{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T07:08:13Z","timestamp":1788764893432,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004515","name":"Universiti Kebangsaan Malaysia","doi-asserted-by":"publisher","award":["GUP\u20102024\u2010049"],"award-info":[{"award-number":["GUP\u20102024\u2010049"]}],"id":[{"id":"10.13039\/501100004515","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Gerodontology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Domiciliary oral care services (DOMS) are important for older adults who are frail, homebound or dependent on others for access to care. In Malaysia, implementation remains limited despite growing oral health needs in an ageing population. This study aimed to co\u2010create and prioritise practical strategies to strengthen DOMS for older adults in Malaysia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative participatory co\u2010creation design was used. Twelve purposively selected stakeholders from academia, clinical practice, professional bodies and community\u2010related sectors participated in a multi\u2010stage process involving context\u2010setting, small\u2010group brainstorming and a co\u2010creation workshop. Identified barriers and proposed strategies were then rated by all 12 participants for perceived feasibility and expected impact using a 5\u2010point Likert scale. Consensus was defined a priori as at least 80% agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Stakeholders identified barriers across four domains: policy and regulatory environment; patient, caregiver, and public engagement factors; workforce capability and professional readiness; and service\u2010delivery and resource constraints. DOMS implementation was perceived to be limited by regulatory ambiguity, insufficient workforce preparedness, coordination challenges and underdeveloped service models. Strongly supported strategies included regulatory clarification, continuing professional training, integrated care pathways involving other healthcare providers, temporary clinic arrangements and partnership\u2010based service support. Undergraduate curriculum reform and broader inter\u2010professional development were viewed as important but less immediately feasible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Strengthening DOMS for older adults in Malaysia will require a phased, system\u2010oriented approach. Near\u2010term priorities include clearer regulatory guidance, targeted workforce development, improved cross\u2010sector coordination and practical partnership\u2010supported delivery models. These findings provide stakeholder\u2010informed directions for policy and service planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ger.70122","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T06:22:30Z","timestamp":1788762150000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prioritising Strategies to Strengthen Domiciliary Oral Care for Older Adults in Malaysia: A Stakeholder Co\u2010Creation Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8587-0408","authenticated-orcid":false,"given":"Afsary Jahan","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Family Oral Health, Faculty of Dentistry Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7660-4095","authenticated-orcid":false,"given":"Haslina","family":"Rani","sequence":"additional","affiliation":[{"name":"Department of Family Oral Health, Faculty of Dentistry Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"},{"name":"Family Oral Wellness Research Group Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3122-3971","authenticated-orcid":false,"given":"Tew","family":"In Meei","sequence":"additional","affiliation":[{"name":"Family Oral Wellness Research Group Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"},{"name":"Department of Restorative Dentistry, Faculty of Dentistry Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8290-9776","authenticated-orcid":false,"given":"Muhammad Syafiq Asyraf","family":"Rosli","sequence":"additional","affiliation":[{"name":"Department of Family Oral Health, Faculty of Dentistry Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"},{"name":"Family Oral Wellness Research Group Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7620-4008","authenticated-orcid":false,"given":"Aznida Firzah Abdul","family":"Aziz","sequence":"additional","affiliation":[{"name":"Family Oral Wellness Research Group Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"},{"name":"Department of Family Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2034-4834","authenticated-orcid":false,"given":"Nur Saadah Mohamad","family":"Aun","sequence":"additional","affiliation":[{"name":"Centre for Research in Psychology and Human Well\u2010Being, Faculty of Social Sciences and Humanities Universiti Kebangsaan Malaysia  Bandar Baru Bangi Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9399-9305","authenticated-orcid":false,"given":"Melissa","family":"Adiatman","sequence":"additional","affiliation":[{"name":"Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry University of Indonesia  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0575-8382","authenticated-orcid":false,"given":"Tuti Ningseh","family":"Mohd\u2010Dom","sequence":"additional","affiliation":[{"name":"Department of Family Oral Health, Faculty of Dentistry Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"},{"name":"Family Oral Wellness Research Group Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,6]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Ageing and Health","author":"World Health Organization","year":"2024"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1111\/ger.12649","article-title":"Oral Health and Oral Health\u2010Related Quality of Life Among Older Adults Receiving Home Health Care Services: A Scoping Review","volume":"40","author":"Henni S. 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A. C.","year":"2017","journal-title":"Gerodontology"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1741-2358.2012.00637.x","article-title":"Oral Health Care and Aspiration Pneumonia in Frail Older People: A Systematic Literature Review","volume":"30","author":"Van der Maarel\u2010Wierink C. D.","year":"2013","journal-title":"Gerodontology"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.25259\/JGOH_2_2024"},{"key":"e_1_2_11_9_1","volume-title":"Guidelines for Domiciliary Dental Health Services","author":"Ministry of Health Malaysia","year":"2021"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"2642","DOI":"10.3390\/healthcare13202642","article-title":"Challenges and Recommendations for Oral Healthcare of Older Adults in a Long\u2010Term Care Facility","volume":"13","author":"Rani H.","year":"2025","journal-title":"Health"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/ger.12023","article-title":"Malaysian Government Dentists' Experience, Willingness and Barriers in Providing Domiciliary Care for Elderly People","volume":"31","author":"Othman A. A.","year":"2014","journal-title":"Gerodontology"},{"key":"e_1_2_11_12_1","volume-title":"National Oral Health Strategic Plan 2022\u20132030","author":"Oral Health Programme, Ministry of Health Malaysia","year":"2022"},{"key":"e_1_2_11_13_1","volume-title":"My Ageing Dashboard","author":"Department of Statistics Malaysia","year":"2023"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1002\/j.0022-0337.2014.78.8.tb05786.x","article-title":"Undergraduate Education in Special Needs Dentistry in Malaysian and Australian Dental Schools","volume":"78","author":"Ahmad M. S.","year":"2014","journal-title":"Journal of Dental Education"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1093\/pubmed\/fdz126","article-title":"Identifying Evidence of Effectiveness in the Co\u2010Creation of Research: A Systematic Review and Meta\u2010Analysis of the International Healthcare Literature","volume":"43","author":"Halvorsrud K.","year":"2019","journal-title":"Journal of Public Health (Oxford, England)"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","DOI":"10.3389\/froh.2024.1355429","article-title":"A Stakeholder Co\u2010Design Approach to Designing a Dental Service for Adults Experiencing Homelessness","volume":"5","author":"Cairns D.","year":"2024","journal-title":"Frontiers in Oral Health"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample Size in Qualitative Interview Studies: Guided by Information Power","volume":"26","author":"Malterud K.","year":"2016","journal-title":"Qualitative Health Research"},{"key":"e_1_2_11_18_1","volume-title":"Integrated Care for Older People (ICOPE): Guidelines on Community\u2010Level Interventions to Manage Declines in Intrinsic Capacity","author":"World Health Organization","year":"2019"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.14917"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010021\u201006788\u20104"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cegh.2024.101544"}],"container-title":["Gerodontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ger.70122","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ger.70122","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ger.70122","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T06:22:34Z","timestamp":1788762154000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ger.70122"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,6]]},"references-count":20,"alternative-id":["10.1111\/ger.70122"],"URL":"https:\/\/doi.org\/10.1111\/ger.70122","archive":["Portico"],"relation":{},"ISSN":["0734-0664","1741-2358"],"issn-type":[{"value":"0734-0664","type":"print"},{"value":"1741-2358","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,6]]},"assertion":[{"value":"2026-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ger.70122"}}