Objectives. We provided oral health care services at 2 sites using a nurse practitioner–dietitian team to increase dental workforce capacity and improve access to care for low-income preschool children. Methods. Our team provided oral health assessments and education, fluoride varnish application, and dentist referrals. The primary endpoint was participants’ access to oral health care. Secondary endpoints included increasing the practice scope of registered dietitians through training programs for oral health assessment and the application of fluoride varnishes for children. The oral health and hygiene and dietary habits of the participants were also determined. Results. From 2010 to 2013, 4360 children received fluoride varnishes in 7195 total visits. Although the proportion of children with dental caries at the first visit was greater at the urban site, both sites were similar by visits 2 and 3. The number of caries declined with increased program visits, which coincided with an increase in the proportion of participants visiting a dentist. Conclusions. Progress toward eliminating dental health disparities requires addressing barriers to dental care access. We showed that expanding access to oral health services through nurse practitioner–dietitian cooperation improved access to preventive fluoride varnishing use in low-income children.

The purpose of this qualitative study was to explore the challenge of self-management of diet in African-American women living with type 2 diabetes. Specifically, the women were asked to talk about dietary challenges of managing diabetes in the context of their personal lifestyle factors, such as daily routines, family responsibilities, and individual needs. Using a phenomenological approach, a descriptive, exploratory design was implemented using four facilitated focus groups. A convenience sample of 24 African-American women was recruited from a family practice center in the midwest. Data from each of the four focus groups were audiotaped and transcribed verbatim. Themes were compared and contrasted within and across each of the four focus groups until consensus was reached. Four themes were identified: frequent difficulties in changing dietary habits, need for individual guidance, support, and misinformation gaps. Overall, the participants expressed the need for more attention to the personal lifestyle factors they viewed as obstacles to managing diabetes.

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