Nursing Commons^™

Strategies To Reduce Chronic Disease: Adding Role To Community Health Workers, Ingrid J. Renwanz Dnp, Pmhfnp-Bc/Aprn, Msn, Rnc

Doctor of Nursing Practice (DNP) Projects

Background: Underserved, rural, immigrant, low-income Latinx communities need to strengthen healthcare access to improve their quality of life (Capitman et al., 2009; McCartney et al., 2019; Save the Children [STC] Organization, 2021). Non-communicable chronic disease of physical and behavioral origin is the leading cause of morbidity for adults and children in Latinx communities (Campbell et al., 2020). Estimates of greater than 30% of the Latinx populations within the United States have these health needs, with projections to reach 28% of the U.S. population by 2060 (Eghaneyan & Murphy, 2019; Ortega et al., 2018).

Local Problem: If poor access to preventive …

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 …

Improvement Of Overweight And Obesity Screening And Intervention In Primary Care, Catherine Lehtinen

Doctor of Nursing Practice (DNP) Projects

Background: Obesity is a chronic health condition, resulting in significant morbidity and mortality, and is inadequately managed and treated in primary care. The Obesity Pathway is an organization-specific algorithm for providers to treat patients with obesity.

Purpose: To improve provider use of an Obesity Pathway in a primary care clinic and to increase the screening and intervention of all adult patients with overweight or obese status.

Methods: The Obesity Pathway was reviewed with primary care providers as well as best practices for weight management, obesity bias and stigma. The NEW Attitudes Scale and satisfaction surveys were completed by providers before …

Utilizing Motivational Interviewing To Encourage Weight Loss In Primary Care, Wendy Sergeant

Doctor of Nursing Practice (DNP) Projects

Purpose and Background: The purpose of this project was to educate nurse practitioners (NPs) and nurses (RNs) to promote healthy changes in obese individuals using the principles of Motivational interviewing (MI). Obesity is a growing epidemic in the United States with two out of every three adults considered overweight or obese. Their health problems become costly and deadly. Ideally, RNs and NPs are the front line providers in this struggle of obesity because of their philosophy of health promotion. RNs and NPs can screen and address obesity through lifestyle counseling. Motivational interviewing, a proven and effective counseling method, is useful …

Stop The Stigma! Eliminating Implicit And Explicit Bias Toward Adult Obese Women Receiving Gynecological Care: A Quality Improvement Project To Cultivate Empathy And Increase Knowledge Of Best Practices, Mary Ellen Burke

Doctor of Nursing Practice (DNP) Projects

Background: Increased weight carries significant health risks, yet obese individuals face stigma, implicit and explicit bias by health care providers that affects quality of care and increases health care avoidance. Obese women may delay or avoid gynecological care due to fear of stigma, inadequate equipment and embarrassment about their weight. Review of Literature: In the United States, 70.7% of adults, almost three quarters of the adult population are overweight or obese. Purpose: The purpose of this quality improvement project was to improve the quality of care and empathy toward obese women by health care providers in an OB/GYN practice through …

An Evaluation Of The Feasibility Of Implementing The National Institute Of Children’S Health Quality (Nichq) Physical Activity And Nutrition Survey In Pediatric Primary Care, Candice Greene

Doctor of Nursing Practice (DNP) Projects

Pediatric obesity is a growing problem in the United States of America causing both immediate and long-term health implications including: cardiovascular disease, diabetes, bone and joint problems, sleep apnea, and social and psychological problems (Centers for Disease Control and Prevention, 2015). The purpose of this quality improvement project is to implement and evaluate an evidence-based screening tool for identifying modifiable risk factors for childhood obesity in children in a pediatric primary care office. The National Institute for Children’s Health Quality (NICHQ) Physical Activity and Nutrition Survey (Appendix A) was administered to 25 pediatric patients ages 2-18 presenting to their primary …

Motivational Interviewing, And Healthy Eating Intervention With Low Income Diabetic Patients, Cornelius Bela

Doctor of Nursing Practice (DNP) Projects

Purpose: The project’s aim was to investigate whether motivational interviewing made a difference for the participants in terms of healthy behaviors, as measured by their weight, BMI, HgA1C and total health eating habits score.

Method: A motivational interviewing intervention was used on thirteen diabetic patients in three monthly group meetings and weekly phone calls surrounding healthy eating. The health behaviors such as improving dietary choices, decreasing sedentary behaviors, and increasing habitual physical activity and exercises were assessed at both pre and post intervention as well as weight, body mass index (BMI), Hemoglobin A1c, and healthy eating habits total score.

Results: …

Obesity Group Medical Visits, Brenda L. Jaeger

Doctor of Nursing Practice (DNP) Projects

Background: Obesity is a major risk factor associated with multiple chronic diseases, presenting a significant global health challenge. Current evidence supports that group medical visits, an alternative format for the provision of primary care, are effective in disease management.

Purpose: The goal of this project was to examine the effectiveness of group medical visits for the management of obesity in primary care.

Methods: Individuals with a BMI greater than 30 participated in a series of six multidisciplinary group medical visits over a 12-week period. Each session included a brief individual medical visit followed by group education and discussion. Topics …

Higher Fat Low Carbohydrate Diet To Improve Health Related Quality Of Life For Overweight Or Obese Diabetics In A Primary Care Clinic, Breck Baker

Doctor of Nursing Practice (DNP) Projects

Diabetes and obesity are chronic diseases that affect individuals worldwide. The American Diabetes Association (ADA) and the American Heart Association (AHA) have developed guidelines for management of diabetes and obesity. The DNP student examined the use of the Higher Fat Low Carbohydrate (HFLC) diet, which conflicts with these frequently used guidelines. The literature on a HFLC diet suggests positive effects for type 2 diabetics, including weight loss, improved HA1c, lower BMI and no detrimental impact on metabolic markers such as cholesterol, triglycerides, or low and high density lipoproteins. The purpose of this project was to provide type 2 diabetics who …

A Small-Change Approach To Weight Loss In Obese Adult Patients: A Research Translation Project, Aimee B. Beck

Doctor of Nursing Practice (DNP) Projects

Abstract

Obesity is a major health threat in the United States. Excess weight can have devastating effects on an individual’s overall health and well-being. This research translation project utilized the 12-week small-change approach to weight loss as an intervention, which is shown to be feasible and beneficial for weight loss. This intervention has been successful in the ASPIRE-VA pilot study with 14 sedentary, obese middle-aged male and female veterans (Damschroder, Lutes, Goodrich, Gillon, & Lowry, 2009). For this project the intervention was implemented in a family practice office in Gardner, Massachusetts. Ten female, predominantly Caucasian, participants volunteered to participate in …