Article type
Year
Abstract
Background: Methodological challenges regarding the synthesis of complex interventions have been discussed extensively. Meta-analyses of randomized controlled trials (RCTs) do not provide sufficient information concerning the implementation of complex interventions such as education programmes. Contextual and component-related factors are indispensable for review users. So far this information is rarely provided in Cochrane Reviews.
Objectives: Produce a description of intervention components and context factors in a Cochrane Review on the effectiveness of oral health promotion education in nursing homes.
Methods: The systematic review was prepared in accordance with the Cochrane Handbook. Data retrieval on research processes of the development, piloting and evaluation of the complex interventions including description of single components and context factors based on the reporting guideline 'Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare' (CReDECI2). In addition to RCTs, other publications on development, piloting and process evaluations were identified and included through additional systematic searches, author requests and reference tracking.
Results: All included studies (2 RCTs, 7 cluster-RCTs) were complex interventions using more than one active component. Results for dental health indicate that educational interventions may have positive short-term effects on dental plaque, denture plaque, and inflammation of oral mucosa (moderate quality evidence). Included studies reported insufficient information on development and evaluation processes of complex interventions. For example, only two studies reported on reasons for the selection of intervention components and no study included information on relevant context factors (Figure 1).
Conclusions: Oral health educational interventions seem to positively influence residents’ dental health in the short term. Conclusions about effective components cannot be made due to insufficient reporting. Facilitators, barriers and resources of the different interventions are unknown, but are crucial for decisions on implementation.
Objectives: Produce a description of intervention components and context factors in a Cochrane Review on the effectiveness of oral health promotion education in nursing homes.
Methods: The systematic review was prepared in accordance with the Cochrane Handbook. Data retrieval on research processes of the development, piloting and evaluation of the complex interventions including description of single components and context factors based on the reporting guideline 'Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare' (CReDECI2). In addition to RCTs, other publications on development, piloting and process evaluations were identified and included through additional systematic searches, author requests and reference tracking.
Results: All included studies (2 RCTs, 7 cluster-RCTs) were complex interventions using more than one active component. Results for dental health indicate that educational interventions may have positive short-term effects on dental plaque, denture plaque, and inflammation of oral mucosa (moderate quality evidence). Included studies reported insufficient information on development and evaluation processes of complex interventions. For example, only two studies reported on reasons for the selection of intervention components and no study included information on relevant context factors (Figure 1).
Conclusions: Oral health educational interventions seem to positively influence residents’ dental health in the short term. Conclusions about effective components cannot be made due to insufficient reporting. Facilitators, barriers and resources of the different interventions are unknown, but are crucial for decisions on implementation.