Online Program

Transforming evidence-based obesity guidelines into clinical practice

Tuesday, November 5, 2013 : 8:30 a.m. - 8:50 a.m.

Ingrid Attleson, RN, BS, BA, School of Nursing, University of Minnesota, Minneapolis, MN
Karen A. Monsen, PhD, FAAN, RN, School of Nursing, University of Minnesota, Minneapolis, MN
Kristin Erickson, RN, BSN, PHN, PartnerSHIP 4 Health, Fergus Falls, MN
Diane Thorson, MS, RN, PHN, Public Health, Otter Tail County Public Health, Fergus Falls, MN
Background: A system-level community obesity prevention project was implemented by public health nurses (PHNs) from four counties that partnered together with ten clinical sites in a obesity-prevention collaborative in the Midwest. The project aimed to increase implementation of the Institute for Clinical Systems Improvement Prevention and Management of Obesity Guideline in ten collaborating partner healthcare settings. The objectives of this study were to investigate perceptions of administrators and providers at partner settings regarding the impact of the project, and to evaluate the reliability of the Omaha System as a tool for documenting system level interventions and outcomes.

Methods: Participants in the mixed methods study (n=40) were administrators (n=10) and clinicians (n=30) from partner settings. Measures: Omaha System Problem Rating Scale for Outcomes knowledge, behavior, and status (KBS) scores for the Health care supervision problem. Procedures and analysis: Key informant interviews (qualitative analysis), pre- and post-intervention KBS scores (quantitative analysis, percentage agreement).

Results: Partner interviews indicated that the community obesity prevention intervention was effective in creating sustainable system-level changes within healthcare sites. Keys to success were inspiring staff-led strategic changes in practice to promote use of guidelines, integrating documentation prompts within clinical records, providing educational resources for weight management conversations, and training partners in motivational interviewing. PHN-observed and partner-reported KBS ratings were consistent across agencies, with preliminary findings showing 77% agreement overall.

Conclusions: System-level PHN interventions were successful in supporting, improving, and sustaining obesity prevention practice. The Omaha System provided reliable data to show system-level outcomes.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Public health or related nursing
Public health or related organizational policy, standards, or other guidelines
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify successful interventions for promoting use of evidence-based obesity guidelines in clinical setting. Demonstrate applicable uses for Omaha System documentation in public health nurse intervention practice.

Keyword(s): Evidence Based Practice, Community Collaboration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the research assistant for this study funded by a translational research grant, focusing on public health nursing intervention in the area of obesity prevention at the clinical level. My previous degree and work experience as a nurse is supporting my current graduate-level training in maternal and child public health, with an emphasis on nutrition and policy.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.