Date of Award
Evidence-Based Project Report
Doctor of Nursing Practice (DNP)
Lindsay A. Munden
Hyperlipidemia is a key risk factor in cardiovascular mortality, and is prevalent in approximately 38% of American adults (CDC, 2022b). Cholesterol levels are intensified by unhealthy lifestyle choices, which means a change in lifestyle behaviors could prevent cardiovascular related deaths (WHO, 2022). The PICOT question for this project was: In adults aged 20 years or older in the primary care setting who have elevated low-density lipoprotein (LDL) levels (P), does the implementation of behavioral counseling on lifestyle modifications (I) compared to current practice (C) decrease LDL levels (O) over a 10- to 12- week period (T)? Fourteen participants from a small direct primary care clinic in Indiana completed the entirety of the project. LDL levels were measured pre-intervention, along with a rapid assessment of physical activity (RAPA) and the rate your plate (RYP) tool, blood pressure (BP), body mass index (BMI), weight, and atherosclerotic cardiovascular disease (ASCVD) risk scores. The nurse practitioner initiated a behavioral counseling session on lifestyle modifications, assisted by educational handouts, and created three healthy goals with the participant. A follow-up telephone counseling session was scheduled at five weeks to review those goals, followed by an in-person counseling session at 10- to 12- weeks. LDL levels were redrawn and the RYP and RAPA tools, weight, BMI, BP and ASCVD scores were completed once more to show a within-group evaluation of pre- and post-intervention outcomes. A paired t-test was used for analysis, and statistically significant data was found by increased RYP scores (p = .001), increased RAPA scores (p = .004), weight reduction (p = .035), BMI reduction (p = .026), systolic BP reduction (p = .025), and ASCVD score reduction (p = .002). There was no statistical significance in LDL reduction (p = .051); however, there was still a decrease in mean scores pre- (137.36) and post- (114.43) intervention. These findings support the use of behavioral counseling for lifestyle modifications in patients with elevated LDL levels.
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Hansen, Blake L., "The Effect of Implementing Behavioral Counseling for Elevated LDL Levels" (2023). Evidence-Based Practice Project Reports. 191.