Purpose for the program: Obesity is epidemic in the United States and is considered a national health threat and public health challenge. Although obesity prevalence among all Americans has increased, data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) demonstrates that there are disparities among racial and ethnic groups, gender, and the less educated (CDC, 2009). The number of obese minority women is disproportionally high with 41.9% of non-Hispanic black women and 30.8% of Hispanic women reported as obese in 2009 (CDC, 2009). More women than men age 20-59 have Class II and Class III obesity (CDC, 2010). Female-specific health risks associated with obesity include breast and endometrial cancer, prenatal complications, and infertility. As primary care providers, advanced practice nurses should prescribe weight loss in a manner that is effective and lasting in the population served.

Proposed change: To address the problem of obesity in low income, overweight women, an evidence-based practice (EBP) project was implemented in a free health care clinic in Northwest Indiana.

Implementation, outcomes and evaluation: Guided by theory, this EBP project was designed into twelve one-hour group sessions that concentrated on: (a) dietary education, (b) physical activity education, and (c) group support. Behavior change was supported using social cognitive theory. A convenience sample of 21 women received the intervention. Two outcomes were expected as a result of this EBP project: (a) a decrease in BMI and/or waist circumference, (b) recorded change in dietary intake and steps taken. (Results will be available April 2012).

Implications for nursing practice: The evidence is clear that obesity is implicated in the pathogenesis and progression of a multitude of diseases. A new level of wellness can be achieved through intentional weight loss. Losing as little as 5 to 10% of baseline body weight has been shown to: (a) decrease blood pressure, (b) improve lipid profiles, (c) improve insulin sensitivity and glycemic control, and (d) lower the risk for breast postmenopausal breast cancer. Nurses-are well suited to combat the obesity epidemic among low-income women by implementing evidence-based health promotion strategies that are proven effective. 

 Keywords: female, self-efficacy, diet, exercise or physical activity, weight loss and low-income or poverty