The development of a feeding, swallowing and oral care program using the PRECEDE-PROCEED model in an orphanage-hospital in Guatemala.

PURPOSE The purpose of this study was to evaluate a long-term on-going international academic service-learning (I-ASL) intervention. Its goal was to improve swallowing, feeding and oral care technique of medical staff in an orphanage in Guatemala to children who are medically complex and have special needs. METHOD The PRECEDE-PROCEED model was used as the conceptual framework of the program. Five major target areas were identified during the diagnosis, assessment, implementation and evaluation phases of the model: knowledge and skills, feeding equipment, feeding and oral care technique, positioning and communication. Verbal instruction, modelling and small group training was provided by the research team across all visits. A five-day intervention designed to increase feeders' knowledge of feeding and oral care technique, signs and symptoms and complications of dysphagia and to improve their feeding, positioning and oral care technique was implemented and evaluated. RESULT Statistical analyses showed significant increases in knowledge and appropriate feeding, positioning and oral care technique. CONCLUSION As a consequence of the intervention, a trusting and mutually supportive relationship was built between the I-ASL team and the host organization.