A CHANGE TOOL FOR LIFESTYLE MODIFICATIONS IN OBESE AND OVERWEIGHT WOMEN

The quality improvement project, “A Change Tool for Lifestyle Modifications in Obese and Overweight Women” by a certified family practice nurse practitioner, utilizes a group of interventions as a “tool bundle” to influence change in obese and overweight women. It is well known that obesity is a risk factor for many health problems and that overweight patients arrive to care settings in various stages of readiness for change (Transtheoretical Model). The tools included a cost-benefit decisional balance analysis form to assess for initial stage of change (for patients) along with motivational interviewing prompts for each stage of change (for practitioners). Also in the bundle were lists of community and Internet resources focused on both exercise and diet and tailored to each stage of change. There was also a planning form to be used by patients. The tool bundle was piloted on 17 obese/overweight Hispanic women in a single clinic setting. Women received monthly calls to assess their behaviors related to weight loss. Initially, most women (71%) were in contemplation phase of weight loss. Over two to six months, 14 women’s reported behaviors indicated that they had progressed one level in their readiness to change. Nurse practitioners wish to help their clients lose weight but have limited time for interventions. This paper describes a pilot project that successfully tested a theoreticallybased (Transtheoretical Model) and evidence-based (motivational interviewing) intervention suitable for a busy outpatient practice.