Improving Effective Weight Management in a University Health Center

Published:October 24, 2021DOI:


      • Applying evidence-based guidelines improves effective weight management.
      • Integrating the 5 As Framework (assess, advise, agree, assist, and arrange) into intervention tools fosters guideline adherence.
      • Collaborative team environments improve quality improvement project outcomes.
      • Implementation of weight management initiatives involves negligible costs.
      • Benefits are increased volume of patients and billable codes.


      The prevalence of obesity has nearly tripled since 1975, making weight management essential yet inadequately addressed in health care. This quality improvement project successfully improved weight management in a university health center with the 5 As (assess, advise, agree, assist, and arrange) Framework and four 2-week plan-do-study-act cycles. Each cycle incorporated data evaluation and tests of change related to project interventions, including a screening trigger tool, shared decision-making tool, case management log, and team engagement plan. Effective care, as measured by a point system based on current evidence-based weight management guidelines, reached a 78% mean score, exceeding the 75% aim of the project.


      To read this article in full you will need to make a payment


      Subscribe to The Journal for Nurse Practitioners
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Centers for Disease Control and Prevention
        National Center for Health Statistics. Obesity and Overweight. Page last reviewed: March 1, 2021.
        (Accessed June 19, 2021)
        • World Health Organization
        Obesity and overweight.
        (April 1, 2020. Accessed June 19, 2021)
        • Cawley J.
        • Biener A.
        • Meyerhoefer C.
        • et al.
        Direct medical costs of obesity in the United States and the most populous states.
        J Manag Care Spec Pharm. 2021; 27: 354-366
        • Obesity Medicine Association
        2021 Obesity Algorithm.
        (Accessed June 19, 2021)
        • Semlitsch T.
        • Stigler F.L.
        • Jeitler K.
        • Horvath K.
        • Siebenhofer A.
        Management of overweight and obesity in primary care: a systematic overview of international evidence-based guidelines.
        Obes Rev. 2019; 20: 1218-1230
        • U.S. Preventive Services Task Force
        Final Recommendation Statement: Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions.
        (September 18, 2018. Accessed June 19, 2021)
        • Christensen S.
        Recognizing obesity as a disease.
        J Am Acad Nurse Pract. 2020; 32: 497-503
        • Thomas P.M.
        Increasing assessment, diagnosis, and intervention of overweight and obesity among college students: a quality improvement project.
        J Dr Nurs Pract. 2019; 12: 232-238
        • Obesity Canada
        5As of Obesity Management.
        (Accessed June 19, 2021)
        • Agency for Healthcare Research and Quality
        Six Domains of Health Care Quality.
        (Page last reviewed November 2018. Accessed June 19, 2021)
        • Ogrinc G.S.
        • Headrick L.A.
        • Barton A.J.
        • Dolansky M.A.
        • Madigosky W.S.
        • Miltner R.S.
        Fundamentals of Health Care Improvement: A Guide to Improving Your Patients’ Care.
        3rd ed. Joint Commission Resources, 2018
        • Mabry-Hernandez I.
        • Ojeda L.
        Behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults.
        Am Fam Phys. 2019; 99: 515-516
        • Li J.
        • Talari P.
        • Kelly A.
        • et al.
        Interprofessional teamwork innovation model (ITIM) to promote communication and patient-centered, coordinated care.
        BMJ Qual Saf. 2018; 27: 700-709


      Dr. Allison Ensign is with the Department of Nursing, Utah Valley University, Orem, UT. Dr. Kimberly Couch is with the Department of Nursing, Frontier Nursing University, Versailles, KY. Allison Ensign, DNP, FNP-C, is an Assistant Professor and a Family Nurse Practitioner and can be contacted at [email protected] . Kimberly Couch, DNP, CNM, FNP-BC, is a Clinical Faculty Member and a Certified Nurse Midwife.