TY - JOUR
AU - E. Joury
AU - E. Steed
AU - E. Heidari
AU - F. Francis
AU - M. B. A. Alhaffar
AU - S. Begum
AU - C. A. Chew-Graham
AU - K. Bhui
A1 - 
AB - BACKGROUND: People with severe mental Illness (SMI) bear an excessive burden of periodontal disease, which can exacerbate their mental and physical multimorbidity. Therefore, improving and sustaining good oral hygiene is key. AIMS: To co-create a theory-driven oral hygiene intervention for people with SMI. METHOD: A two-stage, eight-step method was followed drawing on the Behaviour Change Wheel. Stage 1, understanding the problem, involved evidence review and stakeholder consultations. Stage 2 focused on identifying theoretical barriers and facilitators through semi-structured interviews (n = 20) and co-designing the intervention content alongside people with SMI, carers, primary care, mental health and dental professionals and clinical leads. Interview data were analysed using framework analysis. Identified barriers and facilitators were mapped to the Capability, Opportunity, Motivation-Behaviour model and Theoretical Domain Framework. Intervention functions, policy categories and behaviour change techniques were identified and mapped accordingly. RESULTS: The target behaviour of twice-daily toothbrushing was addressed through understanding the consequences of improving oral health and brushing, forming a brushing habit, brushing instructions and demonstration with consideration of cognitive capacity and exploring the need for financial and social support. Recommendations for intervention delivery included integrating it into the SMI physical health checks, training and remunerating primary care and mental health professionals to deliver it as part of a personalised and integrated care approach to rebuilding broader lifestyle routines; and maintaining engagement through follow-up appointments. CONCLUSIONS: This is the first study to co-create a theory-driven toothbrushing intervention for people with SMI, delivered by primary care and mental health professionals.
AD - Department of Psychiatry, University of Oxfordhttps://ror.org/052gg0110, UK.; Division of Dentistry, University of Manchester, UK.; Wolfson Institute, Queen Mary University of London, UK.; Department of Sedation and Special Care Dentistry, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, and Guy's Hospital, London, UK.; East of England NHS England, Cambridge, UK.; Department of Global Public Health Sciences, Karolinska Institute, Stockholm, Sweden.; Tower Hamlets Early Detection Service, London, UK.; School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Newcastle-under-Lyme, UK.; Nuffield Department of Primary Care Health Sciences, Wadham College, University of Oxford, UK.; East London Health NHS Foundation Trust, London, UK.; Oxford Health NHS Foundation Trust, Oxford, UK.
AN - 41287993
BT - BJPsych Open
C5 - Healthcare Disparities
CP - 6
DA - Nov 25
DO - 10.1192/bjo.2025.10905
DP - NLM
ET - 20251125
IS - 6
JF - BJPsych Open
LA - eng
N2 - BACKGROUND: People with severe mental Illness (SMI) bear an excessive burden of periodontal disease, which can exacerbate their mental and physical multimorbidity. Therefore, improving and sustaining good oral hygiene is key. AIMS: To co-create a theory-driven oral hygiene intervention for people with SMI. METHOD: A two-stage, eight-step method was followed drawing on the Behaviour Change Wheel. Stage 1, understanding the problem, involved evidence review and stakeholder consultations. Stage 2 focused on identifying theoretical barriers and facilitators through semi-structured interviews (n = 20) and co-designing the intervention content alongside people with SMI, carers, primary care, mental health and dental professionals and clinical leads. Interview data were analysed using framework analysis. Identified barriers and facilitators were mapped to the Capability, Opportunity, Motivation-Behaviour model and Theoretical Domain Framework. Intervention functions, policy categories and behaviour change techniques were identified and mapped accordingly. RESULTS: The target behaviour of twice-daily toothbrushing was addressed through understanding the consequences of improving oral health and brushing, forming a brushing habit, brushing instructions and demonstration with consideration of cognitive capacity and exploring the need for financial and social support. Recommendations for intervention delivery included integrating it into the SMI physical health checks, training and remunerating primary care and mental health professionals to deliver it as part of a personalised and integrated care approach to rebuilding broader lifestyle routines; and maintaining engagement through follow-up appointments. CONCLUSIONS: This is the first study to co-create a theory-driven toothbrushing intervention for people with SMI, delivered by primary care and mental health professionals.
PY - 2025
SN - 2056-4724 (Print); 2056-4724
SP - e287
ST - Co-creating a toothbrushing intervention for adults with severe mental illness
T1 - Co-creating a toothbrushing intervention for adults with severe mental illness
T2 - BJPsych Open
TI - Co-creating a toothbrushing intervention for adults with severe mental illness
U1 - Healthcare Disparities
U3 - 10.1192/bjo.2025.10905
VL - 11
VO - 2056-4724 (Print); 2056-4724
Y1 - 2025
ER -