Figure 1
Co-Designing Process Framework.
Table 1
Summary of Results for Each Step of the Co-Designing Process.
| STEPS | METHODS | PARTICIPANTS | RESULTS/CONCLUSIONS |
|---|---|---|---|
| 1. Assessment of oral health situation | Oral examination and interviewing | Dependent older adults (N = 92) | Poor oral health status but minimally impacted their quality of life |
| 2. Capturing oral care experience | Deep interview with video recording | Dependent older adults (N = 3) and stakeholders (N = 9) | Edited film highlighting real-life oral care experiences of stakeholders, used as a discussion resource. |
| 3. Engaging stakeholders | 3 Independent focus group discussion (mainly discussed about each experience and each subgroup ideas of their contribution to oral health of dependent older adults) | 3.1 Family care team (N = 6) | The oral care was not prioritised due to general care workload and lack of a referral dentist. Desired roles included performing oral health screenings. |
| 3.2 Caregivers (N = 8) | Recognised the importance of oral health but were unsure about their skills. They wanted to ensure they could perform oral hygiene care correctly and safely, without causing harm. | ||
| 3.3 Local government and private sector (N = 8) | Strong perception of the importance of oral health in CBLTC. The exclusion of oral health was due to the absence of a government-operated dentist. They were willing to provide financial and bureaucratic support for integrating oral healthcare. | ||
| 4. Co-design oral healthcare service | Focus group discussion | Representatives from previous FCT and caregiver subgroups (N = 8) | The goal was to establish comprehensive oral healthcare for dependent older adults, ensuring emergency dental needs were met, along with regular screenings and quality hygiene care, with caregiver support or independently, as outlined in the final co-designed model (Figure 2). |
| 5. Confirmation of the oral healthcare model | Reviewing | All co-designed members (N = 22) | The final model was shared with all members for a 7-day confirmation period. No rejections were received, indicating unanimous approval. |
Figure 2
Final Co-Designed Oral Healthcare Model.
Table 2
Comparative Features of Conventional Oral Healthcare Models/Protocols and the Co-Designed Oral Healthcare Model.
| CONVENTIONAL MODELS/PROTOCOLS | CO-DESIGNED MODEL | |
|---|---|---|
| Leadership | Dentist-led, expert-driven | Community-led |
| Care Setting | Clinic-based or facility-based | Home-based, integrated into CBLTC system |
| Approach to Intervention | Treatment-focused, episodic | Daily care, prevention, early detection |
| Stakeholder Involvement | Limited | Active involvement of all stakeholders |
| Guidelines & Tools | Formal, technical | Simple, visual, co-created tools |
| Training Delivery | Specialist-led, lecture-based | Peer-led, context-specific |
| Adaptability | One-size-fits-all protocols | Flexible, responsive to local context and feedback |
| Sustainability | Resource-intensive, dependent on professionals | Utilises existing community care structures |