The SPACES Framework: Sustainable Oral Health Programs for Older Adults

Area of Science:

• Gerontology
• Public Health
• Health Services Research

Background:

• Traditional community oral health programs (COHPs) are often reactive and siloed, failing to meet the complex needs of older adults.
• Older adults face challenges like multimorbidity, mobility issues, and access barriers that traditional COHPs do not adequately address.
• Existing programs lack integration with medical, social, and aged-care systems, limiting their effectiveness.

Purpose of the Study:

• To propose SPACES, an implementation-oriented conceptual framework for designing, delivering, and evaluating community oral health programs for older adults.
• To provide a structured approach for addressing the unique oral health needs of the aging population.
• To guide the development of more effective and integrated oral health services for seniors.

Main Methods:

• A targeted interpretive synthesis of literature, policy guidance, and implementation science sources was conducted.
• Sources focused on oral health, healthy aging, integrated care, access barriers, workforce development, and sustainable service delivery.
• The synthesis informed the development of the SPACES framework's six interconnected domains.

Main Results:

• The SPACES framework comprises six domains: Scalable Prevention and Education, Partnerships Across Sectors, Adaptive Care Coordination, Community Access Solutions, Empowered Workforce Development, and Sustainable Service Models.
• It integrates evidence-informed components for older adult oral health, including screening, caregiver support, risk-stratified prevention, and proximity-based delivery.
• The framework is adaptable for adults aged 60+ or 65+ and applicable across various care settings.

Conclusions:

• SPACES is a conceptual tool to aid program planning, clarify roles, identify equity gaps, and align resources for older adult oral health.
• It is not a tested intervention but a guide for improving program design and evaluation.
• Further stakeholder refinement and empirical evaluation are necessary to assess its real-world feasibility, acceptability, cost, and impact on oral health outcomes.