Wisdom-Chambers, Karen

This evidence-based program evaluation assesses the effectiveness and patient adherence to a structured weight loss intervention at a local primary care clinic. The program targeted 21 adults, aged 27-60, with BMI ≥ 27 kg/m², many of whom faced cardiovascular risks. Over nine months, participants engaged in a program combining semaglutide injections, dietary guidance, behavioral counseling, and regular physical activity. Baseline and follow-up measures at three, six, and nine months evaluated outcomes alongside self-reported quality of life assessments. The results demonstrated significant reductions in BMI and weight (p < 0.01, CI: 95%), with participants reporting increased confidence and self-efficacy. The findings underscore the effectiveness of a nurse-led, compassionate primary care approach to weight management. Recommendations include extending follow-up periods and integrating demographic considerations (education, race, culture) to enhance adherence and long-term success. This evaluation provides actionable insights for clinic and broader healthcare contexts, with plans for dissemination through faculty presentations, publications, and local and national conferences.

Breast cancer (BrCa) is the most common cancer diagnosed in American women and the second leading cause of cancer-related death, making it a top public health priority. According to Yedjou et al. (2019), BrCa incidence is quite close between Black women (125.1/100,000) and White women (127.7/per 100,000) in the US, but Black women are 42% more likely to die from this disease, indicating a critical need to increase early detection among this population. The FAU-Northwest Community Health Center Alliance's Community Health Center (CHC) is a Federally Qualified Health Center (FQHC) Look A Like that provides care to thousands of community members with financial disadvantages as well as other barriers, which limits access to care. This DNP project examined barriers to mammography completion among Black/AA women who received care at the CHC through a medical record review and survey. The medical record of Black women between ages 40-74 who were eligible to receive a mammogram revealed that only (57%) completed a mammogram within the past 4 years and even fewer completed a mammogram within the past 2 years (35%). After surveying a sample of these women (n=25), we found higher self-reported rates of mammography screening (80%) within the past 4 years and (68%) within the past 2 years. Participants reported perceived barriers and perceived benefits of mammography screening. Findings of this QI project showed multilevel influential factors work in combination to impact mammography compliance. For example, combined sociodemographic factors (age, education, family medical history, language, and insurance status) had significant impact on mammography completion (p=0.035). Additionally, an open-ended survey item, revealed these barriers: no insurance, age criteria for mammogram not met, Covid-19, lack of financial stability, fear of pain and exposure to mammography, and no current pain. Recommendations include strategies for improving Black/AA women access to mammography screening.

In only 3 decades, obesity has evolved to a leading cause of morbidity and premature mortality in the United States (US) and worldwide (Kotsis et al., 2018). The rise in the prevalence of obesity has been accompanied by a rise in the prevalence of diabetes and nearly 90% of newly diagnosed patients were overweight (Rossouw, 2015). Most guidelines recommend promoting weight loss among overweight or obese individuals by reducing energy intake together with a healthy eating pattern that focuses on a diet composed of whole or unprocessed foods combined with physical activity and ongoing support (Forouhi et al., 2018). Research also show that behavioral interventions for obesity involving face to face meetings in group sessions typically result in weight loss.
The purpose of this quality improvement project is to initiate a practice improvement project through information dissemination using visual displays for healthy eating to improve knowledge, attitudes, and perceptions/practices toward proper nutrition that will ultimately support weight loss and diabetes control. The project was implemented at a federally qualified health center that caters to the underserved population of Okeechobee, FL. The program was led by a prospective doctoral candidate and involved group-based sessions, interactive teaching focused on dietary modification, and offered social networking and social support. Outcomes included improvement in anthropometric measurements, significant Knowledge, Attitude, and Perception (KAP) survey difference scores, and the ability to create or demonstrate a meal plan that suits preferences and reflects individual total daily caloric requirement.

Having high cholesterol levels raises the risk for heart disease, the leading cause of death in the United States. High cholesterol is considered a silent preventable condition. Uncontrolled cholesterol levels increase health disparities experienced by patients of low-socioeconomic status. The purpose of this quality improvement (QI) project is to determine the effect of an evidence-based cholesterol education program in enhancing hyperlipidemia management strategies among Care Coordinators at a Federally Qualified Health Center (FQHC). The overall goal of the project is to improve patient’s cholesterol levels over a 3-month period. This project supports the implementation of enhanced hyperlipidemia education for Care Coordinators based on a literature review and national hyperlipidemia guidelines. The Lipids, Learning and Lifestyle (LLL) program was created by the project leader and delivered in a train-the-trainer approach to the Care Coordinators at the FQHC. The project leader administered a modified Hypertension Knowledge-Level Scale (HK-LS) questionnaire to Care Coordinators before and after the training sessions, and score results were compared. A total of 10 patients were given the enhanced education by Care Coordinators, in individual sessions attended by the project leader. The patient’s pre and post-intervention cholesterol levels were compared to determine the impact of the educational program. Results from the modified HK-LS did show a statistically significant change in mean scores from pre intervention to post-intervention, revealing an overall improvement in knowledge about hyperlipidemia management. Review of the patient data showed there was no statistically significant improvement in Total Cholesterol (t(10)=1.60, p=.14), HDL (t(10)=-.69, p=.51), Triglycerides (t(10)=1.71, p=.12) or LDL (t(10)=.23, p=.82), from pre-intervention to post-intervention. Though there was no statistically significant improvement in overall Cholesterol levels for the patient participants, there was a statistically significant improvement in Care Coordinator knowledge about hyperlipidemia management.