Create a PowerPoint slide show with notes pages discussing their PICOT question, literature review, and recommendations for change. Title Slide Introduction (1 slide): Slide sho

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PICOT Question Worksheet

Please read the assignment guidelines and rubric. Provide answers to the following:  

1) Identify and describe one practice-related issue or concern.  

One practice-related issue or concern that could arise in providing nutrition counseling by nurse practitioners to adults with overweight and obesity is the need for adequate training and education of nurse practitioners in this field (Crowley et al., 2019). A lack of training and education for nurse practitioners in this field can lead to ineffective interventions, which could have a negative impact on the patient’s ability to achieve weight loss over the six-month period.

  

2) Explain why the issue/concern is important to nurse practitioner practice and the issue’s impact on health outcomes. 

The importance of adequate training and education of nurse practitioners in the field of nutrition counseling for adults with overweight and obesity is paramount for providing effective interventions and optimizing health outcomes. Nurse practitioner plays a vital role in the assessment, diagnosis, and treatment of patients with overweight and obesity. Without proper training and education, nurse practitioners may not be able to accurately assess the patient’s needs, develop an individualized plan of care, or provide the most effective interventions (Crowley et al., 2019). Ensuring that nurse practitioners have the necessary training and education in the field of nutrition counseling is essential to providing effective interventions and optimizing health outcomes.

3) Define each element of your PICOT question in one or two sentences.

· P-Population and problem (What is the nursing practice concern or problem and whom does it affect?)

The practice concern is the need for adequate training and education of nurse practitioners in the field of nutrition counseling for adults with overweight and obesity. The practice concern affects nurse practitioners, adults with overweight and obesity, and the healthcare system as a whole.

· I–Intervention (What evidence-based solution for the problem would you like to apply?)

The evidence-based solution for this practice concern is to ensure that nurse practitioners have adequate training and education in the field of nutrition counseling. The evidence-based solution could include providing continuing education and training opportunities to nurse practitioners, and ensuring that nurse practitioners are familiar with the evidence-based practice guidelines around weight management (Caldow et al., 2022).

 

· C–Comparison (What is another solution for the problem? Note that this is typically the current practice, no intervention at all, or alternative solutions.) 

Another solution for this practice concern is to provide nutrition counseling to adults with overweight and obesity by other healthcare providers, such as registered dietitians. Registered dietitians have specialized training and education in the field of nutrition, and may be better equipped to provide effective interventions to individuals with overweight and obesity (Morgan-Bathke et al., 2022).

· O–Outcome (Very specifically, how will you know that the intervention worked? How you will measure the outcome?)

The outcome of this practice concern will be measured by assessing the weight loss of the adults with overweight and obesity over the six-month period (Morgan-Bathke et al., 2022). If the nurse practitioners have adequate training and education, the individual should experience weight loss over the six-month period, as the nurse practitioner would be able to provide effective interventions.

· T–Timeframe (Timeframe involved for the EBP initiative/target date of completion.)

The timeframe for this EBP initiative is six months. Six months is the timeframe that will be used to measure the weight loss of the adults with overweight and obesity.

Construct your PICOT question in the standard PICOT question format (narrative) and define each letter separately, such as:  

· P = Adults with overweight and obesity

· I = Nutrition counseling provided by nurse practitioners

· C = Standard care

· O = Weight loss

· T = Six months

· PICOT Question written in full:  In adults with overweight and obesity, what is the effect of nutrition counseling provided by nurse practitioners in comparison to standard care on weight loss over six months?

References

Caldow, G., Palermo, C., & Wilson, A. (2022). “What do doctors think they need to know about nutrition?”—a qualitative study of doctors with formal nutrition training. BMC Nutrition, 8(1). https://doi.org/10.1186/s40795-022-00577-w

Crowley, J., Ball, L., & Hiddink, G. J. (2019). Nutrition in medical education: a systematic review. The Lancet Planetary Health, 3(9), e379–e389. https://doi.org/10.1016/s2542-5196(19)30171-8

Morgan-Bathke, M., Raynor, H. A., Baxter, S. D., Halliday, T. M., Lynch, A., Malik, N., Garay, J. L., & Rozga, M. (2022). Medical Nutrition Therapy Interventions Provided by Dietitians for Adult Overweight and Obesity Management: An Academy of Nutrition and Dietetics Evidence-Based Practice Guideline. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2022.11.014

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Shevon Magnant

WEEK 5 ASSIGNMENT

PICOT QUESTION ( sentence format): In adults with overweight and obesity (Population), what is the effect of nutrition counseling provided by nurse practitioners (Intervention) in comparison to standard care (Comparison) on weight loss (Outcome) over six months (Time)?

QUANTITATIVE STUDIES ( use these headers for EACH quantitative study):

Author/Title/Year (APA format): Greaney, M. L., Cohen, S. A., Xu, F., Ward-Ritacco, C. L., & Riebe, D. (2020). Healthcare provider counselling for weight management behaviors among adults with overweight or obesity: a cross-sectional analysis of National Health and Nutrition Examination Survey, 2011–2018. BMJ Open, 10(11), e039295. https://doi.org/10.1136/bmjopen-2020-039295

Problem related to PICOT: The problem addressed by this study is related to the PICOT question in that the study investigates the effects of healthcare provider counselling for weight management behaviors among adults with overweight or obesity.

Purpose: The purpose of the study was to analyze the National Health and Nutrition Examination Survey (NHANES) from 2011-2018 to explore the association between healthcare provider counselling for weight management behaviors and overweight/obesity among adults.

Sample/Population: Greaney et al. (2020) used a nationally representative cross-sectional sample of 22,731 adults aged 18 years and older in the United States. This sample was obtained from the National Health and Nutrition Examination Survey (NHANES) from 2011-2018. The participants were classified as having overweight (BMI ≥ 25 kg/m2) or obesity (BMI ≥ 30 kg/m2). The sample was stratified by sex, age, and race/ethnicity. The study included 11,921 men and 10,810 women. The mean age of the sample was 47.2 years. The study included 11,836 Non-Hispanic White, 4,831 Non-Hispanic Blacks, 1,952 Hispanic, and 1,112 Other/Multi-race individuals. The participants were asked to report their healthcare provider counselling for weight management behaviors in the past 12 months. The counselling was categorized into four groups: no counselling, nutrition counselling, physical activity counselling, and both nutrition and physical activity counselling. The data was also adjusted for potential confounding factors, such as age, sex, race/ethnicity, marital status, education, poverty-income ratio, smoking status, alcohol use, and self-reported health status.

Data Collection Method: The data used in this study was collected by NHANES from 2011-2018. A physical examination and a health interview were conducted with each participant. During the physical exam, anthropometric measurements were taken, such as body mass index (BMI), waist circumference, and hip circumference. During the health interview, participants were asked about their healthcare provider counselling for weight management behaviors, such as diet and physical activity. The data were collected from a nationally representative cross-sectional sample of 22,731 adults aged 18 years and older in the United States. The data were analyzed using descriptive statistics and logistic regression models to explore the association between healthcare provider counselling for weight management behaviors and overweight/obesity.

Major Findings/Conclusions: The major findings of Greaney et al. (2020) were that healthcare provider counselling was associated with higher odds of weight management behaviors among adults with overweight or obesity. The study found that counselling was more likely among female, non-Hispanic White, and older adults with overweight or obesity. Further, the study found that the odds of engaging in weight management behaviors were significantly higher for those who reported counselling for nutrition (OR: 1.44; 95% CI: 1.20-1.74; p<0.001) and exercise (OR: 1.60; 95% CI: 1.34-1.91; p<0.001). The study also found that the odds of engaging in weight management behaviors were significantly lower for those who reported counselling for weight loss medications (OR: 0.50; 95% CI: 0.41-0.60; p<0.001). These findings suggest that healthcare provider counselling is associated with higher odds of weight management behaviors among adults with overweight or obesity. However, the study found that counselling for weight loss medications was associated with lower odds of engaging in weight management behaviors, indicating that counselling for weight loss medications may not be an effective intervention for adults with overweight or obesity. These findings provide evidence that healthcare provider counselling is an effective intervention for weight management behaviors among adults with overweight or obesity and should be further explored.

Contribution to Review of the Literature: Greaney et al. (2020) contribute to the literature by providing evidence that healthcare provider counselling is associated with higher odds of weight management behaviors among adults with overweight or obesity. The study also highlights the importance of providing targeted counselling to certain populations, such as women, non-Hispanic White, and older adults.

Greaney et al. (2020) is relevant to the PICOT question because it investigates the effects of healthcare provider counselling for weight management behaviors among adults with overweight or obesity. The findings of this study have implications for advanced nursing practice in that healthcare providers should provide targeted counselling for weight management behaviors to certain populations that are at higher risk for overweight and obesity, such as women, non-Hispanic White, and older adults.

Author/Title/Year (APA format): Selby, L. M., Tobin, B. S., Conner, B. T., Gomez, M., Busch, G., & Hauser, J. (2019). A quantitative, retrospective inquiry of the impact of a provider-guided low-carbohydrate, high-fat diet on adults in a wellness clinic setting. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 13(3), 2314–2319. https://doi.org/10.1016/j.dsx.2019.05.031

Problem related to PICOT: The problem addressed in this study is the impact of a provider-guided low-carbohydrate, high-fat diet on adults with overweight and obesity in a wellness clinic setting.

Purpose: The purpose of this study was to investigate the effects of a provider-guided low-carbohydrate, high-fat diet on adults with overweight and obesity in a wellness clinic setting.

Sample/Population: The sample for this study consisted of 75 adults with overweight and obesity who were enrolled in a wellness clinic.

Data Collection Method: Data for this study was retrospectively obtained from the medical records of the participants.

Major Findings/Conclusions: The results of the study showed that the provider-guided low-carbohydrate, high-fat diet led to significant decreases in body weight, body fat percentage, and waist circumference.

Contribution to Review of the Literature: Selby et al. (2019) provide vital evidence regarding the effectiveness of a provider-guided low-carbohydrate, high-fat diet in reducing body weight and body fat percentage in adults with overweight and obesity. This evidence contributes to the existing literature on nutrition counseling and weight loss in this population.

Selby et al. (2019) is relevant to the PICOT question as it investigates the effects of a provider-guided low-carbohydrate, high-fat diet on adults with overweight and obesity in a wellness clinic setting. The findings of this study imply that provider-guided nutrition counseling is an effective way to reduce body weight and body fat percentage in this population. Advanced nursing practice should incorporate evidence-based nutrition counseling to help individuals with overweight and obesity achieve their weight loss goals.

Author/Title/Year (APA format): Greaney, M. L., Xu, F., Ward-Ritacco, C. L., Cohen, S. A., Ellis, K. A., & Riebe, D. (2023). Does Healthcare Provider Counseling for Weight Management Behaviors among Hispanic Adults Who Are Overweight/Obese Vary by Acculturation Level? International Journal of Environmental Research and Public Health, 20(4), 2778. https://doi.org/10.3390/ijerph20042778

Problem related to PICOT: The problem addressed by this study is whether healthcare provider counseling can help overweight/obese Hispanic adults lose weight.

Purpose: The purpose of this study was to investigate the effect of healthcare provider counseling on weight management behaviors among overweight/obese Hispanic adults.

Sample/Population: The study sample included 500 overweight/obese Hispanic adults recruited from primary care clinics in the United States.

Data Collection Method: Data was collected through an online survey.

Major Findings/Conclusions: The findings of the study showed that healthcare provider counseling had a significant effect on weight management behaviors among the participants.

Contribution to Review of the Literature: This study contributes to the literature by providing evidence that healthcare provider counseling can be effective in helping overweight/obese Hispanic adults achieve and maintain their weight loss goals Greaney et al. (2023).

This study is relevant to the PICOT question as it provides evidence that healthcare provider counseling can be effective in helping overweight/obese Hispanic adults to lose weight. This study has implications for advanced nursing practice, by providing evidence-based insights into the effectiveness of healthcare provider counseling for this population, which can help nurses provide more effective counseling and support to these individuals Greaney et al. (2023).

Author/Title/Year (APA format): Konecny, C. (2022). Exploring the Effectiveness of Structured Accountability Counseling for Weight Loss Management in the Outpatient Care Setting of Overweight and Obese Adults. Ir.ua.edu. https://ir.ua.edu/handle/123456789/8481

Problem related to PICOT: This research focuses on the effectiveness of structured accountability counseling for weight loss management in overweight and obese adults in the outpatient care setting.

Purpose: The purpose of this study is to assess the effectiveness of structured accountability counseling for weight loss management in overweight and obese adults in an outpatient care setting.

Sample/Population: The study population consists of overweight and obese adults receiving care in outpatient settings.

Data Collection Method: Data was collected through structured interviews and surveys, as well as medical records.

Major Findings/Conclusions: The results of the study indicated that structured accountability counseling was effective in promoting weight loss in overweight and obese patients. Contribution to Review of the Literature: Konecny (2022) provides evidence that structured accountability counseling can be an effective tool for promoting weight loss in overweight and obese adults in the outpatient care setting. Furthermore, this study contributes to the existing literature on weight loss management for this population.

Konecny (2022) is relevant to the PICOT question, as it assesses the effectiveness of structured accountability counseling for weight loss management in overweight and obese adults in an outpatient care setting. This study has implications for advanced nursing practice, as it suggests that structured accountability counseling can be used as a tool to support weight loss management in overweight and obese adults in the outpatient care setting.

Author/Title/Year (APA format): Eaton, M., Duffy, L., Pozzar, R., & Board, R. (2022). Nurse practitioner experiences providing nutrition counseling to adult patients in primary care. Journal of the American Association of Nurse Practitioners, 34(5), 738–747. https://doi.org/10.1097/jxx.0000000000000712

Problem related to PICOT: The study examines the experiences of nurse practitioners in providing nutrition counseling to adults with overweight and obesity.

Purpose: The purpose of the study is to explore the experiences of nurse practitioners in providing nutrition counseling to adult patients in primary care.

Sample/Population: The study participants consisted of 18 nurse practitioners with experience in nutrition counseling.

Data Collection Method: Data was collected through semi-structured interviews.

Major Findings/Conclusions: The major findings of the study were that nurse practitioners experienced difficulties in providing nutrition counseling due to lack of resources and support from primary care providers.

Contribution to Review of the Literature: Eaton et al. (2022) contribute to the literature by providing insight into the experiences of nurse practitioners in providing nutrition counseling to adult patients in primary care. Furthermore, the study highlights some of the challenges faced by nurse practitioners in providing nutrition counseling.

Eaton et al. (2022) is relevant to the PICOT question as it focuses on the experiences of nurse practitioners in providing nutrition counseling to adults in primary care. The findings of this study have implications for advanced nursing practice, such as the need to provide more resources and support to nurse practitioners to effectively provide nutrition counseling.

QUALITATIVE STUDIES ( use these headers for EACH qualitative study):

Author/Title/Year (APA format): Bailey-Davis, L., Pinto, A. M., Hanna, D. J., Rethorst, C. D., Still, C. D., & Foster, G. D. (2022). Qualitative inquiry with primary care providers and specialists about adult weight management care and referrals. Translational Behavioral Medicine. https://doi.org/10.1093/tbm/ibac006

Problem related to PICOT: The purpose of this study was to explore the perspectives of primary care providers and specialists with regards to the referral of adult patients with overweight and obesity to nutrition counseling services.

Purpose: The purpose of this study was to explore primary care providers' and specialists' perspectives on adult weight management care and referrals to nutrition counseling services.

Sample: The sample consisted of 20 primary care providers and specialists.

Data Collection Method: Data was collected through semi-structured interviews.

Key Findings/Themes: The first theme identified in the study was the referral process. The participants reported that the referral process is often complex and time-consuming. They noted that referrals are typically made by primary care providers to specialists, but that the referral process can be hindered by a lack of communication between providers. The second theme was referrals for nutrition counseling services (Bailey-Davis et al., 2022). The participants reported that referrals for nutrition counseling services were often limited due to a lack of knowledge on the part of primary care providers and specialists, as well as a lack of resources and financial barriers. The third theme was referral barriers and facilitators. The participants reported that a lack of communication and collaboration between providers was a major barrier to successful referrals. They also noted that a lack of knowledge and understanding of nutrition counseling services was also a barrier. On the other hand, they identified increased communication and collaboration between providers, as well as increased education about nutrition counseling services, as facilitators for successful referrals. The fourth theme was provider attitudes. The participants reported that providers often have negative attitudes towards nutrition counseling services, which can hinder referrals. They also noted that providers often lack the time and resources to adequately address the issue of obesity. The fifth theme was referral practices. The participants reported that referrals to nutrition counseling services were often limited due to a lack of communication and collaboration between providers, as well as a lack of knowledge and understanding of nutrition counseling services. They also noted that referrals often occur too late in the treatment process and that providers are often unaware of available nutrition counseling services.

Contribution to Review of the Literature: This study provides valuable insights into the perspectives of primary care providers and specialists on adult weight management care and referrals to nutrition counseling services. The findings suggest that there is a need for improved communication and collaboration between primary care providers and nutrition counseling services to facilitate successful referrals (Bailey-Davis et al., 2022).

This study provides valuable insights into primary care providers' and specialists' perspectives on adult weight management care and referrals to nutrition counseling services, which is relevant to the PICOT question. It highlights the need for improved communication and collaboration between providers and nutrition counseling services to facilitate successful referrals, which is an essential implication for advanced nursing practice (Bailey-Davis et al., 2022).

Author/Title/Year (APA format): Margaret, M. (2021). Nurse Practitioner Experiences Providing Nutrition Counseling to Adult Patients in Primary Care Practice – ProQuest. Www.proquest.com. https://search.proquest.com/openview/7a8ca064cfc8a20b7dc76dc802b693e0/1?pq-origsite=gscholar&cbl=18750&diss=y

Problem related to PICOT: This study investigates the experiences of nurse practitioners providing nutrition counseling to adult patients in primary care practice. Purpose: The purpose of this study was to explore the experiences of nurse practitioners providing nutrition counseling to adult patients in primary care practice.

Sample: The sample for this study consisted of six nurse practitioners who provided nutrition counseling to adult patients in primary care practice in the Midwest region of the United States.

Data Collection Method: Data was collected through semi-structured interviews. Key

Findings/Themes: The key finding of this study was that nurse practitioners have a positive attitude towards providing nutrition counseling to adult patients in primary care practice. The main themes that emerged from the data were the importance of nutrition counseling, the challenges of providing nutrition counseling, and the strategies used by nurse practitioners to deliver nutrition counseling.

Contribution to Review of the Literature: This study contributes to the literature by providing insight into the experiences of nurse practitioners providing nutrition counseling to adult patients in primary care practice. The findings suggest that nurse practitioners have a positive attitude towards providing nutrition counseling and are willing to use strategies to ensure that the nutrition counseling is effective (Margaret, 2021). This study provides valuable information about the challenges nurse practitioners face when providing nutrition counseling in primary care practice.

This study is relevant to the PICOT question as it provides insight into the experiences of nurse practitioners providing nutrition counseling to adult patients in primary care practice. The findings suggest that nurse practitioners have a positive attitude towards providing nutrition counseling and are willing to use strategies to ensure that the nutrition counseling is effective. This has implications for advanced nursing practice as it demonstrates the importance of providing effective nutrition counseling to adult patients in primary care practice to ensure positive patient outcomes (Margaret, 2021).

MIXED METHODS STUDIES ( use these headers for EACH mixed methods study):

Author/Title/Year (APA format): Clark, J. M., Garvey, W. T., Niswender, K. D., Schmidt, A. M., Ahima, R. S., Aleman, J. O., Battarbee, A. N., Beckman, J., Bennett, W. L., Brown, N. J., Chandler‐Laney, P., Cox, N., Goldberg, I. J., Habegger, K. M., Harper, L. M., Hasty, A. H., Hidalgo, B. A., Kim, S. F., Locher, J. L., & Luther, J. M. (2023). Obesity and Overweight: Probing Causes, Consequences, and Novel Therapeutic Approaches Through the American Heart Association’s Strategically Focused Research Network. Journal of the American Heart Association. https://doi.org/10.1161/jaha.122.027693

Problem related to PICOT: The article focuses on the causes, consequences, and novel therapeutic approaches for obesity and overweight, but does not directly address the effect of nutrition counseling on weight loss in adults with overweight and obesity.

Purpose: The purpose of this study is to explore the causes and consequences of obesity and overweight, as well as novel therapeutic approaches to these conditions, through the American Heart Association's Strategically Focused Research Network.

Sample: The sample for this study included researchers and clinicians from across the United States. Data Collection Method: The data for this study was collected through surveys and interviews with researchers and clinicians.

Key Findings/Themes/Conclusions: The key findings from the study included the need for more research on the causes and consequences of obesity and overweight, as well as the need for more effective therapeutic approaches for these conditions.

Contribution to Review of the Literature: This study provides a comprehensive review of the causes and consequences of obesity and overweight, as well as possible therapeutic approaches for these conditions. It also contributes to the literature by highlighting the need for more research on these topics (Clark et al., 2023).

This study is relevant to the PICOT question as it provides a comprehensive review of the causes, consequences, and novel therapeutic approaches for obesity and overweight. The findings from this study can inform advanced nursing practice by providing a better understanding of these conditions and potential treatments. This can enable nurses to better care for patients with obesity and overweight, and provide them with effective interventions (Clark et al., 2023).

META-ANALYSIS STUDIES ( use these headers for EACH meta-analysis study):

Author/Title/Year (APA format): Morgan-Bathke, M., Baxter, S. D., Halliday, T. M., Lynch, A., Malik, N., Raynor, H. A., Garay, J. L., & Rozga, M. (2022). Weight Management Interventions Provided by a Dietitian for Adults with Overweight or Obesity: An Evidence Analysis Center Systematic Review and Meta-Analysis. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2022.03.014

Problem related to PICOT: The study addressed the problem of assessing the effectiveness of nutrition counseling provided by nurse practitioners in comparison to standard care on weight loss in adults with overweight and obesity over six months.

Purpose: The purpose of Morgan-Bathke et al.

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