
<p>The study is a cluster randomized intervention trial with an institution as unit of randomization. A random sample of 12 (residential) care homes accommodating somatic as well as psycho-geriatric residents in The Netherlands as well as in Flanders (Belgium) are randomly allocated to an intervention or control group. Representative samples of 30 residents in each of the 24 (residential) care homes are monitored during a 6-months period. The intervention consists of supervised implementation of the guideline and a daily oral health care protocol. Primary outcome variable is the oral hygiene level of the participating residents. To determine the stimulating or inhibiting factors of the implementation project and the nurses' and nurse aides' compliance and perceived barriers, a process evaluation is carried out.</p>
</sec>
<sec><title>Discussion</title>
<p>The method of cluster randomization may result in a random effect and cluster selection bias, which has to be taken into account when analyzing and interpreting the results.</p>
</sec>
<sec><title>Trial registration</title>
<p>Current Controlled Trials ISRCTN86156614</p>
</sec>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Branca, S" uniqKey="Branca S">S Branca</name>
</author>
<author><name sortKey="Bennati, E" uniqKey="Bennati E">E Bennati</name>
</author>
<author><name sortKey="Ferlito, L" uniqKey="Ferlito L">L Ferlito</name>
</author>
<author><name sortKey="Spallina, G" uniqKey="Spallina G">G Spallina</name>
</author>
<author><name sortKey="Cardillo, E" uniqKey="Cardillo E">E Cardillo</name>
</author>
<author><name sortKey="Malaguarnera, M" uniqKey="Malaguarnera M">M Malaguarnera</name>
</author>
<author><name sortKey="Motta, M" uniqKey="Motta M">M Motta</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Rothera, I" uniqKey="Rothera I">I Rothera</name>
</author>
<author><name sortKey="Jones, R" uniqKey="Jones R">R Jones</name>
</author>
<author><name sortKey="Harwood, R" uniqKey="Harwood R">R Harwood</name>
</author>
<author><name sortKey="Avery, A" uniqKey="Avery A">A Avery</name>
</author>
<author><name sortKey="Waite, J" uniqKey="Waite J">J Waite</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Schols, Jmga" uniqKey="Schols J">JMGA Schols</name>
</author>
<author><name sortKey="Crebolder, Hfjm" uniqKey="Crebolder H">HFJM Crebolder</name>
</author>
<author><name sortKey="Van Weel, C" uniqKey="Van Weel C">C van Weel</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ettinger, Rl" uniqKey="Ettinger R">RL Ettinger</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Wu, B" uniqKey="Wu B">B Wu</name>
</author>
<author><name sortKey="Plassman, Bl" uniqKey="Plassman B">BL Plassman</name>
</author>
<author><name sortKey="Crout, Rj" uniqKey="Crout R">RJ Crout</name>
</author>
<author><name sortKey="Liang, J" uniqKey="Liang J">J Liang</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Holm Pedersen, P" uniqKey="Holm Pedersen P">P Holm-Pedersen</name>
</author>
<author><name sortKey="Vigild, M" uniqKey="Vigild M">M Vigild</name>
</author>
<author><name sortKey="Nitschke, I" uniqKey="Nitschke I">I Nitschke</name>
</author>
<author><name sortKey="Berkey, Db" uniqKey="Berkey D">DB Berkey</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Holm Pedersen, P" uniqKey="Holm Pedersen P">P Holm-Pedersen</name>
</author>
<author><name sortKey="Russell, Sl" uniqKey="Russell S">SL Russell</name>
</author>
<author><name sortKey="Avlund, K" uniqKey="Avlund K">K Avlund</name>
</author>
<author><name sortKey="Viitanen, M" uniqKey="Viitanen M">M Viitanen</name>
</author>
<author><name sortKey="Winblad, B" uniqKey="Winblad B">B Winblad</name>
</author>
<author><name sortKey="Katz, Rv" uniqKey="Katz R">RV Katz</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Wu, B" uniqKey="Wu B">B Wu</name>
</author>
<author><name sortKey="Plassman, Bl" uniqKey="Plassman B">BL Plassman</name>
</author>
<author><name sortKey="Liang, J" uniqKey="Liang J">J Liang</name>
</author>
<author><name sortKey="Wei, L" uniqKey="Wei L">L Wei</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jokstad, A" uniqKey="Jokstad A">A Jokstad</name>
</author>
<author><name sortKey="Ambj Rnsen, E" uniqKey="Ambj Rnsen E">E Ambjørnsen</name>
</author>
<author><name sortKey="Eide, Ke" uniqKey="Eide K">KE Eide</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Stubbs, C" uniqKey="Stubbs C">C Stubbs</name>
</author>
<author><name sortKey="Riordan, Pj" uniqKey="Riordan P">PJ Riordan</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Simunkovi, Sk" uniqKey="Simunkovi S">SK Simunković</name>
</author>
<author><name sortKey="Boras, Vv" uniqKey="Boras V">VV Boras</name>
</author>
<author><name sortKey="Panduri, J" uniqKey="Panduri J">J Pandurić</name>
</author>
<author><name sortKey="Zili, Ia" uniqKey="Zili I">IA Zilić</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Unluer, S" uniqKey="Unluer S">S Unlüer</name>
</author>
<author><name sortKey="Gokalp, S" uniqKey="Gokalp S">S Gökalp</name>
</author>
<author><name sortKey="Do An, Bg" uniqKey="Do An B">BG Doğan</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Arpin, S" uniqKey="Arpin S">S Arpin</name>
</author>
<author><name sortKey="Brodeur, Jm" uniqKey="Brodeur J">JM Brodeur</name>
</author>
<author><name sortKey="Corbeil, P" uniqKey="Corbeil P">P Corbeil</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Samson, H" uniqKey="Samson H">H Samson</name>
</author>
<author><name sortKey="Strand, Gv" uniqKey="Strand G">GV Strand</name>
</author>
<author><name sortKey="Haugejorden, O" uniqKey="Haugejorden O">O Haugejorden</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Seymour, Gj" uniqKey="Seymour G">GJ Seymour</name>
</author>
<author><name sortKey="Ford, Pj" uniqKey="Ford P">PJ Ford</name>
</author>
<author><name sortKey="Cullinan, Mp" uniqKey="Cullinan M">MP Cullinan</name>
</author>
<author><name sortKey="Leishman, S" uniqKey="Leishman S">S Leishman</name>
</author>
<author><name sortKey="Yamazaki, K" uniqKey="Yamazaki K">K Yamazaki</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Rautemaa, R" uniqKey="Rautemaa R">R Rautemaa</name>
</author>
<author><name sortKey="Lauhio, A" uniqKey="Lauhio A">A Lauhio</name>
</author>
<author><name sortKey="Cullinan, Mp" uniqKey="Cullinan M">MP Cullinan</name>
</author>
<author><name sortKey="Seymour, Gj" uniqKey="Seymour G">GJ Seymour</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ciancio, Sg" uniqKey="Ciancio S">SG Ciancio</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Moore, Pa" uniqKey="Moore P">PA Moore</name>
</author>
<author><name sortKey="Guggenheimer, J" uniqKey="Guggenheimer J">J Guggenheimer</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Tsakos, G" uniqKey="Tsakos G">G Tsakos</name>
</author>
<author><name sortKey="Steele, Jg" uniqKey="Steele J">JG Steele</name>
</author>
<author><name sortKey="Marcenes, W" uniqKey="Marcenes W">W Marcenes</name>
</author>
<author><name sortKey="Walls, Aw" uniqKey="Walls A">AW Walls</name>
</author>
<author><name sortKey="Sheiham, A" uniqKey="Sheiham A">A Sheiham</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kandelman, D" uniqKey="Kandelman D">D Kandelman</name>
</author>
<author><name sortKey="Petersen, Pe" uniqKey="Petersen P">PE Petersen</name>
</author>
<author><name sortKey="Ueda, H" uniqKey="Ueda H">H Ueda</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Mari O, R" uniqKey="Mari O R">R Mariño</name>
</author>
<author><name sortKey="Schofield, M" uniqKey="Schofield M">M Schofield</name>
</author>
<author><name sortKey="Wright, C" uniqKey="Wright C">C Wright</name>
</author>
<author><name sortKey="Calache, H" uniqKey="Calache H">H Calache</name>
</author>
<author><name sortKey="Minichiello, V" uniqKey="Minichiello V">V Minichiello</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Nordenram, G" uniqKey="Nordenram G">G Nordenram</name>
</author>
<author><name sortKey="Ronnberg, L" uniqKey="Ronnberg L">L Rönnberg</name>
</author>
<author><name sortKey="Winblad, B" uniqKey="Winblad B">B Winblad</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Nitschke, I" uniqKey="Nitschke I">I Nitschke</name>
</author>
<author><name sortKey="Muller, F" uniqKey="Muller F">F Müller</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ikebe, K" uniqKey="Ikebe K">K Ikebe</name>
</author>
<author><name sortKey="Matsuda, K" uniqKey="Matsuda K">K Matsuda</name>
</author>
<author><name sortKey="Morii, K" uniqKey="Morii K">K Morii</name>
</author>
<author><name sortKey="Nokubi, T" uniqKey="Nokubi T">T Nokubi</name>
</author>
<author><name sortKey="Ettinger, Rl" uniqKey="Ettinger R">RL Ettinger</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ikebe, K" uniqKey="Ikebe K">K Ikebe</name>
</author>
<author><name sortKey="Morii, K" uniqKey="Morii K">K Morii</name>
</author>
<author><name sortKey="Matsuda, K" uniqKey="Matsuda K">K Matsuda</name>
</author>
<author><name sortKey="Nokubi, T" uniqKey="Nokubi T">T Nokubi</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Hancock, Eb" uniqKey="Hancock E">EB Hancock</name>
</author>
<author><name sortKey="Newell, Dh" uniqKey="Newell D">DH Newell</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Attin, T" uniqKey="Attin T">T Attin</name>
</author>
<author><name sortKey="Hornecker, E" uniqKey="Hornecker E">E Hornecker</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Gil Montoya, Ja" uniqKey="Gil Montoya J">JA Gil-Montoya</name>
</author>
<author><name sortKey="De Mello, Al" uniqKey="De Mello A">AL de Mello</name>
</author>
<author><name sortKey="Cardenas, Cb" uniqKey="Cardenas C">CB Cardenas</name>
</author>
<author><name sortKey="Lopez, Ig" uniqKey="Lopez I">IG Lopez</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Stein, Ps" uniqKey="Stein P">PS Stein</name>
</author>
<author><name sortKey="Henry, Rg" uniqKey="Henry R">RG Henry</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Murray, Pe" uniqKey="Murray P">PE Murray</name>
</author>
<author><name sortKey="Ede Nichols, D" uniqKey="Ede Nichols D">D Ede-Nichols</name>
</author>
<author><name sortKey="Garcia Godoy, F" uniqKey="Garcia Godoy F">F Garcia-Godoy</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Costello, T" uniqKey="Costello T">T Costello</name>
</author>
<author><name sortKey="Coyne, I" uniqKey="Coyne I">I Coyne</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Young, Bc" uniqKey="Young B">BC Young</name>
</author>
<author><name sortKey="Murray, Ca" uniqKey="Murray C">CA Murray</name>
</author>
<author><name sortKey="Thomson, J" uniqKey="Thomson J">J Thomson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="De Mello, Alsf" uniqKey="De Mello A">ALSF de Mello</name>
</author>
<author><name sortKey="Padilha, Dmp" uniqKey="Padilha D">DMP Padilha</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Coleman, P" uniqKey="Coleman P">P Coleman</name>
</author>
<author><name sortKey="Watson, Nm" uniqKey="Watson N">NM Watson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Chung, Jp" uniqKey="Chung J">JP Chung</name>
</author>
<author><name sortKey="Mojon, P" uniqKey="Mojon P">P Mojon</name>
</author>
<author><name sortKey="Budtz J Rgensen, E" uniqKey="Budtz J Rgensen E">E Budtz-Jørgensen</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Sweeney, Mp" uniqKey="Sweeney M">MP Sweeney</name>
</author>
<author><name sortKey="Williams, C" uniqKey="Williams C">C Williams</name>
</author>
<author><name sortKey="Kennedy, C" uniqKey="Kennedy C">C Kennedy</name>
</author>
<author><name sortKey="Macpherson, Lm" uniqKey="Macpherson L">LM Macpherson</name>
</author>
<author><name sortKey="Turner, S" uniqKey="Turner S">S Turner</name>
</author>
<author><name sortKey="Bagg, J" uniqKey="Bagg J">J Bagg</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="O Reilly" uniqKey="O Reilly">O'Reilly</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Vanobbergen, Jno" uniqKey="Vanobbergen J">JNO Vanobbergen</name>
</author>
<author><name sortKey="De Visschere, Lm" uniqKey="De Visschere L">LM De Visschere</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Mcgrath, C" uniqKey="Mcgrath C">C McGrath</name>
</author>
<author><name sortKey="Zhang, W" uniqKey="Zhang W">W Zhang</name>
</author>
<author><name sortKey="Lo, Ec" uniqKey="Lo E">EC Lo</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Burgers, Js" uniqKey="Burgers J">JS Burgers</name>
</author>
<author><name sortKey="Grol, Rp" uniqKey="Grol R">RP Grol</name>
</author>
<author><name sortKey="Zaat, Jo" uniqKey="Zaat J">JO Zaat</name>
</author>
<author><name sortKey="Spies, Th" uniqKey="Spies T">TH Spies</name>
</author>
<author><name sortKey="Van Der Bij, Ak" uniqKey="Van Der Bij A">AK van der Bij</name>
</author>
<author><name sortKey="Mokkink, Hg" uniqKey="Mokkink H">HG Mokkink</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Grol, R" uniqKey="Grol R">R Grol</name>
</author>
<author><name sortKey="Grimshaw, J" uniqKey="Grimshaw J">J Grimshaw</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Maue, Sk" uniqKey="Maue S">SK Maue</name>
</author>
<author><name sortKey="Segal, R" uniqKey="Segal R">R Segal</name>
</author>
<author><name sortKey="Kimberlin, Cl" uniqKey="Kimberlin C">CL Kimberlin</name>
</author>
<author><name sortKey="Lipowski, Ee" uniqKey="Lipowski E">EE Lipowski</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Eccles, M" uniqKey="Eccles M">M Eccles</name>
</author>
<author><name sortKey="Grimshaw, J" uniqKey="Grimshaw J">J Grimshaw</name>
</author>
<author><name sortKey="Walker, A" uniqKey="Walker A">A Walker</name>
</author>
<author><name sortKey="Johnston, M" uniqKey="Johnston M">M Johnston</name>
</author>
<author><name sortKey="Pitts, N" uniqKey="Pitts N">N Pitts</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Fretheim, A" uniqKey="Fretheim A">A Fretheim</name>
</author>
<author><name sortKey="Schunemann, Hj" uniqKey="Schunemann H">HJ Schunemann</name>
</author>
<author><name sortKey="Oxman, Ad" uniqKey="Oxman A">AD Oxman</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Davies, B" uniqKey="Davies B">B Davies</name>
</author>
<author><name sortKey="Edwards, N" uniqKey="Edwards N">N Edwards</name>
</author>
<author><name sortKey="Ploeg, J" uniqKey="Ploeg J">J Ploeg</name>
</author>
<author><name sortKey="Virani, T" uniqKey="Virani T">T Virani</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Planas, Lg" uniqKey="Planas L">LG Planas</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Rosenbrand, K" uniqKey="Rosenbrand K">K Rosenbrand</name>
</author>
<author><name sortKey="Van Croonenborg, J" uniqKey="Van Croonenborg J">J Van Croonenborg</name>
</author>
<author><name sortKey="Wittenberg, J" uniqKey="Wittenberg J">J Wittenberg</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Oakley, A" uniqKey="Oakley A">A Oakley</name>
</author>
<author><name sortKey="Strnage, V" uniqKey="Strnage V">V Strnage</name>
</author>
<author><name sortKey="Bonell, C" uniqKey="Bonell C">C Bonell</name>
</author>
<author><name sortKey="Allen, E" uniqKey="Allen E">E Allen</name>
</author>
<author><name sortKey="Stephenson, J" uniqKey="Stephenson J">J Stephenson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Silness, J" uniqKey="Silness J">J Silness</name>
</author>
<author><name sortKey="Loe, H" uniqKey="Loe H">H Löe</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Augsburger, Rh" uniqKey="Augsburger R">RH Augsburger</name>
</author>
<author><name sortKey="Elahi, Jm" uniqKey="Elahi J">JM Elahi</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Dijkstra, A" uniqKey="Dijkstra A">A Dijkstra</name>
</author>
<author><name sortKey="Tiesinga, Lj" uniqKey="Tiesinga L">LJ Tiesinga</name>
</author>
<author><name sortKey="Plantinga, L" uniqKey="Plantinga L">L Plantinga</name>
</author>
<author><name sortKey="Veltman, G" uniqKey="Veltman G">G Veltman</name>
</author>
<author><name sortKey="Dassen, Tw" uniqKey="Dassen T">TW Dassen</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Tombaugh, Tn" uniqKey="Tombaugh T">TN Tombaugh</name>
</author>
<author><name sortKey="Mcintyre, Nj" uniqKey="Mcintyre N">NJ McIntyre</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Rautalinko, E" uniqKey="Rautalinko E">E Rautalinko</name>
</author>
<author><name sortKey="Lisper, Ho" uniqKey="Lisper H">HO Lisper</name>
</author>
<author><name sortKey="Ekehammar, B" uniqKey="Ekehammar B">B Ekehammar</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Gelo, O" uniqKey="Gelo O">O Gelo</name>
</author>
<author><name sortKey="Braakmann, D" uniqKey="Braakmann D">D Braakmann</name>
</author>
<author><name sortKey="Benetka, G" uniqKey="Benetka G">G Benetka</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Eccles, M" uniqKey="Eccles M">M Eccles</name>
</author>
<author><name sortKey="Grimshaw, J" uniqKey="Grimshaw J">J Grimshaw</name>
</author>
<author><name sortKey="Campbell, M" uniqKey="Campbell M">M Campbell</name>
</author>
<author><name sortKey="Ramsay, C" uniqKey="Ramsay C">C Ramsay</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Oral Health</journal-id>
<journal-title-group><journal-title>BMC Oral Health</journal-title>
</journal-title-group>
<issn pub-type="epub">1472-6831</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">20598123</article-id>
<article-id pub-id-type="pmc">2912776</article-id>
<article-id pub-id-type="publisher-id">1472-6831-10-17</article-id>
<article-id pub-id-type="doi">10.1186/1472-6831-10-17</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Study Protocol</subject>
</subj-group>
</article-categories>
<title-group><article-title>Supervised versus non-supervised implementation of an oral health care guideline in (residential) care homes: a cluster randomized controlled clinical trial</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>van der Putten</surname>
<given-names>Gert-Jan</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>gjvdputten@hetnet.nl</email>
</contrib>
<contrib contrib-type="author" id="A2"><name><surname>De Visschere</surname>
<given-names>Luc</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>luc.devisschere@ugent.be</email>
</contrib>
<contrib contrib-type="author" id="A3"><name><surname>Schols</surname>
<given-names>Jos</given-names>
</name>
<xref ref-type="aff" rid="I3">3</xref>
<email>jmschols@planet.nl</email>
</contrib>
<contrib contrib-type="author" id="A4"><name><surname>de Baat</surname>
<given-names>Cees</given-names>
</name>
<xref ref-type="aff" rid="I4">4</xref>
<email>c.debaat@dent.umcn.nl</email>
</contrib>
<contrib contrib-type="author" id="A5"><name><surname>Vanobbergen</surname>
<given-names>Jacques</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>Jacques.Vanobbergen@Ugent.be</email>
</contrib>
</contrib-group>
<aff id="I1"><label>1</label>
Birkhoven Care-estate, P.O. Box 363, 3800 AJ Amersfoort, The Netherlands</aff>
<aff id="I2"><label>2</label>
Department of Community Dentistry and Oral Public Health, Ghent University, Belgium</aff>
<aff id="I3"><label>3</label>
Department of General Practice, Section Nursing Home Medicine, CAPHRI, Maastricht University, The Netherlands</aff>
<aff id="I4"><label>4</label>
Department of Oral Function and Prosthetic Dentistry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</aff>
<pub-date pub-type="collection"><year>2010</year>
</pub-date>
<pub-date pub-type="epub"><day>2</day>
<month>7</month>
<year>2010</year>
</pub-date>
<volume>10</volume>
<fpage>17</fpage>
<lpage>17</lpage>
<history><date date-type="received"><day>15</day>
<month>3</month>
<year>2010</year>
</date>
<date date-type="accepted"><day>2</day>
<month>7</month>
<year>2010</year>
</date>
</history>
<permissions><copyright-statement>Copyright ©2010 van der Putten et al; licensee BioMed Central Ltd.</copyright-statement>
<copyright-year>2010</copyright-year>
<copyright-holder>van der Putten et al; licensee BioMed Central Ltd.</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<self-uri xlink:href="http://www.biomedcentral.com/1472-6831/10/17"></self-uri>
<abstract><sec><title>Background</title>
<p>The increase of the proportion of elderly people has implications for health care services. Advances in oral health care and treatment have resulted in a reduced number of edentulous individuals. An increasing number of dentate elderly people have tooth wear, periodontal disease, oral implants, and sophisticated restorations and prostheses. Hence, they are in need of both preventive and curative oral health care continuously. Weakened oral health due to neglect of self care and professional care and due to reduced oral health care utilization is already present when elderly people are still community-dwelling. At the moment of (residential) care home admittance, many elderly people are in need of oral health care urgently. The key factor in realizing and maintaining good oral health is daily oral hygiene care. For proper daily oral hygiene care, many residents are dependent on nurses and nurse aides. In 2007, the Dutch guideline "Oral health care in (residential) care homes for elderly people" was developed. Previous implementation research studies have revealed that implementation of a guideline is very complicated. The overall aim of this study is to compare a supervised versus a non-supervised implementation of the guideline in The Netherlands and Flanders (Belgium).</p>
</sec>
<sec><title>Methods/Design</title>
<p>The study is a cluster randomized intervention trial with an institution as unit of randomization. A random sample of 12 (residential) care homes accommodating somatic as well as psycho-geriatric residents in The Netherlands as well as in Flanders (Belgium) are randomly allocated to an intervention or control group. Representative samples of 30 residents in each of the 24 (residential) care homes are monitored during a 6-months period. The intervention consists of supervised implementation of the guideline and a daily oral health care protocol. Primary outcome variable is the oral hygiene level of the participating residents. To determine the stimulating or inhibiting factors of the implementation project and the nurses' and nurse aides' compliance and perceived barriers, a process evaluation is carried out.</p>
</sec>
<sec><title>Discussion</title>
<p>The method of cluster randomization may result in a random effect and cluster selection bias, which has to be taken into account when analyzing and interpreting the results.</p>
</sec>
<sec><title>Trial registration</title>
<p>Current Controlled Trials ISRCTN86156614</p>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Belgique</li>
<li>Pays-Bas</li>
</country>
<region><li>Gueldre</li>
<li>Province de Flandre-Orientale</li>
<li>Région flamande</li>
</region>
<settlement><li>Gand</li>
<li>Nimègue</li>
</settlement>
<orgName><li>Université de Gand</li>
</orgName>
</list>
<tree><country name="Pays-Bas"><noRegion><name sortKey="Van Der Putten, Gert Jan" sort="Van Der Putten, Gert Jan" uniqKey="Van Der Putten G" first="Gert-Jan" last="Van Der Putten">Gert-Jan Van Der Putten</name>
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<name sortKey="De Baat, Cees" sort="De Baat, Cees" uniqKey="De Baat C" first="Cees" last="De Baat">Cees De Baat</name>
<name sortKey="Schols, Jos" sort="Schols, Jos" uniqKey="Schols J" first="Jos" last="Schols">Jos Schols</name>
</country>
<country name="Belgique"><region name="Région flamande"><name sortKey="De Visschere, Luc" sort="De Visschere, Luc" uniqKey="De Visschere L" first="Luc" last="De Visschere">Luc De Visschere</name>
</region>
<name sortKey="Vanobbergen, Jacques" sort="Vanobbergen, Jacques" uniqKey="Vanobbergen J" first="Jacques" last="Vanobbergen">Jacques Vanobbergen</name>
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</record>
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