Online Program

Addressing oral health and healthcare in meals-on-wheels recipients in NYC

Monday, November 4, 2013

Kavita P. Ahluwalia, DDS, MPH, College of Dental Medicine, Section of Social & Behavioral Sciences, Columbia University, New York, NY
Elaine Wethington, PhD, Human Development, Cornell University, Ithaca, NY
Pathu Sriphanlop, MPH, College of Dental Medicine, Section of Social and Behavioral Sciences, Columbia University, New York, NY
Rachel Sherrow, LCSW, Citymeals-on-Wheels, New York, NY
Cary Reid, MD, Division of Geriatrics and Gerontology, Weill Cornell Medical College, New York, NY
Background: A number of community-based services such as Home Delivered Meals (HDM) are designed to help community-dwelling older adults maintain independence. HDM provides food for homebound older adults, but oral disease and dysfunction which are associated with ability to eat are not addressed. This work, designed to assess difficulty eating and oral health needs among HDM recipients in New York City (NYC), is a first step towards developing oral health interventions for this population. Since HDMs are provided across the nation, these data can inform interventions in other states and settings. Methods: A cross-sectional telephone survey was used to assess difficulty eating and oral health related quality of life in a random sample of HDM recipients with a telephone in NYC, using a 54-item instrument which included items from the Oral Health Impact Profile-14. A second in-depth interview which will provide context to the data is on-going with respondents who reported problems in the survey. Focus groups with HDM stakeholders were conducted to assess the feasibility of integrating interventions in the HDM system. Results: Thirty-eight percent of participants reported difficulty chewing and avoiding foods due to problems with their mouth/teeth/dentures. Average time since last dental visit was over three years, and 40% of visits were symptomatic; the most frequent reason for not using dental services was cost. Implications: Oral disease and dysfunction may result in difficulty eating in this population and access to and utilization of dental services is difficult. Interventions targeting caseworkers/careproviders, policy makers and HDM recipients are feasible.

Learning Areas:

Assessment of individual and community needs for health education
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Describe the importance of oral health for older adults receiving home delivered meals. Explain the relationship between oral health, oral disease and oral dysfunction and ability to eat. Identify opportunities and challenges associated with addressing oral health in older adults receiving home delivered meals.

Keyword(s): Community Research, Aging

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal on a number of grants funded by the CDC, NIH, State Department of Health and Foundations focused on oral health and aging. Much of my work has focused on integrating oral health and healthcare in current care systems.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.