Date of Award

Spring 5-27-2023

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Deanna Johnston PhD, RN, CNS, CNL, CHSE

Second Advisor

Kathy James DNSc, FNP, FAAN


Purpose: The purpose of this evidence-based Doctor of Nursing Practice (DNP) project was to assess perceived self-efficacy in overweight women who are participating in a weight loss program and the effectiveness of education being provided using the Diet Readiness Test (DRT).

Background: Obesity is a rapidly growing public health problem affecting an increasing number of countries worldwide because of its prevalence, costs, and health effects. Among women between the ages of 40 and 60, more than 80% report that they are either trying to lose weight or trying to maintain weight. The overall prevalence of obesity was similar among men and women, but the prevalence of severe obesity was higher among women. Among women, 39.7% of those aged 20–39, 43.3% among those aged 40–59, and 43.3% among those aged 60 and over were characterized as being obese. Readiness to change seems to be one of the most promising factors promoting behavior change in individuals who need to modify their lifestyle for health purposes. Personal motivation can, in fact, dramatically influence treatment adherence and effectiveness as well as the choice of intervention. Self-efficacy beliefs provide the underpinning for motivation, well-being, and achievement, which are rooted in the core belief that one has the power to effect changes through one’s actions.

Methods: Administration of the Diet Readiness Test (DRT) to all patients coming into an identified weight loss clinic to assess perceived self-efficacy and knowledge of behaviors. Patients who completed the test moved on to receive standard education on the diet and exercise program provided in the clinic’s guidelines. After an eight to twelve-week period, the test was re-administered to each client to determine if perceived self-efficacy improved showing effective education.

Results: Twenty-one surveys were administered during the project. Two were given to clients to take home, complete and return to the clinic. However, these were not returned, leaving a total of 19 surveys completed. Out of the 19 surveys administered, 10 surveys were completed at the end for a completion rate of 52%. The data recorded showed that the scores from the two subsections (3 and 5) assessing eating behaviors of the DRT improved their control over eating and when emotions were high also improved, respectively.

Evaluation: Given the benefit of behavioral weight loss programs to overweight and obese adults, it is important to determine which psychosocial variables are reliable predictors of successful behavior and weight change. Additional research is needed to determine these barriers before clients sign up for a fee-for-service which could assume a certain level of readiness. Implementing this in a primary care setting could lead to more information in behaviors needing change before completing a diet and exercise program.

Keywords: Obesity, Self-efficacy, Women, Weight-loss, Education, Standardized