Date of Award

5-2020

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Thomas J. Blodgett

Abstract

Obesity is a multifactorial, individualized, chronic disease that increases known risk factors for significant comorbidities and mortality. The primary purpose of this Evidence-Based practice project was to improve indicators of obesity (weight, BMI) among patients served by a free medical clinic, using a tailored multicomponent intervention. The secondary purpose was to determine if the weight loss intervention was associated with a decrease in blood pressure and depression symptoms. The intervention was guided by the Health Promotion Model by Nola Pender. The Johns Hopkins Nursing Evidence Based Practice Model (JHNEBP) guided implementation of the project. A comprehensive literature review was completed in five databases, and strong evidence supported the tailored multicomponent intervention used in this project. Eligible participants (n=26) took part in the 3-month program. Written education materials were provided in English and Spanish, and an interpreter was used when appropriate. Weight, BMI, and BP were measured weekly, then at weeks 8 and 12. The PHQ-9 was measured at baseline and at week 12. Analysis: Continuous outcome variables and dichotomous data were analyzed using the nonparametric equivalent of the paired t-test – the Wilcoxon signed-rank test. A weight or BMI reduction of >3% from baseline is considered clinically significant. Weight significantly decreased from baseline (228.96 lbs., SD = 57.16) to Week 4 (214.87 lbs., SD = 44.68, p = .026). Mean BMI also significantly decreased from baseline (39.87kg/m2, SD = 6.19) to week 4 (38.27 kg/m2, SD = 6.57, p= .028), and from baseline to week 12 (38.64 kg/m2, SD = 6.93, p=.023). Significantly more patients in the intervention group achieved at least 3% weight loss between baseline and Week 12, compared to those who did not receive the intervention (27% vs 16%, p = .034). Depression improved significantly from baseline to Week 12 (p = .014). There were no significant differences in SBP or DBP. Conclusions: Based on these results, a tailored multicomponent weight loss program is effective at reducing weight, BMI, and depression in the primary care setting.

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R. Arnold DNP Poster.pdf (206 kB)
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