Purpose: This project examined the effectiveness of an online educational module on basic Motivational Interviewing (MI) techniques for Nurse Practitioners (NPs) providing obesity management to middle-aged women.

Background: Middle-aged women experience distinct physiological and psychosocial factors that contribute to weight gain and make obesity management especially challenging. The evidence supports the use of motivational interviewing (MI) interventions as a highly effective approach to obesity management in combination with standard medical weight loss programs. Educating NPs that provide medical weight loss on basic MI counseling techniques is necessary to facilitate the use of this intervention.

Methods: NP providers at a group of seven medical weight loss clinics in the southwestern United States completed an online MI educational module that was developed for this project. The module content covered basic MI counseling techniques. MI knowledge was assessed using a 6-item pre/post-test. Participants completed an 8-item course evaluation to provide additional feedback.

Results: Ten of the 13 NPs eligible participated in the project. The overall response to the project was positive as demonstrated by high scores on the course evaluation. The average post-test knowledge scores increased after completion of the module, however no statistical significance was noted.

Conclusions: The basic MI education module was beneficial for NPs providing obesity management and future research should focus on developing standardized MI weight loss interventions.

Findings suggest that stigma associated with mental health may be as strong in healthcare providers as it is in the general public. Research involving non-behavioral health nurses, and medical and nursing students, sought to identify bias and negative attitudes directed towards psychiatric patients in a non-psychiatric setting. Studies were reviewed to determine the effects of educational interventions to teach empathy and increase knowledge related to the pathology of, and treatment modalities for, psychiatric patients. Several scales were used to measure bias and rate interventions to minimize it.

Studies found that healthcare personnel, including nurses, are considered by mental health consumers to be primary contributors to stigma and discrimination against those with mental illness. The studies also discovered that participation in an educational intervention to learn empathy and acquire knowledge about psychiatric patients directly decreased bias. The project utilized the evidence-based practice PRECEDE-PROCEED model (PPM) supported by Bandura’s Social Cognitive Theory (SCT). Combining the PPM with the SCT is supported in the literature as they both rely on learned behavior.

Moving forward, the presentation was completed and participation sought. It was at this point the project shifted its perspective. Out of 80 nurses asked to attend 1 of the 2 presentations, a total of 3 nurses participated. The search for statistical significance was not possible. We were left to formulate descriptive statistics to interpret the outcomes and reflect on their meaning.

Purpose/Aims: The purpose of this project was to evaluate how patient education can improve medication adherence.

Background and Significance: An exhaustive literature search was conducted with critical appraisal and evidence synthesis to evaluate the effectiveness of patient education on medication adherence. The search concluded that adherence is crucial to chronic disease processes. However, there was no one intervention that emerged as being superior for improving medication
adherence. Working with patients individually to address needs through a variety of methods appeared was the best way to improve medication non-adherence.

Methods: A project to improve medication adherence in an outpatient mental health clinic incorporated electronic medical record (EMR) technology with patient education materials. The project evaluated provider satisfaction with the EMR handout system and evaluated providers’ perceptions of improved medication adherence. Providers (n=9) were followed for eight weeks once system was live. Appraisal was conducted on the providers and pre-test, mid project test, and an eight week post-test were administered. The instrument used was the Technology Acceptance Model-2 (TAM-2).

Outcomes: Friedman Test was conducted. Results obtained showed no significant difference between the three tests (χ2 (2) =2.889, p>0.05). The pretest had a standard deviation of 14.24. The posttest standard deviation was 23.75.

Conclusion: Providers educate patients about a variety of topics such as chronic conditions and wellness. It is beneficial to focus on education more broadly, instead of only medication adherence.

Keywords: patient education, medication adherence, physician perceptions

Purpose: The purpose of the project was to improve physical activity (PA), eating habits (EH) and self-efficacy (SE) by implementing short lifestyle modification education in a rural primary care setting.

Background: Although prediabetes awareness has slightly improved, the nationwide unawareness remains high. General knowledge about the disease and its risk factors and prevention are significant variables to adopt health-promoting behaviors. Lifestyle change intervention has been shown to be effective with the risk reduction behaviors in prediabetic population. However, it can be a daunting task to translate during short office visits.

Methods: Sixteen participants with risk for prediabetes or diagnosed prediabetes enrolled into a 5-minute education session in a rural health clinic. They received follow-up phone calls weekly for 4 weeks. Demographics, PA, EH and SE levels were measured before the education session. During the fourth week, PA, EH and SE were measured again. Frequency, descriptive analysis, and paired t-test were used for data analysis.

Outcomes: The mean age of participants was 56.6  13.0 years. Approximately 81% were female, and 62.5% identified as Caucasian. Over 80% reported married, and 56.3% described their health condition as good. The three quarters (75%) noted they have heard of the term prediabetes. The intervention had a significant effect on PA, EH and SE from the baseline to post intervention, p = .005, p = .008, and p = .003, respectively.

Conclusion: This DNP project illustrated that one time brief lifestyle change education could positively impact PA, EH and SE in people with high risk for prediabetes in a primary care clinic.

Purpose:
The purpose was to implement a self-management program to decrease pain and disability and improve self-efficacy among low-income, Latino individuals diagnosed with arthritis.

Background:
All arthritis pain has the potential to impair mobility. Arthritis is the leading cause of disability among American adults, with over 50 million individuals affected. The Latino population experiences a disproportionate incidence of disability attributable to arthritis compared to other populations. Evidence supports self-management education incorporating physical activity as a promising intervention for arthritis.

Methods:
The intervention included a curriculum developed by the Arthritis Association, three teaching sessions, and a pre/post-test. Anticipated outcomes included decreased pain measured by the Pain Visual Numeric, decreased report of disability measured by the Stanford HAQ, and increased self-efficacy measured by the Arthritis Self-Efficacy Scale. The setting was a faith-based medical clinic that services the uninsured population located within Southwest Arizona. Participants included Spanish and English speaking adults diagnosed with arthritis.

Results:
Twelve participants were consented however, only eight participants completed the entire project. Although the mean pain score decreased, indicating reduced pain, it was not statistically significant (pretest- M=5.75 SD=3.19; posttest- M=5.25 SD=2.82; z (7)=-.11, p= .92). However, there was a statistically significant increase in reports of exercise after the intervention (pretest M=.83, SD=.39; posttest- M=.43, SD=.53; z (6)=-2.0, p =.046). This was in response to an non validated question developed by the primary investigator and co-investigator of, “Do you currently exercise?”.

Conclusions:
Results include increases in reports of exercise post-intervention and decreased pain. The use of non-pharmacological interventions such as self-management to reduce pain and increase mobility in arthritic patients can help lessen the socioeconomic health disparity gaps.