KEY PARAMETERS

• Population targeted: Homebound older adults

• Geographic setting: Urban

• Service delivery setting: Community based

• Services offered: therapeutic meals delivered along with dental care aides (toothbrushes/toothpastes/

denture care kits)

• Number of staff/FTEs dedicated to innovation project: 4

• Total grant funds received: $248,046

• Total project period: Two years (2017 – 2019)

• Total funding leveraged from organization (cash/ in-kind): $124,023

ADDRESSING ORAL HEALTH AND EFFECTIVENESS 

OF HOME DELIVERED MEALS IN NYC

PROJECT PURPOSE

• The goal of the innovation project was to build the evidence needed to improve the effectiveness of home

delivered meals (HDMs) by providing therapeutic meals modified to align with dental/oral function and promoting

oral health and dental care.

PROJECT LENGTH

• Two years

PROJECT COMPONENTS

• Test the utility of oral health items included in the Senior Tracking Analysis and Reporting System (STARS) to

identify clients in need of “modified” meals;

• Develop and deliver modified meals aligned with oral/dental function;

• Coordinate the provision of daily oral care aides, education and linkages to dental care.

ORGANIZATION:

Live ON NY in partnership with Citymeals on Wheels, 

Columbia University College of Dental Medicine (CDM), 

New York City Department for the Aging (DFTA) and others

ADMINISTRATION FOR COMMUNITY LIVING INNOVATIONS IN NUTRITION PROGRAMS AND SERVICES CAPSTONE SERIES

ABOUT US

LiveOn NY is the voice for seniors and the aging services network in NYC. LiveOn NY’s programs ensure that 

older New Yorkers have the supports they need. From training the aging service workforce through workshops 

and technical assistance, to ensuring access to financial support through the Benefits Outreach Program, to 

changing how policies are carried out at the City and State level through our advocacy and more, these 

programs are making a difference in how New Yorkers age.

1
PROJECT IMPACT

• For LiveOn, implementing this project has provided valuable experience in coordinating combined research

and social service endeavors. Through the project, LiveOn staff became far more sensitized to how oral and

dental health can have a major impact on the overall well-being of homebound older adults, as well as the

serious nutritional and dental care needs of this often hard-to-reach population.

ADVICE TO PEERS

• One major piece of advice is that recruiting older adults to participate in dental-nutrition projects requires

extensive, yet compassionate outreach, plenty of patience, and months of highly labor and energy intensive

work. Multiple phone calls, revisions to study-related tools, and polite persuasion were needed to encourage

various participants to respond and participate fully in the project. Reaching the original targeted enrollment

goals proved to be elusive, though considerable progress was made, and the collected qualitative information

was quite illustrative of the dental and nutrition issues that all too many seniors face.

• Future researchers and HDM providers who wish to replicate this project are strongly advised to budget

sufficient financial and staff resources, as well as time, to recruit and sustain engagement of the target

older adult population during all stages of the project. Another important note is to think broadly about the

stakeholders to engage in the work. For example, the team’s engagement with a key partner like the

New York City Department for the Aging (DFTA) to ensure the success of this project was so important, as

their support and cooperation proved helpful in different ways.

nutritionandaging.org

Delays in Getting Institutional Review Board (IRB) Approval

• To facilitate an iterative IRB approval process, the project team submitted the research protocol to the IRB

in stages and had several meetings with the IRB committee. The IRB committee approved the first protocol in

April 2018, which allowed the project team to begin work on client recruitment. The final IRB approval (for

both protocols, as well as the project’s approach to Spanish speaking clients) was received six months later

(September 2018).

2

SUCCESSES AND LESSONS LEARNED

Client Engagement Techniques 

• Multiple calls were deemed to be the most effective method for recruiting project participants, ensuring

completed phone interviews, and successfully completing follow up activities. Pretest of screening tools to

ensure questions are organized in such a way as to reduce or eliminate redundancy and ensure only the

most essential questions are included. Expanding the geographic area and enlisting the support of other

case management agencies for client recruitment also increased enrollment. Using gentle, yet persistent

engagement efforts improved the ability to collect highly probative qualitative information through postintervention interviews.

This project was supported, in part by grant number 90PPNU0001 from the U.S. Administration for 

Community Living, Department of Health and Human Services, Washington, D.C. 20201.C. 20201