Award Date

5-1-2016

Degree Type

Dissertation

Degree Name

Doctor of Nursing (ND)

Department

Nursing

First Committee Member

Carolyn Sabo

Second Committee Member

Carolyn Sabo

Third Committee Member

Patricia Gatlin

Fourth Committee Member

Timothy Bungum

Number of Pages

169

Abstract

Despite decades of effort on the part of health care providers and policy makers to reduce the prevalence of obesity, the prevalence of obesity in the United States remains high (CDC, 2015). In the adult population ages 20 years of age and older, 35.7% are considered obese. The annual medical costs for people who are obese are $1,429 higher than people of a healthy weight (CDC, 2013). Obesity increases the risk for chronic health conditions such as hypertension, type 2 diabetes, hypercholesterolemia, coronary heart disease, stroke, asthma, arthritis, and cancer (Hammond & Levine, 2010). Over-weight and obesity are the main cause for most health related conditions treated by heath care providers (Tsai, Abbo, & Ogden, 2011). Barriers to the treatment of obesity include difficulty in treating patients with complex co-morbidities, time constraints, resources, training, and reimbursement (Tsai et al., 2011). Identifying strategies to assist healthcare providers to evaluate, treat, and manage their overweight and obese patients are essential.

A review of the literature revealed gaps in the literature related to the limited number of collaborative self-management resources that enable providers to assist and empower their patients to lose weight. To address this gap, this DNP project was developed as an evidenced-based collaborative workbook for healthcare providers and patients to work together to facilitate patients weight loss efforts.

An initial step in the evaluation of a new workbook is the analysis of the content and relevance of the proposed workbook. A 28 question survey was developed by the DNP student for use on Survey Monkey. The survey questions were developed to provide content validity to the proposed workbook and were designed to evaluate each section of the workbook by health care providers engaged in the care for overweight and obese patients. Each question was rated on a 1–4 Likert scale and was calculated to establish a percentage of agreement by the provider / evaluator with a content validity index (CVI). The CVI is a measurement tool to evaluate abstract concepts. Polit and Beck (2017) recommend a scale range of .80 to 1.00 that would be considered as having excellent content validity. When calculating a CVI only the items rated 3 or 4 are calculated, this provides a percentage in agreement among the evaluators about relevance of the concept being evaluated and measured (Polit & Beck, 2017).

The results of the CVI for the proposed workbook were calculated with a CVI of 1.0 which translates to 100% of agreement of relevance among the evaluators. Since the CVI was so high, a second CVI was calculated by removing all the items rated as 3. There were 17 items rated as 3. The 17 items were subtracted from the total items rated. The second calculation of the CVI resulted as 0.93 which is 93% of agreement among the evaluators. The evaluators also provided qualitative statements in the comments section for each question. The qualitative responses will be helpful in the next revision of the workbook.

The next step in the development of this weight loss tool will be the implementation of the evaluators’ recommended revisions. After the workbook is revised, subsequent validity measurement will be conducted by health care providers and patients. Participants will be sought to review the revised workbook for the appropriate literacy level, readability, helpfulness of content, ease of use, and weight-loss results. On final review and modification, the workbook will be ready for dissemination and implementation by providers and patients.

Keywords

Functional assessment; Health Promotion Model; Out-patient care; Readiness to lose weight; United States Preventive Services Task Force; Weight-loss resource

Disciplines

Mental and Social Health | Nursing | Science and Mathematics Education

Language

English


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