Date of Award

Fall 2019

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)


Leadership and Advanced Nursing Practice

Committee Chair

Dr. Cathy Hughes

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. Sheree Conley-Donaldson


Obesity is at epidemic levels within the United States (U.S.), but the Southern U.S. has some of the most obese states. Mississippi (MS) is the most obese state in the country (Robert Wood Johnson Foundation, 2018). Factors such as diet, sedentary lifestyle, cultural influences, and socioeconomic status contribute to the state’s citizens being overweight and obese.

Contributing to the state’s obesity is the fact that MS has more people living in poverty than any other state (Center for American Progress [CAP], 2018). Lacking the ability to afford healthy foods and the ability to afford quality healthcare adds to the state’s obesity index. This multifaceted problem has placed MS further into a spiraling trend of poor health.

This doctoral project focused on assessing readiness to change in overweight and obese patients, ages 18-64, in a patient-centered medical home in South MS. A screening tool was given to patients identified as overweight and obese. The University of Rhode Island Change Assessment Scale (DiClemente & Hughes, 1990), psychotherapy version, was used to yield a readiness to change score indicative of the stage of change the patient was in at that point in time. Patients received education using handouts on a heart-healthy diet and physical activity.

A total of 37 patients were screened over a period of three weeks as part of this project. Sex distribution showed participants were 78% female (n=29) and 22% male (n=8). The data indicated that 62% of identified patients were in the precontemplation stage meaning they had not acknowledged their weight as a problem. Furthermore, 35% were in the contemplation stage and had only begun to recognize being overweight or obese as a problem and were beginning to consider change. A large majority, 73% (n=27), of patients screened were African American. The mean body mass index (BMI) was 40.4 kg/m2.

These project findings indicate a need to establish a patient’s readiness to change. Future projects should work to enhance interprofessional practices aimed at reducing obesity within their patient population. These practices should include primary care providers, psychologists, dieticians, and social workers.