Award Date

May 2017

Degree Type

Dissertation

Degree Name

Doctor of Nursing (ND)

Department

Nursing

First Committee Member

Jessica Doolen

Second Committee Member

Carolyn E. Sabo

Third Committee Member

Christopher Heavey

Number of Pages

76

Abstract

Adult obesity has become a significant problem in the United States. To reduce health consequences and the rising cost of obesity, evidence-based guidelines to identify and treat obesity are available to primary care providers (PCPs). Despite literature supporting favorable outcomes by PCPs who address obesity at a patient's visit, studies indicate obesity counseling is occurring infrequently, particularly in military primary care settings.

Guided by the Diffusion of Innovations Theory, this research utilization project evaluated whether there is an implementation gap between use of the Department of Veterans Affairs (VA) and Department of Defense (DoD) Clinical Practice Guideline for Screening and Management of Overweight and Obesity and military primary care providers’ provision of care for adult obese individuals. A retrospective review of electronic medical records was conducted at an Air Force military treatment facility and continued until 50 records were identified that met inclusion criteria (i.e., TRICARE beneficiaries age 19 and older with a body mass index (BMI) of 30 kg/m2 or greater).

The rate of identification of adult obesity was 36%. Only 36% of individuals were offered diet and exercise counsel. Sixteen percent were offered behavioral counsel and 12% received a one-month follow-up appointment. No individuals eligible to receive pharmacologic and bariatric surgical treatment were offered these interventions. The overall composite score for obesity treatment was 0.22, indicating identification and treatment of obesity occurred an average of 22% of the time. Results of this research utilization project are consistent with other studies, suggesting the need to determine barriers and implement interventions that can assist PCPs in translating evidence to practice to reduce rates of adult obesity in the primary care setting.

Keywords

adult obesity; evidence-based guidelines; identification of obesity; primary care providers; treatment of obesity

Disciplines

Medicine and Health Sciences | Nursing

Language

English


Included in

Nursing Commons

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