DNP Role in Equality and Justice

The final months of the program were devoted to completing my data for the program initiative evaluation. There were 25 children and teens with their parents (mothers) enrolled in the program during the first month, but only 15 were seen by the third month of the program. The participants received 3 monthly low-intensity behavioral modification counseling sessions targeting certain eating/dietary habits and behaviors, physical activity and sedentary behaviors associated with overweight and obesity. The Stage 1 Prevention Plus Protocol developed by the Expert Committee is a treatment protocol for overweight and obese children that can be given in the office/clinic or primary care setting. It involves active parental participation, and it is patient-centered because it uses motivational interviewing counseling techniques to help improve the families' levels of self-efficacy and readiness to change. It empowers them to be major decision-makers in the change process, setting their own goals based on their willingness and perceptions.

At the end of the third month visit, I was able to give each participant a Certificate of Completion and a sporting item, which I purchased from a small amount of scholarship award that I received from a nursing professional organization. I am still finalizing my written report and will be presenting the findings to the health center next May.

Children receive their Certificate of Completion and a sporting item at the end of the project.

This Service Leaning Project provided much needed access to childhood obesity treatment and prevention services to socioeconomically at-risk populations who visit the federally qualified health center (FQHC) for primary care. The FQHC had 4 clinical sites, but the project was piloted only in 2 sites. The target population for the health center was largely Hispanic followed by black non-Hispanic, with annual incomes 200% below the federal poverty limit. Interestingly, 92% of the participants seen on the first month of the program were Hispanic, 45% of the mothers had elementary education or less and 33% had middle school, and 78% had family incomes < $20,000/year. These data are consistent with national data reflecting the racial/ethnic and socioeconomic disparities that exist in childhood obesity prevalence.

Programs or interventions developed or designed to address complex issues such as childhood obesity, and those that involve behavioral change needs to be culturally sensitive, patient- and family-centered, supported by evidence and based on theory. And this is true for any kind of intervention that needs change to improve outcomes.

The two questions to answer for this final blog are the following:

What is my role as an educated and privileged citizen in our society in creating a society rooted in equality and justice? 


As a DNP-prepared nurse, my role is to ensure that healthcare delivery models/interventions/programs takes into consideration the cultural background, values, beliefs, and perceptions of the individual/population's. Additionally, the type of setting, the type of neighborhood or community, the educational background of the families/population, their SES need to be identified and respected. The future of our healthcare system is uncertain, but I know that in whatever area of practice I may be in, respect for the dignity of the human life in all of life stages from the moment of conception until the time of death will be at the forefront of everything I do. I am responsible and accountable not to men-but to God-for the knowledge and skills I am privileged to have as a DNP-prepared nurse.


What have I learned about myself and what are my future plans?

The greatest thing I've learned about myself is that I am capable of initiating change in any healthcare setting I may be in, and that I am now more confident that I can lead big projects or program initiatives such as this. As I present the findings of my project this May, I have recommendations that I will make before the Peer Review Committee and if they want to follow these recommendations, I will provide my services for free as a service to my community.

My partners in this project: DNP Student (Mimi Ramos) at the left upper photo and the dietician (Cristina Morales) at the right. Below to the left is the Special Projects Officer of the health center and my DNP Mentor, Penny Pabst with the dietician.