Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Christina Cavinder


Diabetes, the seventh leading cause of death in the United States (Centers for Disease Control and Prevention [CDC], 2020a) and the ninth leading cause of death worldwide (World Health Organization [WHO], 2020), has increased by 70% over the last two decades (WHO, 2020). Type 2 diabetes (T2D), the most prevalent type accounting for 90% to 95% of diagnosed cases (CDC, 2020a), affects individuals of all ages and often results in major health problems including stroke, heart attack, and kidney disease. The purpose of this patient-centered, evidence-based practice (EBP) project was to evaluate the effectiveness of a multimodal intervention on hemoglobin A1c (HgbA1c) levels and diabetes self-management (DSM) behaviors. Adults who were 18 years of age or older, had T2D, and desired to make lifestyle changes (n = 33) were recruited at a rural primary care office in Northern Indiana to participate in the project. Participants set individualized, specific, measurable, attainable, realistic, and time-specific (SMART) goals, received a packet containing DSM educational supplements and tools, and received frequent follow-up at 2, 4, and 8 weeks by way of reminder letters and a progress telephone call. Prior to and 12 weeks after enrollment, a HgbA1c level was evaluated, and a self-report DSM questionnaire (DSMQ) was administered. Data were analyzed using paired t-tests to compare pre- and post-intervention HgbA1c levels and DSMQ scores and determine the effectiveness of the multimodal intervention. The primary outcome demonstrated a reduction in mean HgbA1c levels from pre- to post-intervention. Secondary outcomes demonstrated improvements in DSM behaviors related to diet, physical activity, and blood glucose monitoring following implementation of the intervention. Additional secondary outcomes demonstrated individual satisfaction with the intervention, and participants reported helpfulness, benefit, and improved accountability as a result of the intervention. Findings from this EBP project support the use of a multimodal intervention in the treatment plan for diabetic patients and will be discussed.

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

A. Snyder DNP poster.pdf (421 kB)