Date of Award

Spring 5-5-2020

Degree Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Lisa Cranwell-Bruce

Abstract

Problem Statement: Most nurse practitioners working in retail clinics do not address obesity, although there is an association between obesity and chronic illnesses.

Purpose: The DNP project was to determine whether an educational intervention will improve weight loss management by decreasing barriers and improving providers' confidence in the management of obesity. The project's overall goal is to increase the volume of obese patients who receive education on obesity management. The clinical setting for the change project is a retail clinic located in the southeast.

Method: Nurse practitioners who work in retail clinics were recruited via email. Participants were given an online pre-intervention survey, a thirty-minute educational intervention, and a post-test. Implementation was guided by the Transtheoretical Model of Change and the 5As of behavioral counseling (Assess, Advise, Agree, Assist, and Arrange). The educational intervention included modules on comorbidities related to obesity, the perception, attitudes, and barriers providers face in addressing obesity, and the healthcare burden caused by obesity. Descriptive and inferential statistics were used in analyzing the data.

Results: A total of 23 nurse practitioners participated in the project. There was a statistically significant increase in scores on the providers’ confidence in providing weight management education to obese patients. Chart review pre and post-intervention showed no change in provider’s documentation on obesity. After the intervention, the practitioner continued to identify additional barriers, including time restraint, lack of referral resources, provider's comfort level, provider’s lack of confidence, patient receptiveness, and patients being intimated by the process. Furthermore, nurse practitioners' providers were concern that patients may lack the educational level, interest, support system, and willpower, fear from past failures, and maybe in denial and not be ready to lose weight.

Conclusion: Among nurse practitioners who practice in retail clinics in the southeast US, an educational intervention can increase confidence in discussing obesity with patients; however, additional changes need to be implemented to address system and personnel barriers.

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