The DNP Project: Literature Synthesis

PICOT QUESTION: In overweight adult patients in a primary care clinic, what is the impact of implementing the American Heart Association Diet and Lifestyle recommendations, compared to standard care, on body weight in 8-10 weeks?

Implementation: Project participants will follow the American Heart Association Diet and Lifestyle recommendations guidelines, that focus on knowing how many calories you should be eating and drinking to maintain your 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 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.

The program is feasible and can be implemented within the projected time. There is a lot of confidence that the program is achievable and that the results will impact practice. Potential barriers include participants forgetting to input their data to the tracking app and a lack of reliable mobile access. These can be mitigated with training and support and weekly reminders to participants. If a potential participant does not have access to a smartphone, one will be provided for them by the clinic for use during the project. The DNP student will also provide participants with the free Fitbit smartphone app to track weekly food intake and activity. A consumer-based wearable activity tracker might be an ideal tool for health professionals to provide continuous monitoring and aid to patients, as well as another way to encourage people to be more active (Brickwood et al., 2019).

I attached some references that may serve for the synthesis, as they support this project.

References

Brickwood, K. J., Watson, G., O'Brien, J., & Williams, A. D. (2019). Consumer-Based Wearable Activity Trackers Increase Physical Activity Participation: Systematic Review and Meta-Analysis. JMIR mHealth and uHealth, 7(4), e11819. https://doi.org/10.2196/11819Bray, G. A., & Ryan, D. H. (2021). Evidence-based weight-loss interventions: Individualized treatment options to maximize patient outcomes. Diabetes, obesity & metabolism, 23 Suppl 1, 50–62. https://doi.org/10.1111/dom.14200

Følling, I. S., Oldervoll, L. M., Hilmarsen, C., & Ersfjord, E. (2021). A qualitative study explores the use of activity monitors for patients with obesity during weight-loss treatment. BMC sports science, medicine & rehabilitation, 13(1), 25. https://doi.org/10.1186/s13102-021-00253-9

Gal, R., May, A., van Overmeeren, E., Simons, M., & Monninkhof, E. (2018). The Effect of Physical Activity Interventions Comprising Wearables and Smartphone Applications on Physical Activity: a Systematic Review and Meta-analysis. Sports Med Open, 4(1). https://doi.org/10.1186%2Fs40798-018-0157-9

Hu, L., Illiano, P., Pompeii, M. L., Popp, C. J., Kharmats, A. Y., Curran, M., Perdomo, K., Chen, S., Bergman, M., Segal, E., & Sevick, M. A. (2021). Challenges of conducting a remote behavioral weight loss study: Lessons learned and a practical guide. Contemporary Clinical Trials, 108, 106522. https://doi.org/10.1016/j.cct.2021.106522