“More than Before:” A Quality Improvement Project to Increase Physical Activity in Patients with Type 2 Diabetes with a Smartphone App

This paper describes the planning, implementation, and evaluation of a quality improvement project that aimed to augment the standard practice of verbally providing recommendations to perform physical activity (PA) to patients with Type 2 Diabetes (T2D) through the recommendation of the Type 2 Diabetes: Lifestyle & BG by Nourishly (“Nourishly”) app. Five providers at a family practice clinic in Cary, North Carolina participated. The target population was adult patients with T2D who could independently use a smartphone and perform PA without contraindications. A literature review revealed smartphone apps are an underutilized tool with potential to increase PA levels. Project implementation took place over 14 weeks. Of 101 eligible patients, 61 patients received a Nourishly app recommendation, achieving the goal of at least 60%. At 12-week follow-up, 35 of the 61 patients either downloaded the app, requested information on the app again, or used another tool to help them increase their PA levels. 22 patients reported an increase in their PA levels, achieving “More than Before.” Five of the 22 patients started from a baseline of “no exercise.” Thirteen of the 22 patients had downloaded the Nourishly app; nine increased their PA through other means. Augmenting standard practice by taking time in the visit to provide a recommendation to perform PA using evidence-based tools is an effective means to increase PA levels in patients with T2D. Providers caring for patients with T2D should consider integrating this intervention into routine practice.Doctor of Nursing Practic