Date of Award

5-10-2019

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Theresa A. Kessler

Abstract

In 2015, the U.S. Department of Health and Human Services published a National Health and Nutrition Survey (NHANES) on obesity from 2011 through 2014. From the survey, it was determined that the prevalence of obesity in the U.S. was 36% in adults and 17% in young adults/children (Ogden et al., 2015). Lifestyle modifications including moderation of caloric intake and increased exercise have been shown to be effective for both prevention and treatment of obesity. The purpose of this evidence-based practice (EBP) project involved the design, administration, and evaluation of a technology-assisted weight loss intervention to address the health problem of obesity. This 12-week weight loss intervention utilized a smartphone anthropometric tracking application, MyFitnessPal®, and text message reminders to obtain the real time tracking of dietary and fitness data. The use of convenient mobile technology enabled data to be self-reported in real time and reinforced responsible behaviors that lead to caloric intake awareness, increased weight loss, and lower BMI in participants. The Health Belief Model (HBM) formed the theoretical framework and guided the behavioral changes necessary to achieve the desired weight loss. A sample was drawn from a family practice (N = 66), 34 participants were recruited for the intervention period and a random sample of 33 participants were selected from electronic charts for comparison from the previous year. One participant was lost to attrition in the intervention group (final n = 33) and the non-intervention group (final n = 33). Participant baseline data included weight, BMI, and self-reported activity. Intervention effectiveness was assessed by comparing baseline to post intervention data. Paired t-test analysis demonstrated significant weight loss from pre-intervention (M = 2.03, SD = 3.54) to post-intervention (M = 9.97, SD = 6.24) (t (32) = -6.46, p < .05). Independent t-test demonstrated significant weight loss in the intervention group (M = 9.97, SD = 6.24) compared to the non-intervention group (M = 5.3333, SD = 4.61) (t (2) = 3.433, p < .001). A one-way ANOVA compared self-reported monthly login entries for caloric intake over 3 months and demonstrated a significant gradual decrease in login entries (F (1,2) = 2.55, p < .05). A one-way ANOVA compared self-reported monthly physical activity; 1st month (M = 1.18, SD = .39), 2nd month (M = 1.24, SD = .44), and 3rd month (M = 1.424, SD = .50). There was a significant increase in self-reported physical activity over the 3-months (F (1, 31) = 5.568, p < .05). Paired t-test analysis demonstrated significant BMI reduction from pre-intervention (M = 42.83, SD = 11.77) to post intervention (M = 41.22, SD = 11.54) (t (32) = 9.47, p <.001). Technology-assisted weight loss interventions utilizing low-cost smartphone applications hold promise because it crosses socioeconomic and geographical barriers when treating overweight or obese patients.

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