Nurse clinics can focus care on a particular area of practice as per the nurse’s specialised knowledge and experience, such as weight management (ACN 2015).

Nurse-led healthy weight programs have been delivered in various settings. For example, in North Carolina, there was a healthy weight program delivered by nurses (with teacher assistance) to adolescents in school (Dupart et al. 2017).

Similarly, nurse-led weight management programs have been delivered to Midwestern suburban primary-school-aged children (Kubik & Lee 2013).

Yaeger et al. (2018) focused on a nurse-led risk factor modification program in achieving weight loss in obese adults with atrial fibrillation (AF). This intervention focused on lifestyle modifications, goal-setting and regular phone calls to successfully assist participants in losing weight.

Yardley et al. (2014) note that weight management programs can also be web-based, with support from practice nurses in the primary healthcare context.

Who Are Nurse-Led Weight Management Programs For?

Dupart et al. (2017) outlined a school-based healthy weight intervention for adolescents that focused on education regarding nutrition and exercise. The intervention involved twice-weekly meetings for seven weeks, with meetings lasting for 45 to 60 minutes each.

Kubik and Lee (2013) found in their study of young, suburban school children that the people who showed more interest in the weight management program were:

• Parents with concerns regarding the weight of their child
• Parents from families of colour
• Parents of female children.

Health professionals caring for clients who are obese (a body mass index of 30kg/m2 or more with AF may potentially be interested in weight management programs led by nurses or specialist medical officers. As Yaeger et al. (2018) suggest, weight loss reportedly improves ‘arrhythmia' outcomes for obese patients with AF’.

Nurses, specifically mental health nurses, may be in an optimal position to deliver weight management programs to people with mental health conditions (Nugent & Duckworth 2016).

Nugent and Duckworth (2016) explain that people with mental illness could also be interested in weight management programs as they may have an increased risk of weight-related non-communicable diseases. Hence, carers and health professionals treating people with mental health conditions may be interested in establishing nurse-led weight management programs.

Why a Nurse-Led Weight Management Program?

Yaeger et al. (2018) state that a regular practical approach to weight management generally involves:

• Engagement with clients
• Motivational interviews
• Person-centred lifestyle modification goal-setting regarding diet and exercise
• Support phone calls.

Petit Francis et al. (2017) revealed in their systematic review that the more successful nurse-led weight management interventions also involved:

• Nurse participation in health promotion
• Nurses collaborating with the interprofessional team
• Nurse consultations
• Nurse education on being physically active
• Telephone coaching by nurses.

When is Data Collected for Weight Management Programs?

Dupart et al. (2017) highlighted data collection points in their study at the baseline, post-intervention (at completion) and post-intervention (3 months later).

Yaeger et al. (2018) gathered data via biweekly phone calls for the first 2 months of the intervention, and then monthly phone calls for 12 months.

The data collected was for the purpose of assessing weight loss and goal-setting adherence (Yaeger et al. 2018).

The systematic review by Petit Francis et al. (2017) showed that some studies complete follow-up for up to two years post-intervention.

Are Weight Management Programs Cost-Effective?

Petit Francis et al. (2017) found in their systematic review of randomised trials that nurse-delivered weight management interventions successfully led to weight loss or BMI reduction in 65% of studies.

Dupart et al. (2017) found that the seven-week school-based weight management intervention was cost-effective and positively received by stakeholders. However, Yaeger et al. (2018) said that some weight management strategies can use many resources and not be very realistic.

Yardley et al. (2014) found that web-based weight management interventions with practice-nurse support for clients could be practical solutions for primary healthcare settings. It is not believed that automated web-based weight management programs can be effective without human support, such as that of nurses (Yardley et al. 2014).

Aboueid et al. (2018) state that primary healthcare management of obesity can be limited if there is not enough access to allied health teams, time and other resources. It appeared that clients preferred weight management activities that involved referrals to health professionals and health education resources (Aboueid et al. 2018).

References

• Aboueid, S, Jasinka, M, Bourgeault, I L & Giroux, I 2018, 'Current Weight Management Approaches Used by Primary Care Providers in Six Multidisciplinary Healthcare Settings in Ontario', Canadian Journal of Nursing Research, viewed 21 June 2018, http://journals.sagepub.com/doi/abs/10.1177/0844562118769229#articleCitationDownloadContainer
• Australian College of Nursing 2015, Nursing in General Practice: A Guide For the General Practice Team, Australian College of Nursing, Canberra, viewed 21 June 2018, https://acn.edu.au/wp-content/uploads/2017/11/Nursing_in_General_Practice_C20.pdf
• Dupart, G, Berry, DC, D, Auria, J, Sharpe, L, McDonough, L, Houser, M, Flanary, S & Koppelberger, S 2017, 'A Nurse-Led and Teacher-Assisted Adolescent Healthy Weight Program to Improve Health Behaviors in the School Setting', The Journal of School Nursing, viewed 21 June 2018, https://www.ncbi.nlm.nih.gov/m/pubmed/29202626/
• Petit Francis, L, Spaulding, E, Turkson-Ocran, R A & Allen, J 2017, 'Randomized Trials of Nurse-Delivered Interventions in Weight Management Research: A Systematic Review', Western Journal of Nursing Research, vol. 39, no. 8, pp. 1120-50, viewed 21 June 2018, https://www.ncbi.nlm.nih.gov/pubmed/28322648
• Kubik, M Y & Lee, J 2013, 'Parent Interest in a School-Based, School Nurse-Led Weight Management Program', The Journal of School Nursing, vol. 30, no. 1, pp. 68-74, viewed 21 June 2018, https://www.ncbi.nlm.nih.gov/pubmed/23598566
• Nugent, S & Duckworth, I 2016, 'Smoking Cessation and Healthy Weight Management', British journal of Mental Health Nursing, vol. 5, no. 3, viewed 21 June 2018, https://www.magonlinelibrary.com/doi/abs/10.12968/bjmh.2016.5.3.134
• Yaeger, A, Cash, NR, Parham, T, Amaro, A, Deo, R, Frankel, DS, Epstein, AE, Santangeli, P, Riley, M, Nazarian, S, Lin, D, Garcia, FC, Schaller, R, Arkles, J, Supple, G, Kumareswaran, R, Callans, DJ, Marchlinski, FE & Dixit, S 2018, ‘Abstract 146: Efficacy of a Nurse-Led Risk Factor Modification Program in Achieving Weight Loss in Obese Atrial Fibrillation Patients’, Cardiovascular Quality and Outcomes, vol. 11, no. 1, viewed 21 June 2018, https://www.ahajournals.org/doi/10.1161/circoutcomes.11.suppl_1.146
• Yardley, L, Ware, L J, Smith, E R, Williams, S, Bradbury, K J, Arden-Close, E J, Mullee, M A, Moore, M V, Peacock, J L, Lean, M E, Margetts, B M, Byrne, C D, Hobbs, R F & Little, P 2014, 'Randomised Controlled Feasibility Trial of a Web-Based Weight Management Intervention With Nurse Support for Obese Patients in Primary Care';, International Journal of Behavioural Nutrition and Physical Activity, vol. 11, no. 67, viewed 21 June 2018, https://www.ncbi.nlm.nih.gov/pubmed/24886516