Measuring Intention to Make Lifestyle Modifications in Hispanic Women Based on Their BMI and Health Risks: A Quality Improvement Project

Abstract

Obesity is a rising public health concern in the United States that contributes to the development of long-term health conditions. Development of such conditions can be detrimental to women of childbearing age, as it affects their ability to conceive. Obesity is highest among the Hispanic population, and is estimated to be about 33.1% in Hispanic women in Pima County. This rate is still above the Healthy People 2020 goal of 30.5%. Reducing obesity will help to reduce the annual cost of treating obesity, which is estimated to be about $149.5 billion. Primary care providers (PCP) use body mass index (BMI) scores to quickly identify obesity and health risks for each patient. The purpose of this quality improvement project was to determine the effect of an educational intervention on intention to engage in lifestyle modifications. Measured outcomes included motivation to engage in healthy diet, regular exercise, knowledge acquisition of BMI scores, and knowledge acquisition of high BMI score health complications. This project was a one group quasi-experimental design with pre- and post-test based in a family practice clinic in Green Valley, Arizona. After 10 days of recruitment, 30 Hispanic women agreed to participate. Participants were aged 20-49, non-pregnant, non-lactating, non-diabetic, and able to read in English or Spanish. Participants filled out a demographic sheet and a pre-test prior to the intervention. Height and weight were measured using a scale and stadiometer, and BMI scores were calculated. Current weight, BMI score, and ideal weight range were written on the personalized educational sheet (PES) that also included health risks associated with high BMI scores, BMI score ranges, and healthy weight maintenance recommendations. Post-tests were given after complete explanation of the PES. Total time to complete the project was about 20-30 minutes. Pre- and post-test questions included questions from the Self-Determination Theory healthcare questionnaires, which measure perceived competence and motivation for change in participants. On the pre-test, 6.7% of participants knew their current BMI score, and on post-test 96.7% knew their current BMI score. The participants (66.7%) knew BMI score components on the pre-test, and there was only a 20% increase in the number of women that knew the components on post-test. On post-test, 86.6% of the participants knew 10 or more high BMI score associated health risks. Paired t-tests scores revealed that there was a statistically significant difference for both autonomous (-2.1) and controlled (-3.3) motivation for exercise, but not for healthy diet. The PES that was developed successfully motivated participants to engage in regular exercise, but it did not motivate them to engage in healthy eating. Perhaps other ways to encourage motivation to eat a healthy diet should be added to the PES to obtain more robust outcomes for healthy behavior. The PES can provide PCPs with the opportunity to talk to women about healthy weight.