A Study of the Strategies and Barriers to Nutrition Counseling Perceived by Nurse Practitioners

Obesity is the major public health issue in the United States today. According to the Unites States Department of Health and Human Services (2001), approximately 61% of adults were overweight of obese in 1999. The national Heart, Lung and Blood Association (NHLBI) (1998), reports that overweight is often accompanied by high blood pressure, high blood cholesterol, Type II diabetes, coronary heart disease and other health problems. Primary care providers often have the first chance to participate in weight management with their patients (Ashley et al., 2001). Yet, current literature suggests that barriers to a weight management partnership between clients and providers exist. The increasing prevalence of obesity and its accompanying co-morbidities make weight management extremely important to the practice of nursing. The Elaboration Likelihood Model (Petty and Cacioppo, 1981) provided the theoretical framework for this study. The basic premise of the theory is that clinician promotion and explanation of information can assist in a learning process that may lead to long-term behavior change. The purposive sample for this study was randomly selected from a list of nurse practitioners (NPs) certified by the State Board of Nursing to practice in Michigan. The sample consisted of 54 NPs practicing primarily in family practice, internal medicine, women's health and geriatrics. The majority of NPs were female and mainly practicing in urban and suburban locations. The mean number of practice years was 9.5, and the age ranges of respondents spanned from 31 to over 66 years. A mailed, self-administered survey was used to assess potential barriers and strategies related to nutrition counseling. Results of this study indicated that the nurse practitioners considered dietary counseling a high priority. The majoity of NP respondents reported feeling confident in their ability to change patients' diets. Related to counseling, the more time NPs spent in nutrition counseling, the more time they desired to spend. More than half of the respondents indicated that lack of adequate eimbursement is a barrier to providing nutrition counseling. However, there was no correlation betwen counseling time and lack of adequate reimbursement. Thee are few published studies addressing the role of NPs in caring for patients with weight management problems. Therefore, additional research is recommended, particularly studies that incorporate qualitative methods.Master'sSchool of Health Professions and Studies: NursingUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/117911/1/Slagor.pd