The intervention for the DNP project includes the implementation of the American Heart Association (AHA, 2021) Diet and Lifestyle Recommendations, which focuses on a healthy diet, knowing how many calories the patient should be eating and drinking to reduce body weight, and aiming for at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical exercise, or an equivalent combination of both (Arnett et al., 2019). Appendix (A) contains the complete (AHA, 2021) Diet and Lifestyle Recommendations as a guide for this DNP project.
Week 1: Pre-Implementation: The DNP student will post flyers about the project in the clinic and answer questions of potential participants. The brochure is attached as an appendix (F). Recruitment will commence. The DNP student will then educate staff on American Heart Association Diet and Lifestyle Recommendations and project expectations with a PowerPoint presentation and handouts for easy access to the evidence-based guidelines. The DNP student will administer informed consent to patients who agree to participate. The informed consent is attached to (Appendix B). Once participants have consented, the DNP student will provide instruction on the free Fitbit smartphone app to track weekly food intake and activity. The DNP student will ask participants to use the free Fitbit smartphone app to track daily meals/calories and exercise. The goal for the participants will be to participate in calorie tracking through the app and at least 150 minutes of moderate physical activity also tracked through the tracker/app. The DNP student will also demonstrate the use of the smartphone app with a repeat demonstration from participants and collect pre-implementation body weight measurements of participants in a private setting using the same scale that is calibrated weekly.
Weeks 2-9: Implementation: Project participants will follow the American Heart Association Diet and Lifestyle recommendations guidelines, that focus on knowing how many calories an individual should be eating and drinking to maintain body weight and aiming for at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical exercise (or an equivalent combination of both) each week. As a formative evaluation, the DNP student will call participants weekly to reinforce them to follow the diet and lifestyle recommendations, audit the smartphone app and tracker usage, and answer any questions. The DNP student will meet with staff weekly to discuss questions and concerns with calorie and activity tracking and offer support for the program. The DNP student will collect participants’ compliance data with app and tracker usage during each phone call.
Week 10: Post-Implementation: The DNP student will meet with each participant in a private exam room setting at the clinic to discuss progress and challenges during the project and collect post-implementation body weight measurements. Also, during this clinic visit, the American Heart Association Diet and Lifestyle Recommendations will be summarized, encouragement to continue with positive behavioral changes will be provided, and any needed resources for ongoing follow-up. The DNP student will also work with the statistician to conduct data analysis to compare the participants’ pre/post-implementation body weight for summary reporting purposes. The DNP student will thank the stakeholders and present a summary of project results to the primary care clinic office staff and Chamberlain University faculty and colleagues. The implementation strategy is arranged in the Gantt chart (Appendix C) as a week-by-week description of implementation tasks.
The educational plan includes educating the stakeholders and project participants by conducting simple but formal sessions that include the project objectives, expectations, and goals. We will discuss the American Heart Association Diet and Lifestyle Recommendations, and each stakeholder and project participant will be provided with a copy. The participants will discuss and verbalize understanding of the AHA Diet and Lifestyle Recommendations elements, which include a healthy diet, regular physical activity, and tobacco avoidance to reduce obesity. Providers will demonstrate how to teach participants about using the Fitbit app to track daily meals/calories and exercise and the AHA Diet and Lifestyle Recommendations.
There will also be weekly meetings to evaluate stakeholders’ understanding of their roles, specifically focusing on their roles, how to check the Fitbit tracker, and other areas. Verbal and written content delivery materials will be available to enhance mastery of the concept. Providers will have the opportunity to demonstrate how they will teach the participants how to use the Fitbit tracker and address any gaps that may be evident during these sessions. The teach-back method will assess their understanding of the education provided, and the patient’s weight loss will be the most critical evaluation outcome. Appendix (D) has a detailed description of the Educational Plan.