The MOOD Study
Research type
Research Study
Full title
Exploring Multilevel barriers and facilitators Of Oral and Dental care utilisation among adults with severe mental illness: the MOOD study.
IRAS ID
289598
Contact name
Easter Joury
Contact email
Sponsor organisation
Queen Mary University of London
Duration of Study in the UK
0 years, 6 months, 13 days
Research summary
Short title: The Mood Study
Rationale: Supporting recovery from severe clinical depression amongst young adults is a national priority for NHS England. This includes providing dental care to treat and prevent oral diseases (e.g. tooth decay and gum diseases), which, if not treated, can hinder recovery from depression due to persistent inflammation, pain and psychological consequences. Although providing such dental care is a national priority the uptake of dental care is poor amongst these adults. To improve the situation we will propose an intervention that is co-produced, research-informed and theory-driven. This requires first a better understanding of the multiple barriers and facilitators of dental care utilisation from the perspectives of different stakeholders, especially the patients.
Aims / Objectives: To explore the views, experiences and suggestions of young adults with severe clinical depression or clinical depression with complexity, their carers, mental health and dental care teams, and commissioners regarding the multilevel barriers and facilitators of dental care utilisation amongst these young adults.
Methodology This is a qualitative study that will recruit a purposive sample of young adults aged 18-25 years, with severe clinical depression or clinical depression with complexity, their carers, mental health and dental clinicians, healthcare professionals, receptionists, managers and commissioners. Patients and carers will be recruited from a secondary mental healthcare setting in Tower Hamlets (East London Foundation Trust; ELFT). Other stakeholders will be recruited from primary and secondary care settings in Tower Hamlets. All participants should be willing and able to provide informed consent, understand written and verbal English and are not participating in other studies. Qualitative data will be collected by approximately 60 individual interviews (or until saturation is reached), audio-recorded, transcribed and analysed thematically.
Study duration: 9 months.Lay summary of study results: Plain English Summary
“Restart Smiling: Helping People with Severe Mental Illness Regain Their Smiles”
People with severe mental illness (for example, schizophrenia, bipolar and other psychoses) often have serious gum and teeth problems. This can worsen their overall mental and physical health, cause them to be hospitalised, affect their eating, talking and sleeping, and interfere with their relationships and ability to find and keep a job. Because of this, helping them build and maintain good oral hygiene is very important.
In this study, we wanted to work with people with severe mental illness and professionals to develop an oral hygiene intervention based on established behaviour-change theory.
We used an eight-step process based on the Behaviour Change Wheel. In Stage 1, we reviewed existing evidence and spoke with key groups to understand the problem. In Stage 2, we carried out interviews with 20 people to identify barriers and supports related to oral hygiene. We then developed the intervention with people with severe mental illness, carers and primary care, mental health, and dental professionals. The interview data was analysed using framework analysis, and the findings were mapped to behaviour-change models, including the Capability, Opportunity, Motivation–Behaviour model and the Theoretical Domains Framework. We then selected appropriate intervention functions, policy options, and behaviour-change techniques.
The intervention, called Restart Smiling, focused on encouraging toothbrushing twice a day. It included a dialogue about the benefits of better oral health, support for building a brushing routine, clear instructions and demonstrations, and consideration of cognitive challenges. It also explored the need for financial help and social support. The study recommended delivering this intervention as part of physical health checks for people with severe mental illness and training and compensating primary care and mental health professionals to provide it as part of personalised, joined together care. Ongoing follow-up was advised to help maintain engagement.
In summary, this study is the first to co-develop a theory-based toothbrushing intervention for people with severe mental illness, delivered by both primary care and mental health professionals.
REC name
Wales REC 5
REC reference
21/WA/0058
Date of REC Opinion
14 Apr 2021
REC opinion
Further Information Favourable Opinion