Instituting a Behavioral Wellness Program and Updating a Clinical Pathway for Economically Disadvantaged Overweight and Obese Adults in a Community Health Center: A Clinical Scholarship Project
Doctor of Nursing Practice
Date of Defense
Shelly Hanko, PhD, FNP
Kuei-Hsiang Hsueh, PhD, RN
Rajeev John, ACSW, LCSW
This project is intentionally instituted in an underserved community in an attempt to bridge the gap of health disparities in a population that would otherwise not have access to such programs. The purpose of this clinical scholarship project is to work with the Midwestern health center to encourage weight loss as well as to promote healthy lifestyles and reduce risk factors among economically disadvantaged persons by: (a) starting a wellness program that incorporates both behavioral and physical health using principles of motivational interviewing and health coaching, and (b) updating a clinical pathway for persons with a body mass index twenty-five or greater. Data were limited to attendance, BMI, and weight and reported using descriptive statistics. Data were collected at two sites. Results revealed attendance ranged from 1 to 5 sessions out of 6 at site 1 with a mode of 1 session. Attendance ranged from 1 to 5 sessions out of 5 at site 2 with a mode of 1 session. The mean BMI fat at baseline for site 1 was 41.4 (range = 28.3 – 47.3) and the mean BMI fat at baseline for site 2 was 42.4 (range = 34.2 – 64.8). There was no BMI increase at either site regardless of number of sessions attended. The mean weight at baseline for site 1 was 237.1 pounds (range = 174.8 – 299.8) and the mean weight at baseline for site 2 was 244 pounds (range = 194.6 – 364.2). Participants at site 1 lost between 0.2 and 5.8 pounds. Participants at site 2 lost between 0.2 and 6.2 pounds. Evidence-based guidelines support strategies aimed at intensive behavioral counseling and regular, moderate physical exercise for prevention and treatment of adult obesity (Christie, Meires, & Watkins, 2007). MI and HC as a part of this program continue to show promise in regard to its use with the socioeconomically disadvantaged. These strategies allowed the participants to become active in their goals and health. Targeting this population helps to reduce risk factors and chronic conditions that contribute to the health of the population.
Buck, Kimberly D., "Instituting a Behavioral Wellness Program and Updating a Clinical Pathway for Economically Disadvantaged Overweight and Obese Adults in a Community Health Center: A Clinical Scholarship Project" (2014). Dissertations. 228.