Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Vanessa Loyd, DNP, Ph.D., RN (College of Nursing)


Tonya Haynes, DNP, RN

Barbie Fulton, MSN, APRN, FNP-BC



Problem: In the United States, obesity is one of the leading causes of death among Americans and rates of obesity continue to rise. Geographic location significantly affects the number of obesity cases, with rural areas being affected more than other locations. Despite this, obesity continues to be undertreated by rural primary care providers.

Method: This quality improvement (QI) pilot project utilized a descriptive, observational design to evaluate the implementation of an evidence-based clinical practice guideline algorithm for obesity management in a rural primary care clinic. An algorithm was implemented on patients aged 18-60 years and with a BMI of at least 25 kg/m2. There were two BMI categories with associated treatments: BMI of 25 to 29.9 kg/m2 or BMI of at least 30 kg/m2. Based on the patient’s BMI, appropriate treatment was provided. Data collection occurred from January 2023 to April 2023.

Results: Of the eligible patients (N =348), 27% (n = 94) patients had a BMI of 25 to 29.9 kg/m2, and 73% (n = 254) had a BMI of at least 30 kg/m2. The algorithm was utilized in 74% (n = 257) of patients. Of the (n = 94) patients with a BMI of 25 to 29.9 kg/m2, 66% (n = 62) of patients were provided treatment. Of the (n = 254) patients with a BMI of at least 30 kg/m2, 76% (n = 195) were provided treatment.

Implications for practice: This QI project demonstrated a feasible and cost-efficient method for the enhancement of clinical practice change within rural primary care. Utilization of the obesity management algorithm by the provider could impact patient treatment plans.