Date of Award

5-11-2021

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Jamie Bump

Abstract

The United States (U.S.) is amidst an obesity epidemic, with Indiana ranking as the 15th worst state (Institute of Medicine, 2012; United Health Foundations, 2020). Despite current management strategies, the obesity rate in both the U.S. and Indiana continues to rise (WHO, 2020). Therefore, obesity management must change. The purpose of this evidence-based practice (EBP) project was to determine if the addition of shared medical appointments (SMAs) consisting of informational group sessions by specialists and brief individualized meetings with the provider will result in greater reduction of weight and body mass index (BMI) compared to standard care alone in those with a BMI of greater than or equal to 30 kg/m2. The Iowa model of evidence-based practice was used as a framework to guide the project in a hospital-owned, primary care clinic in Central Indiana. Upon gaining organizational approval of the EBP project, specialists (registered dietician, psychologist, and bariatric nurse practitioner) were secured to provide the educational component of the SMAs. The SMAs were implemented with the support of the primary care providers (PCPs) and clinical staff. To determine if implementation of the SMAs were effective, two-group comparison and between-group comparison analyses were conducted. SMA group (n = 10) data were collected prior to implementation, and at 1, 2, and 3 months post intervention. A retrospective review of non-SMA group (n = 11) data were collected at baseline and at 3-months via medical records. These data were analyzed using an independent t- test and ANOVA to determine the effectiveness of the SMAs. SMAs resulted in greater reduction of BMI when compared to non-SMAs, however the results were not statistically significant (p = 0.833). The results were, however, clinically significant. T-tests run on the difference of BMI in each group from baseline to 3 months, then compared between groups, showed statistical significance (p = 0.023). Implications for practice include the use of SMAs for obesity management, especially when coupled with behavioral counseling and motivational interviewing, as they have shown to have statistically significant results.

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Creative Commons Attribution-NonCommercial 4.0 International License
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