Obesity Prevention A small test of change to decrease obesity.

Shellie RayAuburn University

Introduction• Obesity is one of the most challenging health

crises the country has ever faced.• Second only to cigarette smoking, obesity is a

leading cause of preventable death in the U.S.• Associated with HTN, DM, CAD, hyperlipidemia,

obstructive sleep apnea & cancers of the breast, uterus, prostate & colon.• Sixty-eight % of the American population are

overweight or obese.• > 110,000 deaths yearly associated with obesity.• Alabama is second only to Mississippi as the

fattest state in the nation.

Introduction• Americans spend more than $150 billion on health

care related to obesity. Considerable health risks associated with obesity so prevention should be a high priority for health care providers but is often not addressed.

• An objective of Healthy People 2020 is to increase the number of health care providers who regularly assess BMI in their adult patients.

• In a large national study of adults with BMI >30, only 42% reported that their health care provider advised them to lose weight.

• Routine screening with BMI and WC could detect a large percent of adults who are overweight or obese.

PICO• In primary care patients 18 years and older, will

Body Mass Index (BMI) and waist circumference measurements at every visit reduce the incidence of obesity?

•Small test of change• In a small group of approximately 15 adult

patients will the implementation of BMI and WC measurements increase the awareness of their weight status thus helping them to achieve a normal BMI?

Needs Assessment• Many patients who are overweight or obese either don’t

realize it or are in denial and too few doctors are addressing the issue with their patients.

• Patients at the Wound Healing Center are treated for chronic, non-healing wounds.

• Large number of patients are overweight or obese.• The only time weight is addressed is on the admission

paperwork that the patient fills out. They enter their height and weight. BMI is not calculated and WC not measured.

• Weight is not assessed at return visits.

Stakeholders• Patients: Healthier, more active, possibly decrease

some medications (HTN, diabetes, cholesterol meds)

• Medical Staff: physicians, nurses• National Wound Healing Center: Obesity can

impact wound healing. Obtaining normal BMI can help wound healing times thus increasing their wound healing time rates.

• Insurance companies: $150 billion in healthcare related expenses related to obesity is spent by Americans yearly.

Implementation Plan• Site: Northeast Alabama Regional Medical

Center Wound Healing Clinic. Outpatient clinic where patients return to clinic for weekly or bi-weekly follow-up appointments.

• Week 1• Patients will be given an information letter

regarding the project. Only patients who give consent will be a part of the project. Approximately 15 patients will be chosen for this small test of change.

• Patients BMI and WC will be measured during the vital sign assessment. BMI will be charted on a graph as normal, overweight or obese. WC will also be charted.

Implementation Plan

• Overweight & obese patients will be given a Patient Readiness Assessment to assess their readiness to make lifestyle changes in order to lose weight.

• Patients who are ready and willing to make lifestyle changes will be provided with education regarding changes to incorporate in order to decrease their weight thus decreasing BMI and WC. ( exercise, proper nutrition)

• Weeks 2-6• When patients return to clinic BMI and WC will be

measured and charted on graph. Each patient should have at least 3 measurements

Evaluation Plan• Week 7• All measurements should be obtained by this

point.• BMI and WC will be analyzed to see if there was a

decrease in BMI and WC.• Final paper will be prepared.• Week 8• Results will be presented to stakeholders with a

poster presentation.

Budget and Barriers

• Anticipated budget needs are small. The only tools needed are scales and a tape measure which I will provide. I will develop a learning tool which will provide information for proper nutrition and exercising tips. The WHC has a copier which will be available to me for copies of the info tool and the charts.

• Barriers:• Weight is a sensitive issue which may cause emotional

discomfort.• Patient’s willingness to participate • Bedridden patients unable to stand on scale and lift scales

not available.