In addition, the Greenhalgh model also underscores the importance of effective teaching strategies that take into account the local practice environment in developing sustained improvements. The knowledge base among direct-caregivers is a significant variable contributing to poor oral hygiene practices in LTC. The need for new training strategies and ongoing support of direct-care staff that is more practice-oriented, “hands-on” instruction rather than traditional classroom teaching is well-recognized. In this project, information about oral health problems in frail elders and oral care procedures were disseminated using both mass media and interpersonal communication approaches as described in the DOI model to enhance staff knowledge, motivation and skill.