Community-academic partnership to address oral health and healthcare in meals-on-wheels recipients

Background: Community-based senior services are designed to help community-dwelling older adults maintain independence and prevent institutionalization. Daily home meal delivery, also known as Meals-on-Wheels (MOW), is designed to provide food and nutrition for older adults unable to prepare meals due to cognitive/physical impairments. Although MOW has been in existence for almost 40 years, and serves one million Americans daily, there has been no systematic examination of this public health system's potential utility to deliver interventions which may prevent future institutionalization. A community-academic partnership was convened in NYC to address oral health among MOW recipients because almost 30% of NYC MOW recipients have difficulty eating due to problems with their teeth or mouth and oral health is central to food consumption and ensuring MOW delivers meals recipients can actually eat. Methods: The partnership, headed by Citymeals-on-Wheels, Columbia University College of Dental Medicine and Weill-Cornell Medical College brought together MOW stakeholders and researchers to collaborate on capacity-building and future funding initiatives. Data from focus groups, key-informant interviews and survey research were used to develop appropriate interventions that can be integrated into MOW systems in order to promote sustainability and effectiveness. Results: NYC's Department for the Aging (DFTA) has included additional oral health items on system-wide screening and enrollment instruments, and funding has been secured for the delivery of toothbrushes/toothpaste to meal recipients. Key stakeholders (NY State DOH, DFTA, foundations and industry) have been engaged, and plans are underway to implement and test interventions to improve meal recipients' oral health and healthcare.