Date of Award

Spring 5-31-2026

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Tracie Gadler, DNP, APRN, ACHPN, RNFA, FNP-C, Adjunct Faculty DNP/NP Programs

Abstract

Prediabetes affects approximately one in three adults in the United States, with an estimated 10% progressing to Type 2 Diabetes Mellitus (T2DM) annually. Despite strong evidence supporting exercise as a first-line intervention to prevent disease progression, most patients in primary care settings do not receive structured physical activity counseling. This evidence-based project (EBP) aims to address this gap by implementing a standardized protocol to assess baseline physical activity levels and deliver individualized exercise prescriptions to adults with prediabetes in the primary care clinic.

Eligible participants, defined by HbA1c values between 5.70% and 6.49%, were identified during routine primary care visits and completed the Physical Activity Vital Sign (PAVS) survey to quantify weekly activity. Based on survey results and American College of Sports Medicine (ACSM) guidelines, each participant received a personalized exercise prescription recommending 150–300 minutes of moderate-intensity, or 75–150 minutes of vigorous aerobic activity per week, along with strength training at least twice weekly. A pre and post educational survey was completed at the appointment. At the 90-day follow-up, participants repeated the PAVS, weight and HbA1c.

A total of 20 adults enrolled in the exercise‑prescription project, with 18 completing the intervention and varying follow‑up availability across outcomes. Despite incomplete data, participants showed clear improvements: mean weekly physical activity increased from 132.8 to 262.5 minutes (n=12), moving the cohort above ACSM’s recommended threshold; mean weight decreased from 197.2 to 194.7 lb (n=8); and mean HbA1c improved from 5.92% to 5.79% (n=15). These trends indicate that integrating PAVS screening with a structured, written exercise prescription in primary care can meaningfully increase physical activity and support early improvements in weight and glycemic control over 90 days.

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