Medicine and Health Sciences Commons^™

Implementing Community Health Workers To Improve The Management Of Chronic Non-Communicable Diseases In Children, Julia L. Newell

Doctor of Nursing Practice (DNP) Projects

Background: Childhood obesity, asthma, and untreated mental health conditions are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Minority children from low-income families, especially those with environmental disadvantages, face additional risk factors for the development of these diseases. Community health workers (CHWs) are in a unique position to help address these negative health externalities by being attuned with the linguistic, cultural, and socioemotional needs of members of their communities. Research has demonstrated success in CHW-led interventions curtailing the negative impacts associated with these diseases in low-income, minority communities.

Methods: A literature …

The Effect Of Obesity On Comorbidities: A Benchmark Study, Kaley Nolen

MSN Capstone Projects

Obesity is distinguished by a body mass index (BMI) greater than 30. Tremmel et al. (2017) reports obese individuals are at a greater risk for developing cardiovascular disease, diabetes, and cancer. In 2014, approximately 641 million adults were classified as obese (Zhang et al., 2018). This epidemic has drastically worsened over the last two decades resulting in obesity ranking as the fifth most common cause of death globally (Safaei et al., 2021). Okunogbe et al. (2021) states, slowing the incidence rate of obesity by 5% will save approximately $3.3 billion annually between 2020-2060. The pathophysiology and cause of obesity is …

Community Health Worker Program: Chronic Non-Communicable Diseases In Children, Julia L. Newell

DNP Qualifying Manuscripts

Abstract

Background: Childhood obesity, asthma, and untreated mental health conditions, are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Community health workers (CHWs) are in a unique position to address these negative health externalities by leveraging linguistic, cultural, and socioemotional connectedness within their communities.

Local Problem: Minority children in the Central Valley of California, face additional risk factors for the development of CNDs. CHWs working in this area require enhanced training on CNDs to improve their practice.

Methods: In partnership with Save the Children (STC), the University of San Francisco (USF) …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

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 …

Health Promotion Module For Migrant Youth Adults In Obesity Prevention: A Pilot Project, James Chongsu Wong

Doctoral Projects

The obesity epidemic continues to worsen. It is estimated there are over one half billion adults worldwide struggling with obesity. In the United States of America, 42% of the adults and over 15 million children are obese. Obesity leads to a myriad of other chronic diseases such as diabetes mellitus, hypertension, and hyperlipidemia. With an annual spending exceeding 173 billion dollars, obesity not only has a negative impact on quality of life but also a huge economic impact on the health care system.
This quality improvement project utilized 4 educational modules as intervention and measured the mean changes using a …

Nutritional Medicine: Education For Advanced Practice Providers, Natalie Organ

DNP Research Projects

Abstract

OBJECTIVE: The project's primary goal was to educate the APP and develop positive attitudes and beliefs concerning plant-based nutrition regarding obesity, diabetes, cardiovascular disease, and cancer. The project addressed a crucial gap in healthcare education. APPs were not routinely given the chance to learn nutritional medicine, leading to decreased confidence in providing nutritional guidance in clinical practice.

METHODS: The DNP project participants were practicing advanced practice providers. The Knowledge, Attitude, Behavior (KAB) education theory and CREATION Life were used. This project used Qualtrics to send a pre-and post-intervention survey titled Student Survey for Nutritional Medicine. The intervention was a …

Childhood And Adolescent Obesity: Related Comorbidities And Interventions, Jasmine Wong

Nursing | Senior Theses

Background

The prevalence of childhood and adolescent obesity in the United States has steadily risen over the years and has become a public health concern. Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex. Obese children and adolescents are at risk for poor health and poor quality of life. Furthermore, there are numerous comorbidities associated with childhood and adolescent obesity. While some of the associated diseases are acute, others can become chronic and result in lifelong conditions.

Objective

The purpose of the present thesis is to explore …

The Emerging Epidemic Of Type 2 Diabetes And Obesity Amongst Young Children, Juliana Morales

Nursing | Senior Theses

Background:

In the past years childhood obesity has increased tremendously and currently ⅓ of children in the United States are obese today. Obesity and Type 2 Diabetes are illnesses that can later on lead to more severe health complications when as a child enters adulthood. Children who are obese have a greater risk of developing Type 2 diabetes, and currently more than 80% of children who already are diagnosed with Type 2 diabetes are obese. In school and often by health care providers we are told daily physical activity and healthy diet are the best ways to maintain optimal health, …

Increased Access To Physical Activity For School-Aged Children In Community Settings, Kathleen Cobb, Alexandra Peary, Ashley Ricker, Leah Wilcox

Non-Thesis Student Work

Childhood obesity has reached unprecedented levels in the United States, which often continues into adulthood. Physical activity (PA) has shown to be an effective strategy in combating obesity in children by improving cardiovascular health and decreasing metabolic disease in adulthood. This literature review explored the effect of increased access to PA opportunities in community settings on the amount of time children ages 5-18 spent being physically active. Search of the literature included Google Scholar and CINAHL databases using the following terms: “child*,” “obesity,” “physical activity OR exercise,” “built environment,” and “school.” Inclusion criteria included peer-reviewed articles published from 2017-2022 with …

Implementation Of Nola Pender’S “Clinical Assessment For Health Promotion Plan” To Increase Patient Self-Efficacy, Weight Loss And Health Promoting Behaviors Such As Improving Nutrition And Increased Physical Activity In Obese Women In A Weight Loss Clinic, Christine Ngwazini

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to review research-based studies on Nola Pender’s Health Promotion Model for weight loss and implement the evidence. The goal was to increase patient self-efficacy, weight-loss, and health promoting behaviors such as improved nutrition and increased physical activity among obese women in a weight loss clinic.

Background: Obesity leads to an increased risk of heart disease, stroke, type 2 diabetes, cancer, and premature death (CDC, 2020). From 2016 to 2017, 42.4% of people in the United States were obese (2020). Worldwide, over 650 million people were obese …

Diet, Exercise, Self-Monitoring, Technology, And Motivational Interviewing For Weight Loss In Adults, Ashleigh D. Warburton

Evidence-Based Practice Project Reports

Obesity, an epidemic in the United States (US), affected 42.4% of adults as of 2017-2018 (Hales, 2020). Comorbidities associated with obesity, such as cardiovascular disease, cancer, and diabetes (Orringer et al., 2020), are some of the leading causes of death in the US (Kochanek et al., 2020). The purpose of this evidence-based practice (EBP) project was to answer the following PICOT question: In adult patients aged 19 years or older who are considered overweight or obese as measured by body mass index (BMI) of ≥ 25 kg/m2 (P), how effective is diet and exercise combined with self-monitoring, a phone application, …

Health Equity & Obesity Management: An Improvement Project In A Federally Qualified Healthcare Center In Central Harlem, Brianna Bouchez

Doctor of Nursing Practice Scholarly Projects

Description of the problem: Obesity is a growing healthcare problem worldwide with extraordinary costs to the individual's health and the healthcare system. Individuals most affected by obesity include socioeconomically disadvantaged individuals, often with limited resources to seek specialized care.

Available knowledge: Various weight-loss interventions exist but access and success rates vary. Weight loss is often modest and additional factors such as social determinants of health, health literacy, and patient motivation are all factors important to the success of an intervention.

Specific Aims: The purpose of this quality improvement project was to improve self-regulatory weight loss behaviors and increase weight loss …

Weight Management Program Using Myfitnesspal© In A Rural Primary Care Setting, Taylor Rittman

The Eleanor Mann School of Nursing Student Works

Obesity is a growing health concern that is linked to the development of chronically debilitating physical and mental illnesses. Obesity is a result of a long-term positive imbalance between energy intake and energy expenditure. Evidence has shown more than one third of U.S. adults suffer from obesity. Primary care providers in the United States report being overburdened in treating obesity, citing a lack of time, structured approach, and structured resources. Furthermore, the disparities in obesity are even more prevalent in rural areas where older adults are the fastest growing part of the population at risk for this disease. Evidence indicates …

Implementing Obesity And Comorbidity Education In A Faith-Based Setting, Tammy Lynn

Doctor of Nursing Practice Projects

The aim of the study was to increase knowledge of the damaging consequences of obesity and related comorbidities. Obesity has reached epidemic proportions on a global scale and increases the potential health risk of many associated diseases. Faith-Based organizations have been found to be optimal resources for public health education. The shared beliefs and comradery are a source of support and encouragement for those who face many of life’s challenges, as well as life’s joys. The purpose of the project was to investigate the effectiveness of education delivered in a Baptist church on the topics of obesity and related comorbidities. …

Evaluating The Indirect Effects Of A Community-Based Child Obesity Prevention Program On Adult Health Behaviors, Emily K. Rocheleau

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose: Community-based intervention (CBI) programs aim to change individuals’ behaviors to reduce the risk of chronic disease, often by addressing factors that contribute to obesity. To provide information for improving interventions, program evaluation is needed. In Franklin and Grand Isle Counties, childhood extreme obesity decreased where a child-targeted, obesity prevention focused CBI was implemented. It has been shown that these programs can have an indirect effect on parent health/body mass index (BMI), but it is unclear if indirect effects of such programs have an impact on adult BMI and related health behaviors. The purpose of this project was to determine …

Thinking Inside The Food Pantry Box, Elizabeth Shoaf

Doctor of Nursing Practice Projects

Background: Prior research has indicated a varying relationship between food security and obesity risk. Food insecurity is a known complication of men and women’s underlying health issues, such as hypertension and diabetes, because of altered food choices.

Objective: Provide healthier food options to the food insecure within the facility’s food distribution boxes, as available, for the two most common health issues (diabetes and high blood pressure).

Methods: Clients at a local food pantry were interviewed individually to learn more about food insecurity and complicating health issues, such as obesity, diabetes, and high blood pressure (hypertension) while simultaneously offering alternative food …

The Physiological Benefits Of A Plant-Based Diet On Cardiovascular Health, Jenevieve Petray

Nursing | Senior Theses

Cardiovascular disease (CVD) is increasingly more prevalent in today’s society and is attributed to an alarming percentage of American hospitalizations and deaths. Americans are unhealthier than ever before, and the main contributor is the Western diet. Diet is a double-edged sword that can offer benefits or detriments to one’s health. CVD encompasses numerous diagnoses originating from various underlying physiological alterations. These alterations are downstream effects of increased body weight and BMI, increased cholesterol levels, decreased insulin sensitivity and increased arterial plaque buildup. Research shows that a plant-based diet has the potential to manage and reverse all fundamental physiological alterations that …

How Physical Activity Implementation Strategies Changed During The Covid-19 Pandemic In Schools Enrolled In The Let’S Go! Program, Alexandra Peary

Honors College

Childhood obesity is a serious public health issue in the United States. Many children fail to meet the recommended daily physical activity of 60 minutes. Poor metabolic health at a young age puts children and adolescents at a significantly higher risk of developing chronic health issues in adulthood. With the potential to further exacerbate the obesity epidemic, the onset of the Covid-19 pandemic challenged students’ abilities to participate in structured physical activity, such as recess and physical education, due to school closures, strict social distancing guidelines, and hybrid or remote models of learning. This lack of structure and opportunities for …

Food Addiction And Obesity, Lisa Ling

Electronic Theses and Dissertations

The obesity rate in the U.S. adult population has increased to epidemic levels despite attempts to decrease obesity through evidence-based knowledge, clinical practice guidelines, medical interventions, and individual efforts. For certain individuals, food addiction behaviors such as food cravings, loss of control, and binge eating contribute to obesity and require a different approach to care. Little work has been done on adding the possibility of food addiction to obesity screening and treatment. This study utilized a quasi-experimental quantitative pre- and postsurvey research design based on Lewin’s change theory. Nurse practitioners were surveyed regarding the provider’s perceptions, attitudes, and beliefs about …

Better Together? The Effects Of Shared Medical Appointments On Bmi In Obese Adults, Amanda Larson

Evidence-Based Practice Project Reports

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 …

Body Mass Index, Waist Circumference, And Hemoglobin A1c In The Lower Income African Americans, Lisa Gabel, Joci Verb, Lauren Windham

Williams Honors College, Honors Research Projects

The Honors project is in conjunction with a larger, state funded, intervention study, the Finding A Better U! (FABU) project, by Carolyn J. Murrock, PhD, RN, Mary Jo MacCracken, PhD, Judi-Juvancic-Heltzel PhD, and Alex Holt. While the larger study focuses on the effects of a weekly exercise and nutrition intervention on cardiovascular disease (CVD) and type 2 diabetes (T2DM) outcomes, the honors project will analyze data to determine preliminary findings, specifically, the relationship between body mass index (BMI), waist circumference, and hemoglobin A1C in the lower income African Americans (AA). The honors students will also assist the FABU team in …

Association Between Dietary Macronutrient Intake And High-Sensitivity C-Reactive Protein Levels Among Obese Women In Kuantan, Malaysia, Siti Zuhaidah Shahadan, Azlina Daud, Muhammad Ibrahim, Muhammad Lokman Md. Isa, Samsul Draman

Makara Journal of Science

Elevated high-sensitivity C-reactive protein (hs-CRP) levels may be associated with an increased risk of cardiovascular disease (CVD). In general, an individual’s dietary intake may influence the hs-CRP level. However, evidence on the influence of dietary macronutrient intake on hs-CRP levels among obese Malaysian women remains fragmented. Therefore, this study aims to investigate the association between the hs-CRP level and dietary macronutrient intake of obese adults living in Kuantan. The assessment of 24-hour dietary recall and venous hs-CRP levels were investigated in 67 women with a body mass index of 27.5 to 39.9 kg/m². The findings revealed that obese women living …

Exploring The Relationship Between Dietary Self-Monitoring With A Mobile App And Weight Change, Jason Payne

Electronic Theses and Dissertations

Background: Approximately 70% of the adult population in the United States has overweight or obesity and increased risk for developing chronic diseases. Dietary self-monitoring adherence using a paper diary is associated with weight loss; however, few studies have examined this association with dietary self-monitoring apps. Objectives: 1) explore if an association exists between app-based dietary self-monitoring and weight change among adults with overweight or obesity and 2) explore the relationships between the frequency, consistency, and completeness of self-monitoring and weight change. Methods: Participants self-monitored dietary intake for 8 weeks using the app Calorie Counter by FatSecret. Participants were assigned …

A Multicomponent Tailored Intervention Program Protocol For Weight Loss In An Underserved Adult Patient Population With Obesity, Rita R. Arnold

Evidence-Based Practice Project Reports

Obesity is a multifactorial, individualized, chronic disease that increases known risk factors for significant comorbidities and mortality. The primary purpose of this Evidence-Based practice project was to improve indicators of obesity (weight, BMI) among patients served by a free medical clinic, using a tailored multicomponent intervention. The secondary purpose was to determine if the weight loss intervention was associated with a decrease in blood pressure and depression symptoms. The intervention was guided by the Health Promotion Model by Nola Pender. The Johns Hopkins Nursing Evidence Based Practice Model (JHNEBP) guided implementation of the project. A comprehensive literature review was completed …

The Effects Of A Nutritional Intervention On Healthy Eating Habits And Body Mass Index, Kelley Eshenaur

Evidence-Based Practice Project Reports

In the US, overweight and obesity are growing concerns, as both can have life altering consequences if not prevented or treated. Since 2000, there has been nearly a 10% increase of adults who are obese, from 30.5% (85.8 million) to 39.8% (93.9 million) in 2016 (CDC, 2017). These conditions are preventable with early intervention and motivation. Obesity statistics are especially of interest during the transition to young adulthood. The purpose of this project was to improve student outcomes by identifying barriers, effective strategies, and healthy choices that would ultimately impact weight, increasing healthy food choices, and decreasing overall BMI in …

Implementing A Health Promotion Physical Activity Program For Middle School Youth In A Rural, Faith-Based Organization, Karmin Maher-Hasse

Doctor of Nursing Practice Projects

Problem: Childhood obesity is more prevalent in rural areas, and these areas have fewer resources to address it. Geographic distance to available resources, health care provider shortages, parental obesity, and poverty contribute to higher prevalence of obesity in rural children compared to urban children.

Rationale: Obesity prevention and treatment often requires long-term healthy lifestyle behavior changes including nutrition counseling and physical activity (PA). It is likely an obese pre-adolescent will have obesity as an adult, and the likelihood increases if obesity continues into adolescence. Pre-adolescence provides a window of opportunity to influence healthier PA habits to prevent overweight (OW) and …

Provider-Led Intervention For Overweight Or Obese African American Women Ages 18-65 With A Bmi 25 Kg/ M₂, Tonya A. Harvey

Evidence-Based Practice Project Reports

Overweight and obese African American women tend to suffer most from the impacts of diseases, health disparities, disabilities, and decreased qualities of life (Sutton et al., 2016). Most weight loss programs are not culturally specific, despite the benefits of dietary changes and increased physical activity for all groups. The purpose of this EBP project was to implement a provider-led program including lifestyle, dietary, and activity components to decrease weight, BMI, waist circumference and blood pressure in African American women. The Iowa Model of Evidence-Based Practice to promote quality care was used to guide the EBP project, aimed to address obesity …

Community Cooking Course To Combat Nutritional Knowledge Deficit, Heather R. Bohman

MSN Capstone Projects

More than two-thirds of American adults and almost one-third of American children are overweight or obese. Not only are the statistics alarming, the cost of obesity is staggering. Obesity robs an individual of their quality of life and costs the U.S. healthcare system an estimated $147 billion a year in obesity-related illness (Finkelstein, Trogdon, Cohen, & Dietz, 2009). The need to find solutions to improve the health of Americans is clear and communities are called to respond. The Centers for Disease Control and Prevention (CDC, 2018) recommends partnership with local agencies to promote obesity prevention initiatives and create a healthier …

Increasing Healthy Lifestyle Behaviors In Cargo Drivers, Ronda L. Bell

Electronic Theses and Dissertations

The purpose of this project was to examine the extent to which lifestyle behaviors of transportation drivers in North Texas can be improved with health education. This research study was conducted to examine the health behaviors of transportation drivers as a result of an educational partnership between nursing and the transportation industry. The goal was to improve healthy lifestyles through education to decrease chronic illness and comorbid conditions of a significantly at-risk occupational population. The impact of this education was immediate and verified with quantitative measurement and statistical analysis. Results demonstrated that after nurse-led health education, transportation drivers reported significant …

Examining Body Mass Index And Sepsis Mortality At One Year After Sepsis, Jamie D. Robinson

Theses and Dissertations

Introduction: Sepsis is a serious and life-threatening syndrome affecting 1.7 million Americans annually and resulting in approximately 270,000 deaths. An “obesity paradox” where obese individuals have lower sepsis mortality than their non-obese counterparts has been described. The problem is that the longevity of the effect is unknown, and few studies have examined the obesity paradox after 1-2 months post-diagnosis.

Methods: This retrospective cohort study examined clinical, demographic, and biomarker variables thought to affect sepsis mortality at three-time points: 30 days, 180 days, and at one year post-sepsis diagnosis in order to shed light on specific factors that might define …