The World Health Organization noted that 2 global health problems have reached epidemic proportions: obesity and type 2 diabetes. These conditions affect nearly 170 million people worldwide. The clinical practice problem addressed by this project was the prevalence of adults ages 50 and older in an ambulatory care setting who suffer from obesity and diabetes and may benefit from a tailored weight management and nutrition education intervention. The purpose of this project was to design a program that would decrease body mass index and hemoglobin A1c in older patients through adaption of the Chronic Disease Self-Management Program. The evidence supporting this project was obtained through a systematic literature review. The self-efficacy theory guided the project, and the evidence-based practice model used to plan the translation of the evidence into practice was the plan-do-check/study-act cycle, a continuous process improvement model used in many health care settings. The product of the project was an education intervention implementation plan that will be agreed upon by the project team and tracked using a Gantt chart. The program's effectiveness will be evaluated by analyzing the themes of qualitative feedback from patients who complete the program and through comparisons using t test statistics of body mass index and A1c that will be collected at 12 weeks and 12 months after the program start. The social change expected of this program, when implemented, is an increase in patients' engagement in and self-management of their care and a more trusting relationship among patients and the health care team. The recommendations from this project also may be useful in addressing health disparities often experienced by patients suffering from obesity and diabetes.

Reducing diabetes risk among Hispanic-American adults in the United States is a critical public health need and programs targeting young Hispanic-American adults with prediabetes can reduce the risk for developing diabetes. The purpose of this project was twofold: (a) to examine the literature related to diabetes prevention best practices among young adult Hispanic-Americans with prediabetes and (b) create an intervention program to promote these best practices to delay or reverse the trajectory toward diabetes. The inclusion criteria for the literature review were studies with at least a 12-month follow-up and reported outcomes related to changes in diet, increased exercise, and the effects of psychotherapy as modeled in the Diabetes Prevention Program (DPP). Studies that met these inclusion criteria for the period 2002 through January 2016 were evaluated and 11 studies supported the development of recommendations for future implementation. Pender's health promotion model provided useful theoretical support for the effectiveness of individual health behavior changes to reduce the risk of developing diabetes. Based on the literature review, proposed interventions included dietary interventions, behavior modifications, and both aerobic and resistance exercise training adapted for the young adult Hispanic-American population. The planned interventions will fill an evidence-to-practice gap in application of the DPP. The program when implemented will promote social change through lifestyle modifications among young adult Hispanic-Americans with prediabetes and is expected to improve dietary intake, weekly exercise, fasting glucose, and glucose tolerance and support weight loss, all of which can delay or stop progression to diabetes.