Utilizing Motivational Interviewing to Encourage Weight Loss in Primary Care

This quality improvement project aims to change how nurses and nurse practitioners approach obese patients through the use of Motivational Interviewing (MI). Obesity has become a burdensome health problem in the United States. In the status quo, primary care providers often fail to treat obesity by deferring to other providers; thus there exists a need for Primary Care Providers must start a conversation with their obese patients. The providers need to use a different approach than the ineffective behavior currently used.

Purpose and Background: Obesity is a growing epidemic in the United States with two out of every three adults considered overweight or obese. Primary Care Providers (PCP) need to screen for BMI in adults over the age of 18 years; whereas Nursing has an opportunity to address obesity through lifestyle counseling. Motivational Interviewing (MI) has been proven to be effective in enhancing changes directed towards reaching health behavior goals.

Methods: The purpose of this project will be to educate Nurse Practitioners (NPs) and Nurses (RNs) to promote healthy changes in obsess individuals using the principles of MI. The training in MI will include a pre-survey, then the viewing of an online MI module, followed by a written post-survey and asked at one month to see if they are utilizing these skills in their practice.

Implementation Plan/ Procedure: This project will begin after Institutional Review Board (IRB) approval, and recruiting graduate students will occur in December 2018. The first part of the project will commence in December 2018 / January 2019 with pre-survey, educational session, post-survey, then one month post-survey January /February 2019.

Implications/Conclusion: The intended primary outcome of the project is that NPs and RNs will demonstrate increased knowledge on MI principles and core skills after completing online training. The secondary outcome is the NPs and RNs will recognize the value of MI counseling methods; and will facilitate the use of MI techniques in practice of obesity management.

This project will bring awareness to the barriers to obesity management in Nurses and Nurse Practitioners and how they are or are not using a Motivational Interviewing framework. The expected outcomes of the project are that University of Massachusetts College of Nursing Graduate Students, who are Nurses and Nurse Practitioners, will demonstrate increased knowledge of Motivational Interviewing principles and core skills after completing online training; and that NP/RN will recognize the value of MI counseling methods and will facilitate the NPs/RNs use of MI techniques in practice of obesity management.

Although the project focuses on obesity, MI has been used in other areas of chronic illnesses such as diabetes and hypertension. When a nursing professional becomes proficient in using MI, then all patients with chronic disease will benefit from this technique.

Using MI is a paradigm shift from telling the patients about their care in to engaging them in their care. Showing the importance of MI has momentous effects not just in chronic care management but more importantly a change in therapeutic communication taught in nursing school, and how nurses approach patients.