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Date of Award

5-16-2012

Degree Type

Restricted Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Theresa A. Kessler

Abstract

Obesity is epidemic in the United States and disproportionately affects low-income, minority women. To address the problem of obesity in low-income women, an evidence-based practice (EBP) project was implemented at a free health care clinic in the Midwest. The PICOT question addressed by this EBP project was: In obese, low-income women who desire weight loss, will a 12-week group nurse-led behavioral intervention result in increased nutrition and physical activity self-efficacy? The Stetler model of evidence utilization and social cognitive theory were used as frameworks for project planning and implementation. Synthesis of the literature supported a 12-week group intervention designed to enhance nutrition and encourage walking as a means of physical activity. Dietary changes focused on portion control, increased servings of fruits and vegetables, and substituting water for sugary beverages. Pedometers were worn in order to monitor steps and motivate physical activity. Weekly meetings included group discussion that encouraged problem solving, goal setting and peer support. The mean age of the women participating was 44 (SD = 13.4). The sample was ethnically diverse with nine self-identified as Caucasian (39%), seven as Hispanic (30%), and seven as African-American (30%). All participants were medically uninsured with income identified as 200% of the federal poverty level. Data included nutrition and physical exercise self-efficacy scores; biometric measures of weight, BMI, and waist circumference; and a log of self-reported diet and exercise habits. At project end, paired t-tests revealed a statistically significant improvement in nutrition self-efficacy scores (p =.03). Outcome data also demonstrated a statistically significant improvement in weight, BMI, dietary intake and physical activity (p < .05). The results of this EBP project reinforced that a nurse-led weight loss intervention is effective. Replication of this EBP project could serve as model for combating the obesity epidemic in low-income women.

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