Date of Award

Spring 5-28-2022

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Kathy James, DNSc, APRN, FAAN

Second Advisor

Kevin J Maxwell PhD, DNP, FNP-BC


Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to review research-based studies on Nola Pender’s Health Promotion Model for weight loss and implement the evidence. The goal was to increase patient self-efficacy, weight-loss, and health promoting behaviors such as improved nutrition and increased physical activity among obese women in a weight loss clinic.

Background: Obesity leads to an increased risk of heart disease, stroke, type 2 diabetes, cancer, and premature death (CDC, 2020). From 2016 to 2017, 42.4% of people in the United States were obese (2020). Worldwide, over 650 million people were obese in 2016 (World Health Organization, 2020). According to the CDC, only 1 in 10 adults eat the recommended intake of vegetables and only 1 in 4 adults meet physical activity guidelines (CDC, 2021). Research shows that with a balanced diet and health-conscious lifestyle practices, obesity is preventable and reversible. Increased self-efficacy can promote utilization of these practices and increase engagement.

Methods: Nola Pender’s Clinical Assessment for Health Promotion Plan questionnaire was used to assess self-efficacy and perceived barriers affecting participant’s engagement of health promoting behaviors such as improving nutrition and increasing physical activity. Educational materials at the clinic were gathered to create an individualized education plan for the participant. Baseline measurements for weight, abdomen and waist were documented prior to the project. Meetings were conducted weekly over the course of 12 weeks. The participant completed the questionnaire following the completion of the intervention and final measurements were documented.

Results: There was a correlation between increased self-efficacy and increased health promoting behaviors. This was consistent with previous studies which found a significant increase in self-efficacy and health promoting behaviors after receiving individualized education and materials. After the 12-weeks, the participant lost a total of 12 pounds and 4 inches around the waist and abdomen.

Evaluation/Conclusion: Nola Pender’s “Clinical Assessment for Health Promotion Plan” allows providers to understand the variables that may affect a patient’s success at engaging in health promoting behaviors and guide counseling. Additional barriers to health promoting behaviors may be considered such as socioeconomic status and access to resources.