Evaluating Cognitive/Emotional and Behavioral Mediators of Oral Health Outcomes in Vulnerable Older Adults

Abstract

Inconsistent outcomes of oral hygiene interventions require testable theories combining cognitive and behavioral domains to guide intervention and improve results. This article evaluates the integrated model as a cognitive-behavioral approach to improve oral health clinical outcomes in ethnically diverse low-income older adults. Baseline data from a clinical trial utilizing the integrative model (IM) model evaluated predictors of gingival index (GI) and plaque score (PS). Individual logistic regression was performed for all predictors in relation to GI and PS. Multiple logistic regression was performed with significant predictors of GI and PS only. Greater locus of control and more brushing predicted lower GI; greater locus of control predicted lower PS. Both cognitive and behavioral domains impact GI, requiring more prolonged effort for improvement while locus of control, a cognitive variable, predicts PS, immediately improved by daily brushing/flossing. A streamlined IM including locus of control and tooth brushing should improve oral hygiene of low-income older adults.

Trial registration: ClinicalTrials.gov NCT02419144.

Keywords: applied cognition; health disparities; health promotion; prevention; quantitative methods.

Conflict of interest statement

Conflict of Interest: The authors declare that there is no conflict of interest

Trial Registration: Clinicaltrials.gov NCT02419144.

IRB Review: The studies were approved annually by the UCONN Health Center IRB, fuinal IrB approval number 14-1990-6.1, IRB Panel 1; the Institute for Community Research IRB deferred to the UCONN Health Center IRB.

Figures

Figure 1:

Integrated Model of Behavioral Change

Figure 2:

Path Analysis for GI and PS