Date Approved

7-2015

Graduate Degree Type

Dissertation

Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Karen Burritt

Second Advisor

Ruth Ann Brintnall

Third Advisor

Deborah Lown

Fourth Advisor

Mary Kay Williams

Abstract

Over the last decades, obesity in the United States has reached epidemic proportion. Obesity rates have nearly doubled since 1960 when 43% of the United States population was overweight or obese and 1% was extremely obese. In 2012, approximately 69% of the US population was overweight or obese while 6.3% were extremely obese. Obesity rates are expected to progressively increase; therefore, interventions and guidelines are imperative in order to reduce the long term health risks of the Nation and to reduce overall health care costs (National Institute of Health [NIH], 2012).

Obesity increases morbidity resulting from associated hypertension, cardiovascular disease, diabetes, stroke, sleep apnea as well as other comorbidities. Moreover, obesity and its related disorders substantially increase the Nation’s health care costs (Jensen et al., 2013). Although comprehensive weight management clinics and bariatric surgery remain viable options for the treatment of obesity, variability among weight management programs is problematic. Ultimately, a better awareness of contributing factors for successful lifestyle change is called for in order to support sustained weight loss, promote weight maintenance, and sustain healthy lifestyle choices. This project evaluated select lifestyle behavior modification following participation in a comprehensive weight management program. Specifically, dietary and exercise habits were evaluated. Donabedian’s theoretical framework of structure, process, and outcome was utilized to evaluate a current institutional system, monitor end results of patient care, and evaluate structures and/or processes in a comprehensive weight management clinic. Bandura’s self-efficacy theory was utilized to support and augment participant’s perception of their abilities to change behaviors, support behavior change, gain confidence, and influence health related goals and thoughts.

Seventeen participants were recruited from a small community weight management clinic in the Midwest. Participant informed consent was obtained after a full review of the project. Two established instruments, the Paffenbarger Physical Activity Questionnaire and the Three Factor Eating Questionnaire-R18V2, were used to gather data relative to physical activity and eating behavior. Instruments were repeated at six weeks and again at three months. Descriptive statistics were reported relative to select lifestyle behavior and changes while engaged in a weight management clinic using Statistical Packages for the Social Sciences (SPSS®) and Statistical Analysis System (SAS®).

Participants demonstrated weight loss and decreased BMI during the study period. Trends in improved eating behaviors were seen in a small portion of participants. Physical activity showed some increase but was inconsistent in the study population. Attrition and compliance with instrument completion in this small sample precluded further statistical analysis. Further exploration into the rationale for minimal physical activity among some participants, the evaluation of barriers to physical activity, continued evaluation of physical activity, and education regarding time management for physical activity should be considered.

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