ORIGINAL ARTICLE MT Rosedale SM Strauss N Kaur C Knight D Malaspina Authors’ affiliations: MT Rosedale, New York University College of Nursing and Department of Psychiatry, New York University School of Medicine, New York, NY, USA SM Strauss, N Kaur and C Knight, New York University College of Nursing, New York, NY, USA D Malaspina, Department of Psychiatry, New York University School of Medicine, New York, NY, USA Correspondence to: SM Strauss New York University College of Nursing 433 First Avenue, 6th Floor New York, NY 10010, USA Tel.: (212) 998 5280 Fax: (212) 995 3143 E-mail: ss4313@nyu.edu Dates: Accepted 17 February 2016 To cite this article: Int J Dent Hygiene DOI: 10.1111/idh.12214 Rosedale MT, Strauss SM, Kaur N, Knight C, Malaspina D. Follow-up with primary care providers for elevated glycated haemoglobin identified at the dental visit. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Follow-up with primary care providers for elevated glycated haemoglobin identified at the dental visit Abstract: Objectives: This study examined patient experiences after receiving elevated diabetes screening values using blood collected at a dental clinic. It explores patients’ reactions to screening, whether or not they sought recommended medical follow-up, and facilitating factors and barriers to obtaining follow-up care. Methods: At the comprehensive care clinics at a large, urban College of Dentistry in the United States, haemoglobin A1C (HbA1C) values were obtained from 379 study participants who had not been previously diagnosed with diabetes. In all, 169 (44.6%) had elevated HbA1C values. We analysed quantitative and qualitative data concerning these patients’ follow-up with primary care providers (PCPs). Results: We were able to contact 112 (66.3%) of the 169 study participants who had an elevated HbA1C reading. Of that group, 61 (54.5%) received recommended follow-up care from a PCP within 3 months, and an additional 28 (25.0%) said they intended to seek such care. Qualitative themes included the following: the screening letter – opportunity or burden, appreciation for the 3-month follow-up call and barriers to medical follow-up that included the following: lack of knowledge about diabetes, not understanding the importance of follow-up, busyness, financial concerns, fear and denial. Conclusions: Quantitative and qualitative data demonstrate that dentists, dental hygienists and nurses are well poised to discover and translate new models of patient-centred, comprehensive care to patients with oral and systemic illness. Key words: dentistry; diabetes; interprofessional collaboration; mixed-methods research; nursing; prediabetes; screening Introduction In 2012, 29.1 million Americans had diabetes, including an estimated 8.1 million who were undiagnosed (1). Additionally, an estimated 86 million U.S. adults had prediabetes that year (1), a condition that often progresses to diabetes in the absence of lifestyle changes (2), with the vast majority unaware of their prediabetes status (3). To reduce the number of persons with undiagnosed prediabetes and diabetes, some have suggested imple- menting screening at unconventional sites of opportunity, such as pharma- cies, optometry practices and community churches (4–6). Because many adults visit a dentist each year (7), and because there is a bidirectional relationship between periodontal disease and diabetes (8), the dental visit has also been identified as an opportune site for diabetes screening. There is a growing need to discover new ways to provide patient-centred, Int J Dent Hygiene | 1