Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Rebecca L. Peterson


U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search of six databases yielded sixteen pieces of moderate to high-quality evidence supporting lifestyle modifications related to principals of the Mediterranean diet, physical activity, and increased adherence via parental involvement, education, psychosocial support, and frequent follow-up. A sample of 29 Hispanic adolescents, age 10-21, with a history of NAFLD or elevated ALT levels, from an underserved urban pediatric clinic in the Northeastern U.S., were provided an educational intervention based on the Mediterranean diet and physical activity recommendations. Over the next 12 weeks, to promote adherence to the lifestyle changes, four follow-up phone calls were made to promote compliance and provide psychosocial support. Two nutritional educational classes were also offered to all participants. The KIDMED tool was assessed at the beginning and end of the intervention. A Wilcoxon test examined the results of the pre-intervention mean ALT and postintervention mean ALT. No significant difference was found in the results (Z = -1.113, p > .05). The mean pre-intervention was 76.48 (SD = 43.92), and the mean post-intervention was 69.81 (SD = 33.65). These findings suggest more time may be needed to assess the longitudinal benefits of lifestyle interventions on NAFLD in Hispanic adolescents. Future research should address preventable health care disparities related to poor nutrition and improve access to healthy, affordable food in low-socioeconomic neighborhoods.

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.

B. Miller DNP poster.pdf (100 kB)