Nursing Commons^™

Improving Obesity Management In Primary Care, Jeffrey M. Waddell

Doctor of Nursing Practice Scholarly Project

This project examined how advanced practice nurses (APNs) manage overweight and obesity in primary care. Not only were their general attitudes and beliefs toward overweight and obesity explored, but their beliefs about the treatment and management of obesity were also examined. The APNs’ knowledge and current practice with managing obesity in the primary care setting were evaluated. This project went on to examine the APNs’ awareness and utilization of clinical practice guidelines in managing overweight and obesity. Finally, the study asked about the perceived impact of a website designed to provide guidance managing obesity based on the American Association of …

Influence Of Social And Economic Factors On Elementary Student Health In Northwest Arkansas, Megan Marks

The Eleanor Mann School of Nursing Undergraduate Honors Theses

A child’s wellbeing is influenced by many factors related to the environment they are raised in. The purpose of this study was to investigate the relationship between a child’s social and economic factors and his or her health. A convenience sample of 588 2nd and 4th grade children was taken from three elementary schools in Springdale Independent School District. Health status was represented by calculations of each child’s body mass index (BMI) and number of days counted absent from school. Socioeconomic and demographic factors examined include the child’s grade level, gender, ethnicity, number of parents over the household, number of …

General Nutrition Knowledge And Perceived Stress In A Rural Female Faith Community, Lori Alexander, M. Laurie Branstetter Dnp

International Journal of Faith Community Nursing

In rural America, high rates of obesity are influenced by a lack of education and limited community resources. The purpose of this study was to assess the effect of an educational intervention on recommended nutrition and body mass index knowledge and to describe the perceived stress in a rural female faith community. A quantitative quasi-experimental pre-test post-test research design was used. English speaking female participants (N=49) 18 years of age and older from two rural community churches received an educational intervention based on the Health Belief Model. Participants completed a demographic survey, self-reported height and weight, general nutrition …

Efficacy Of A Weight Loss Intervention For African American Breast Cancer Survivors, Patricia M. Sheean, Melinda Stolley, Ben Garber, Claudia Arroyo, Linda Schiffer, Anjishnu Banerjee, Alexis Visotcky, Giamila Fantuzzi, Desmona Strahan, Lauren Matthews, Roxanne Dakers, Cynthia Carridine-Andrews, Katya Seligman, Sparkle Springfield, Angela Odoms-Young, Susan Hong, Kent Hoskins, Virginia Kaklamani, Lisa Sharp

Nursing: School of Nursing Faculty Publications and Other Works

African American women with breast cancer have higher cancer-specific and overall mortality rates. Obesity is common among African American women and contributes to breast cancer progression and numerous chronic conditions. Weight loss interventions among breast cancer survivors positively affect weight, behavior, biomarkers, and psychosocial outcomes, yet few target African Americans. This article examines the effects of Moving Forward, a weight loss intervention for African American breast cancer survivors (AABCS) on weight, body composition, and behavior.

Get Moving: Motivating Sedentary Young Adults, Rebecca Edmunds, Neil Peterson

Journal of Undergraduate Research

Obesity and sedentary behavior are increasing in the United States and the world. On the Centers for Disease Control and Prevention (CDC) website recent statistics put over one third of the American adult population as obese and over half as overweight (2015). This epidemic has contributed to a drastic increase in disease and cost. Obesity and the accompanying diseases are not only expensive to treat but also decrease quality of life. Prevention is essential. Many companies are working to find devices that help motivate people and encourage physical activity and a healthy lifestyle. This research project focused specifically on the …

Implementation Of Screening Guidelines To Improve Quality Of Care In A Small, Ethnically Diverse Pediatric Primary Care Practice…Then What?, Brooke Basford

Doctor of Nursing Practice Final Manuscripts

Although best practice guidelines have been shown to be effective, the process of translation into everyday practice can be challenging. The purpose of this evidence-based project (EBP) was the implementation of standardized screening tools into annual well-child visits in a small, ethnically diverse pediatric primary care practice in southern California. Standardized screening is recognized as an important process in identifying conditions early to facilitate early intervention. The practice site identified obesity has a priority and consequently the Department of Health Care Services: Child Health and Disability Prevention (CHDP) Program Guidelines for Diet and Nutrition Screening for Children assessment form was …

Prevalence Of Binge Eating Disorder In An Insurance-Based Weight Management Center, Kimberly M. Kittleson Dnp, Fnp, Karen Macauley Phd, Dnp, Fnp-Bc, Gnp-Bc

Doctor of Nursing Practice Final Manuscripts

Purpose: This project was anticipated to demonstrate an increase in the number of those diagnosed with BED according to Diagnostic and Statistical Manual (DSM) 5 criteria, diagnosed with ICD-10 code F50.8 or R63.2 and treated according to best practice guidelines.

Background: Binge eating disorder (BED) is the most common eating disorder in the United States, more than both anorexia and bulimia combined. It affects 3.5 percent of women, 2 percent of men and 30 percent of those seeking weight management.

Design: This evidenced-based project consisted of a retrospective analysis of 150 patients seen in a weight management …

Evaluation Of Hypertensive Clinical Significance In A Primary Care Setting With Veterans With Diabetes, Claire S. Moga Msn, Rn

Doctor of Nursing Practice Final Manuscripts

Analyses of hypertensive confounding factors were identified by looking retrospectively at patient demographics, medications, recent blood pressure and the medical history of hypertensive patients with diabetes. The data trends found in this database highlighted potential areas for improvement with regards to the care of patients with this co-morbidity in the outpatient setting. All prescription anti-hypertensives prescribed for the 102 patients followed the National Joint Committee (JNC-8) Hypertension Guideline Algorithm. Of 102 adult males (over the age of 18), 22 patients had a blood pressure that is out of control (over 140/90). Within this group of patients, 33.3% of the patients …

Effect Of Activity Trackers And Text Messaging On Exercise, Fitness, And Physical Activity Self-Efficacy Of Middle School Students, Alison F. Pittman

Nursing Theses and Dissertations

A decrease in physical activity as children age is a contributing factor to the U.S. obesity epidemic. Middle school children are particularly vulnerable to sedentary activities. Activity trackers show promise as a means to motivate children and adults to increase physical activity (PA). This study examined the effect of a text messaging intervention and use of activity trackers with a companion social website on the body mass index (BMI), body fat percentage, physical fitness, and PA self-efficacy of middle school children. Children aged 11-14 (n=102) were randomly assigned to one of three groups for a 10-week intervention: activity tracker group; …

Evaluation Of A Primary Care Weight Loss Program, Callie Chiroff, Christine Shaw, Kristin Haglund, Susan Breakwell

College of Nursing Faculty Research and Publications

Nurse practitioners at a primary care clinic established a weight loss program to address high obesity rates among their African American patients. Interviews and a retrospective chart review were used to evaluate the weight loss program. Number of appointments was the only significant predictor of weight loss, and there was a strong positive correlation between total number of appointments and weight loss. The overall view of the program was positive. This description and evaluation of the program may be useful to nurse practitioners seeking to develop an individualized effective weight loss intervention for African Americans within a primary care setting.

Moderating Effects Of Immunosuppressive Medications And Risk Factors For Post-Operative Joint Infection Following Total Joint Arthroplasty In Patients With Rheumatoid Arthritis Or Osteoarthritis, Elizabeth G. Salt, Amanda T. Wiggins, Mary Kay Rayens, Brent J. Morris, David M. Mannino, Andrew Hoellein, Ryan P. Donegan, Leslie J. Crofford

Nursing Faculty Publications

Objective—Inconclusive findings about infection risks, importantly the use of immunosuppressive medications, in patients who have undergone large-joint total joint arthroplasty challenge efforts to provide evidenced-based perioperative total joint arthroplasty recommendations to improve surgical outcomes. Thus, the aim of this study was to describe risk factors for developing a postoperative infection in patients undergoing TJA of a large joint [total hip arthroplasty, total knee arthroplasty, or total shoulder arthroplasty] by identifying clinical and demographic factors, including the use of high risk medications (i.e., prednisone and immunosuppressive medications) and diagnoses (i.e., rheumatoid arthritis [RA], osteoarthritis [OA], gout, obesity, diabetes mellitus), that …

The Impacts Of Preconception Nutrition On Pregnancy: An Educational Module Promoting Preconception Care, Alexa R. Holleran

College of Nursing and Health Sciences Nursing Master Project Publications

Recent research has shown that maternal overweight and obesity (OW/OB) prior to conception are directly and independently associated with negative outcomes in pregnancy, birth, infancy, childhood, and beyond. The purpose of this project was to create and evaluate educational materials for providers who work with women of childbearing age, in order to encourage and facilitate conversations about the importance of preconception nutrition in family planning. A literature review was conducted, and from it two documents were created: 1) an educational module for providers offering background information, relevant research, and tips for discussing the matter with patients; and 2) an infographic-style …

Provider Attitudes And Practice Patterns Of Obesity Management With Pharmacotherapy, Brittany Granara

Graduate College Dissertations and Theses

Background and Purpose: More than one-third of American adults are obese. The prevalence of extreme obesity is rapidly rising. Nine medications are currently approved for weight loss yet they remain under utilized with the focus primarily on lifestyle modifications. The study's objective was to determine current prescribing patterns and attitudes of weight loss medications in the management of obesity among primary care providers (PCPs).

Methods: PCPs were surveyed to determine practice patterns, attitudes, barriers, and facilitators for prescribing weight loss medications.

Conclusions: A total of 105 surveys were completed. 76% of all PCPs did not prescribe weight loss medications for …

Health Care Providers' Knowledge Of Childhood Obesity Within The Hispanic Community, Daysi Fardales

Student Theses, Dissertations and Capstones

Background: Recent studies indicate a rise in the prevalence of obesity in children of various age groups. Obesity was officially recognized as a disease by the American Medical Association (AMA) in June 2013. It has been acknowledged as a progressive epidemic public health crisis in the United States for the past 20 years. This is a health care concern that needs examination and the development of new and more effective prevention and treatment modalities for obesity in children. Environmental, hereditary, behavioral, and socioeconomic factors play a significant role in the prevalence of obesity (Rooney, Mathiason, & Schauberger, 2011). Childhood obesity …

Assessing For Awareness And Knowledge Regarding Diabetes In Pre-Diabetes Obese Patients, Remona Lysa Brown

Walden Dissertations and Doctoral Studies

Over the past few decades, there has been an increase in prevalence of diabetes in the United States. Prevention of diabetes and improving patients' knowledge and awareness of diabetes are crucial for healthcare providers. Using the Health Belief Model (HBM) as a theoretical foundation, the student used the National Diabetes Prevention Program (NDPP) from the Centers for Disease Control and Prevention (CDC), to improve awareness and knowledge of diabetes among obese individuals with prediabetes. The key research question of this project was to determine whether the patients' diabetes knowledge and awareness improved after the NDPP program. A convenience sample of …

Effectiveness Of A 10-Week Weight Reduction Program In A Retail Clinic, Love Chibuihe Nzeako

Walden Dissertations and Doctoral Studies

Obesity is a serious health problem that leads to several chronic diseases and premature deaths. TheIn this project,was used to evaluate the effectiveness of the the Weigh Forward (WF) program, a 10-week weight-loss program administered in retail clinics, was evaluated, and it is provided in retails stores. The project analysis was completed on a limited data set on The population consisted of 15 obese participantsmembers of the program, 18 years and above, at 13 dispersed clinics in Maryland and Virginia.in the WF program from 13 dispersed clinics in Maryland and VirgiObesity is a body mass index (BMI) > 30 kg/m2. Participants …

10,000 Step Challenge For Bedside Registered Nurses Working 12 Hour Shifts, Katherine Louise Schnebly

Walden Dissertations and Doctoral Studies

Obesity is a pandemic that directly affects chronic health problems and mortality. Researchers have shown that more than 54% of nurses are obese. The increasing rate of obesity among nurses and the long hours they work make healthy lifestyles, including daily physical activity, difficult. Tracking daily activity using a pedometer or fitness application has shown improved awareness and sustainability of daily physical activity. This project was an investigation of the daily steps of bedside nurses working a 12-hour shift, and their subsequent awareness of their daily physical activity. Pender's Health Promotion Model was used to consider motivating factors for improving …

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: …

An Evaluation Of An Innovative Weight Management Program In A Primary Care Setting, Susan Peak

DNP Projects

Background- Kentucky ranks third in the nation for childhood overweight and obesity. . Consumption of high dietary fat, excessive use of electronics, low levels of physical activity and consumption of sugar filled drinks are modifiable behaviors believed to be the biggest culprits behind these statistics.

Purpose- The purpose of this evaluation was to assess the implementation of the 5-2-1-0 plan in the management of childhood overweight or obesity within an urban primary care clinic.

Methods- After initiation of the program by the clinic focused interviews with the primary care providers were conducted to evaluate barriers and benefits to …

Effectiveness Of School-Based Interventions Versus Family-Based Interventions In The Prevention And Treatment Of Childhood Obesity, Ashley Capestrain, Emily Montague, Meghan Frantz

Williams Honors College, Honors Research Projects

Childhood obesity affects 155 million children worldwide. As prevalence increases, it is important to identify effective interventions in the treatment and prevention of childhood obesity. Obesity may result in short and long term effects linked to some of the leading causes of morbidity and early mortality. The purpose of this systematic review is to identify, review, and critically appraise evidence from studies examining the effect of family and school based interventions. This review answers the following PICO question: In children, how do family based interventions compare to school based interventions, in the prevention and treatment of obesity? Methods included literature …

Hedonic Mechanisms Of Weight Changes In Medication Assisted Treatment For Opioid Addiction, Elizabeth Mcdonald

Graduate College Dissertations and Theses

Opioid abuse and addiction affects more than 2.4 million people in the United States. Medication assisted treatment (MAT), in combination with counseling, is recognized as the most effective treatment for patients with opioid dependence and abuse. Although MAT is considered the most effective treatment, previous research has found clinically significant weight gain with methadone. The purpose of this study was to determine if hedonic eating behaviors, sugar cravings, and addictive like eating was related to weight gain in opioid addicted patients receiving methadone and buprenorphine/naloxone (Suboxone™). Hedonic eating behaviors were measured using three validated surveys. Following survey collection, a chart …

Development And Validation Of An Adult Diet And Physical Activity Program In Primary Care Setting, Christiana Chinyere Keke-Ekekwe

Walden Dissertations and Doctoral Studies

Obesity is a national health problem with serious medical, psychological, and economic outcomes. Nurses and nurse practitioners (NPs) are frequently the first point of patient contact and play an essential role in the management of obesity. The current literature noted that practitioners working in primary care settings demonstrate inadequate knowledge related to evidence based practice (EBP) strategies to treat obesity, including diet modification and physical activity. The purpose of this DNP project was to develop and validate an EBP provider educational module related to diet modification and physical activity education for adult patients diagnosed with obesity in a primary care …

Quality Improvement Through Evidence-Based Education: Advancing Obesity Awareness And Clinical Management Strategies For People Living With Mental Disorders, Ellis Ehizele Opusunju

Walden Dissertations and Doctoral Studies

People living with mental disorders (PLWMDs) are at an increased risk for developing obesity due to poor diet, physical inactivity, and antipsychotic medications. In the United States, the general-population obesity rate is 36% compared to more than 50% for PLWMDs. Mental health professionals (MHPs), focused on addressing psychiatric conditions, seldom recognize and clinically manage obesity. Furthermore, this population is socioeconomically disadvantaged with poor dietary habits while consuming psychiatric medications that stimulate hunger, further exacerbating the risk for obesity. The Promoting Action on Research Implementation in Healthcare Services (PARISHS) framework guided this quality improvement project to improve obesity awareness and management …

The Perceptions And Experiences Of African American Parents In The Management And Care Of Obese Children, Priscilla Ann Huggins

Walden Dissertations and Doctoral Studies

Childhood obesity is a global concern among all ethnic groups. Childhood obesity is a problem that continues into adulthood, exacerbating the incidence of diseases such as diabetes or heart disease. The purpose of this phenomenological study was to explore, understand, and describe the perceptions and experiences of African American parents in the management and care of their obese or overweight children. This study used the health-belief model (HBM) as its theoretical foundation, focusing on the constructs of perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. This research study used an interview tool and an 8-item …

Walkability Assessment To Reduce Childhood Obesity In Wilson County Kansas, Nancy Lee Carpenter

Walden Dissertations and Doctoral Studies

Promoting physical exercise is necessary to combat childhood obesity. Walking to school is an encouraged physical activity, but the feasibility of walking to school depends on the walkability of the environment. During the last 40 years, the number of U.S. schoolchildren who walk to school has declined. The purpose of this evidence-based practice project was to perform a walkability assessment of the 2 largest communities in Wilson County Kansas to identify and address walkability issues. Frameworks for this practice initiative were social cognitive theory and the Health Promotion model. Questions for the project addressed whether sidewalks along the main pedestrian …