Assessing the Problem: Leadership Collaboration Communication Change Management and Policy Considerations 

Assessing the Problem: Obesity Among African Americans

Obesity is a complex disorder that involves excessive body fat. Obesity is a serious health concern that increases the risk of other diseases and health problems. It increases the risk of heart diseases, high blood pressure, diabetes, stroke, and some cancers.

Assessing the Problem: Leadership Collaboration Communication Change Management and Policy Considerations

The increasing prevalence of obesity poses a significant population health burden globally. Currently, in the US alone, the adult obesity rate stands at 42.4%, the highest ever recorded. The rate of childhood obesity has also increased, with the current rate being 19.3% among children and young people aged 2-19 years.

Obesity prevalence in the US varies in different health populations, socioeconomic factors, races, and ethnic backgrounds. Obesity is often ignored and may compromise healthcare service delivery and population health. Nursing interventions can therefore be used to address the situation at individual and population levels.

This paper aims to assess the obesity health concern among African Americans from the nursing perspective and propose strategies to address the problem through leadership, collaboration, communication, change management, and policy considerations.

Population Health Problem

Obesity is one of the most prevalent chronic diseases and a leading cause of morbidity (Byrd, Toth & Stanford, 2018). African Americans are one of the minority groups in the US. They are one of the populations that record high obesity rates.

Different socioeconomic factors such as poverty and discrimination may impact people’s ability to maintain a healthy weight, thus the high prevalence of obesity in minority populations. A report by the Center for Disease Control and Prevention (CDC) shows that African Americans have the highest obesity rates among US adults, with 49.9% age-adjusted prevalence (, n.d.).

Studies show that the disparities in the prevalence of obesity in racial/ethnic minorities are also associated with other factors such as diet, genetics, physical activity, psychological factors, income, stress, and discrimination, among others.

Obesity is a condition that requires the input of a multidisciplinary team to address the concern. It requires lifestyle and behavioral interventions, pharmacologic therapies, and access to bariatric surgeries. Due to their high costs, health inequalities, and other societal roadblocks, it is difficult for racial and ethnic minority populations to access some of these services, such as pharmacologic therapies and bariatric surgeries. Therefore, obesity among the African American population needs particular focus, and evidence-based interventions must be applied to combat the crisis.

The relevance of the problem of obesity to nursing practice is that it is an alarming global health issue that requires evidence-based interventions and research. Nurses are among the healthcare providers participating in research and development of interventions to ensure efficiency and quality of care in addressing health issues across different populations.

Obesity Among African Americans Literature Evaluation

Current practices to manage obesity majorly include obesity screening, diagnosis, and obesity counseling (Kahan, 2018). Screening and diagnosis is the first step in addressing a medical condition. Healthcare providers should screen adults for obesity at least every year and refer the obese patients for multicomponent behavioral interventions to attain a healthy weight.

Obesity and weight loss counseling substantially affect weight loss behaviors. These are the effective practices of obesity management. However, other practices, such as pharmacologic therapies and bariatric surgeries, are currently used to manage obesity. As mentioned earlier, the access to obesity healthcare services by minority populations such as African Americans may be compromised by health inequality and high costs (Byrd et al., 2018).

Nursing practice standards reflect nursing values that improve the quality of care delivery and patient outcomes. Literature shows that nursing practice standards and policies have significantly contributed to managing obesity across different health populations. Nurses are responsible for developing care plans and obesity management interventions for patients based on their needs.

According to Schutz et al. (2019), nurses are best suited to give patient-centered obesity education, conduct motivational interviewing, and provide a report to the interprofessional team. Nurses are also trained to develop care plans that consider the psychological aspects of obesity, such as self-esteem, body image, and quality of life, thus encouraging other health benefits and reducing comorbidities in a specific population (Schutz et al., 2019).

Nurses actively participate in all the stages of the policy-making process to ensure it is representative of the health needs of the total population. They provide relevant data during its formulation and pre-evaluation before implementation. Through their participation, nurses help determine areas of improvement and help produce high-quality healthcare policies. Therefore, nurses help improve patient outcomes through viable policies, prevent readmissions through good care quality and prevent illness by offering promotive and preventive health.

Obesity being a worldwide pandemic, nurses play a significant role in its management. Bucher Della Torre et al. (2018) note that individuals with obesity face stigmatization and discrimination in various settings, including healthcare settings.

More so, obese and overweight individuals are likely to suffer less educational and career access, low pay, and poor healthcare services. They are also significantly likely to be bullied, fired, teased, or even romantically rejected. Research shows that some healthcare providers, including nurses and dieticians, may have weight bias. They may also have negative stereotypes and associate obese patients with lazy, non-compliant, and undisciplined.

Weight bias is one of the barriers to implementing evidence-based practice in addressing obesity among health minority populations. Therefore, it is essential to avoid weight bias in nursing interventions towards obesity, thus preventing stigmatization and promoting obesity help-seeking behavior, especially among minority groups.

Weight bias, especially from healthcare providers, may have severe psychological consequences on the patient. Individuals who encounter weight bias record poor body image, low self-esteem, stress, depression, and other psychiatric disorders.

Nursing theories provide the framework for all interventions in nursing. Younous and Quennell (2019) note that nursing theories enable nurses to evaluate and discern their roles in healthcare. The theory of modeling and role modeling ensures that nurses care for and nurture patients while respecting every patient’s uniqueness. The theory will guide my actions during practicum. Since obesity is a bit personal condition, the theory will frame my interactions with members of the population.

Based on the literature discussed above, I have noted consistency between research and actual nursing practice. I would know if the data was unreliable if the literature has insufficient or incomplete information, is not peer-reviewed, and if the research measures what it claims to measure. The information in this literature review is reliable since I used peer-reviewed scholarly sources, which fulfill their purpose.

Impact of State Board Nursing Practice Standards and or Organizational/Governmental Policies on Obesity

Health policies may help create various strategies and build environments that promote healthy lifestyles, thus preventing obesity. Care providers can also encourage policy change and environments supporting obesity reduction (Bowen et al., 2018). Various government policies may affect the nursing scope of practice, thus influencing the management of obesity among African Americans.

Obesity management requires the attention of RNs and APRNs. State government bodies produce the nursing practice act (NPA), which regulates nurses’ professional conduct and the scope of practice. Specific government policies also regulate the nurses’ curriculum, affecting the nurses’ scope of practice.

However, in some states, the nursing scope of practice restricts the nurses from prescribing anti-obesity medications. However, some states exercise full practice, whereby nurses can evaluate patients, diagnose illnesses, order and interpret diagnostic tests, and prescribe medications. In such states, nurses are even allowed to open clinics, thus increasing healthcare access, especially for healthcare populations.

Leadership Strategies

Leadership is vital in healthcare since it influences care and care activities. Obesity management requires a multidisciplinary approach to ensure good patient outcomes. Obesity management requires the collaboration of the patients, their families, nutritionists, therapists, nurses, physicians, dieticians, and counselors.

A participative leadership strategy ensures that all the stakeholders of obesity management are involved in decision-making and setting common goals based on the patient’s needs (Asif et al., 2019). Therefore, patient outcomes are better due to targeting individual patient needs. Patient-centered care through participation enhances patient satisfaction and adherence to behavioral change, thus significantly contributing to the overall outcome.

Participative leadership requires effective coordination and communication. The team leader should communicate the best care plan and interventions based on patient needs to the other team members (Asif et al., 2019). Planning and communication of change will be the best change management strategy to improve care outcomes. Therefore, communication, collaboration, coordination, and an active, participative approach are essential leadership strategies to ensure high-quality patient-centered care.


Obesity is a global health issue that requires consideration at all levels. Current interventions include bariatric surgeries, pharmacologic therapies, and behavioral interventions. Nurses have a role in collecting data for policy-making and evaluating policies to accommodate diverse and complex population needs.

The local and national governments greatly influence the nursing scope of practice through the nursing practice act and other acts and regulations. Nurses must be aware of these regulations to ensure interventions in healthcare conform to their stipulations. Nurse leaders should also be aware of leadership strategies to carry out leadership roles, ensuring healthcare institutions’ success in managing obesity.


  • Asif, M., Jameel, A., Sahito, N., Hwang, J., Hussain, A., & Manzoor, F. (2019). Can leadership enhance patient satisfaction? Assessing the role of administrative and medical quality. International Journal Of Environmental Research And Public Health16(17), 3212.
  • Bowen, P. G., Lee, L. T., McCaskill, G. M., Bryant, P. H., Hess, M. A., & Ivey, J. B. (2018). Understanding health policy to improve primary care management of obesity. The Nurse Practitioner43(4), 46–52.
  • Bucher Della Torre, S., Courvoisier, D. S., Saldarriaga, A., Martin, X. E., & Farpour‐Lambert, N. J. (2018). Knowledge, attitudes, representations, and declared practices of nurses and physicians about obesity in a university hospital: training is essential. Clinical Obesity8(2), 122-130.
  • Byrd, A. S., Toth, A. T., & Stanford, F. C. (2018). Racial Disparities in Obesity Treatment. Current Obesity Reports, 7(2), 130–138.
  • Kahan, S. I. (2018, March). Practical strategies for engaging individuals with obesity in primary care. In Mayo Clinic Proceedings (Vol. 93, No. 3, pp. 351-359). Elsevier.
  • Schutz, D. D., Busetto, L., Dicker, D., Farpour-Lambert, N., Pryke, R., Toplak, H., Widmer, D, Yumuk, V. & Schutz, Y. (2019). European practical and patient-centered guidelines for adult obesity management in primary care. Obesity facts12(1), 40-66.
  • The Center for Disease Control and Prevention (n.d.). Adult Obesity Facts.
  • Younas, A., & Quennell, S. (2019). Usefulness of nursing theory‐guided practice: an integrative review. Scandinavian Journal Of Caring Sciences33(3), 540-555.

Leadership Collaboration Communication Change Management and Policy Considerations Sample 2

Assessing the Problem: Diabetes Among African Americans

Noncommunicable diseases have contributed significantly to mortality and morbidity among various populations in the United States. Type II diabetes mellitus is one such non-communicable disease that has been studied and documented to have a significant impact on the American population’s health.

According to the centers for disease control and prevention, about 37 million Americans have diabetes mellitus. This means that one person in every ten has diabetes. Unfortunately, about 1 in every 5 persons are unaware that they have diabetes mellites. Among African Americans, diabetes mellitus has been tagged to sociocultural and genetic context (Shiyanbola et al., 2018a).

African American race is one of the ethnicities with the highest prevalence of diabetes mellitus (Ajuwon & Love, 2020). This understanding critically impacts how nursing can be applied to address the situation at the individual and population levels. The purpose of this paper is to assess the diabetes mellitus problem among African Americans from a nursing perspective and propose strategies to address this problem through leadership, collaboration, communication, change management, and policy considerations.

Population Definition

African Americans are the largest minority group in the United States. This population is colloquially referred to as blacks. Chronic diseases most common in this population are depression, anxiety, diabetes, coronary artery disease, hypertension, and substance abuse (Ellis et al., 2020). Type II diabetes is inheritable, but environmental factors and lifestyle play a major role in this causation and pathogenesis.

In this capstone project, African Americans are selected because they have been documented to present worse outcomes in diabetes mellitus progression alongside having a higher prevalence. Recent literature evidence has indicated that diabetes mellitus is increasingly being diagnosed among the younger population, especially black teens (CDC, 2022).

For African American men, the incidence has increased to 160% (Hurt et al., 2020). Adult African Americans are at increased risk. Therefore, this population requires care in all dimensions to prevent and treat type II diabetes mellitus from preventive to curative care models. This project, therefore, focuses on preventative care among adult blacks.

Diabetes mellitus is a disease that requires nursing as well as medical strategies of care. The role of nurses is unhospitable in that various supportive treatments and definitive management of diabetes include nursing intervention. Coordinative care is essential in diabetes management and prevention.

Nursing provides excellent care coordination and leadership that would see the best population health outcomes among this population group. This health problem is relevant to my future practice as a baccalaureate-prepared nurse. The current nursing practice is based on evidence-based practice and cultural sensitivity.

Diabetes management requires cultural sensitivity to understand the patient disease and address specific factors and health determinants that are specific to these patients. Understanding diabetes mellitus among African American adults would enable me to understand and apply the role of culture, family, genetics, and socioeconomic determinants of health among blacks. I would be able to navigate through the gender, family, and cultural norms that determine the incidence of this disease among African American adults.

Analysis of Evidence

Diabetes mellitus among African Americans has been attributed to various factors. Some literature evidence sources attribute this health problem among African Americans to lower health literacy levels. The knowledge of diabetes and this prevention, as well as treatment, is essential in improving outcomes. Skrine-Jeffers et al. (2019) carried out a qualitative study that aimed at addressing the role of informal and formal knowledge about diabetes among African American males with uncontrolled diabetes mellitus. The theme of the social construction of knowledge about diabetes mellitus came out from this study.

African Americans’ construct of knowledge about diabetes mellitus relies upon their lived and observed experiences. Therefore, nurses as patient educators have a crucial role in identifying these experiences in the process of culturally sensitive care. Personalizing patient education is thus an essential strategy when addressing this health problem among African Americans.

Health Literacy and Patient Perception

Patient perceptions of illness are influenced by their cultural contexts. The perception of diabetes among African Americans is influenced by their cultural beliefs and practices. Shiyanbola et al. (2018b) explored the perceptions of African Americans about diabetes mellitus through a qualitative study and concluded that the meaning that African Americans attach to diabetes mellitus plays a vital role in the success of self-management and adherence to medical treatment.

Culturally, this population believes that faith in God and positive thinking about survival are essential strategies for diabetes control. In education and daily experience, blacks tend to be more spiritual than other ethnicities, and this could be an important element in understanding their health determinants.

Barrier to Implementation

Barriers to implementing the nursing intervention in addressing diabetes among African Americans have led to poor disease outcomes. As aforementioned, depression is among the most common chronic diseases among African American adults. Ajuwon & Love (2020) conducted a systematic review study that linked a relationship between diabetes and depression among African Americans to the disease outcomes.

As much as it may be thought that diabetes could be familial, the presence of comorbidities and cultural practices are also important in understanding diabetes among African Americans. The culture, among other health disparities, has a critical role in the prevalence of diabetes among African Americans. As nurses, we require culturally relevant education to mitigate these barriers.

Access and Coverage

Access to primary care and insurance coverage among African Americans has been attributed to the lower success of interventions to lessen the burden of diabetes among African Americans (King et al., 2018; Hu et al., 2021). Nursing standards and policies have a role to play in mitigating these barriers. Nursing education about available universal healthcare coverage, such as the affordable health care act (ACA) and Medicaid, can enlighten patients about the benefits of these federal policies in diabetes management.

According to King et al. (2018), most patients are unaware of familial risk in type two diabetes. Lifestyle, diet, and physical activity are key established risk factors among African Americans. Patient education can help patients reflect on personal barriers to health behavior change and improve their perceptions about diabetes mellitus (Ard et al., 2020). In sum, multidisciplinary involvement is key in addressing the above-explained barriers.

Quality of Evidence Used

The evidence used to support the existence of diabetes as a health problem among African American adults is of good quality and reliable. I have sued both quantitative and qualitative sources to assess the problem. Qualitative studies used are scholarly and do not just represent expert opinions but are systematically carried out and documented in scholarly and peer-reviewed studies. They have been sourced from reputable journals and databases. The findings of all studies relate well with what I encounter in daily training among the selected population.

Most importantly, I have included current studies that are less than five years old. This makes my sources reliable for application in my current training and future practice. The conclusion of systematic reviews in my problem assessment adds a great value to the validity and reliability of the findings in my analysis due to their high level of evidence. I used only one website to assess the health problem. The website is scholarly because it is managed by CDC, which is a government organization because the universal reference link ended with .gov

The Impact of State Board Nursing Practice Standards and Government Policies

Governance of health regulates the delivery of healthcare interventions and how patients seek care. On the other hand, state board standards regulate nursing practices at the state level that determine how nurses offer care and aim at protecting the public (Torrens et al., 2020). As aforementioned, multiple chronic diseases can be present in one patient, which worsens the outcomes.

Current health policies such as the affordable care act aimed at improving coverage and discouraged insurance companies from denying patients with chronic diseases insurance coverage at subsidized rates. Government policies can affect access or care for patients with diabetes mellitus, especially African Americans who have additional health disparities.

Nurses can offer better patient education and diabetes management interventions, but state and federal policies can limit their performance and care outcomes (Nikitara et al., 2019; Alshammari et al., 2021). The policies should support both the patients and the nurses in the care process

Primary care is essential for diabetes management, monitoring, and follow-up. Nurses in primary care settings, therefore, need to have adequate knowledge to enable them to offer culturally sensitive patient education. Most state boards of nursing standards require nurses to practice to the full extent of their education and training. Therefore, the nurses get full practice authority that enables them to offer treatment as well as patient education. However, this privilege is limited in some states by the state boards.

In these cases, nurses cannot prescribe medical treatment independently for patients with diabetes. Therefore, state boards’ regulations can greatly affect how diabetes is managed among patients with risks of the disease. Limitations in the workforce worsen the situations where practice scope for nurses is reduced or limited.

Leadership Strategies to Improve Outcomes and Care Quality in Diabetes Management

Diabetes management requires a multidisciplinary approach to ensure the best outcomes. Key stakeholders such as patients, their families, family caregivers, nurses, endocrinologists, dieticians, state-based policymakers, and other healthcare specialists must be involved in the management.

Participative leadership and policy-making are key strategies that would improve patient outcomes and patient-centered care. When the patients are involved in their care, the healthcare providers can target their interventions to meet patients’ needs rather than the needs at the group level. Bringing together the above stakeholders may not be enough. Their participation can be greatly contributory to the final patient care outcomes. This participative approach requires good care coordination (Asif et al., 2019).

Best coordination in diabetes management can be provided by nurses, thus their essentiality in diabetes care. Nurses’ participative leadership will ensure patient satisfaction and improve their adherence and positive behavior change toward disease prevention (Nikitara et al., 2019). This is because the multidisciplinary approach contribution will be goal-oriented and focused on meeting patient needs.

Patient care communication will also be essential for the success of this participative approach. As the chief coordinator, the nurse should communicate the best care plans effectively and collaborate with all stakeholders. To this population, the nurse needs to be involved positively in policy-making and influence policies that will encourage access and eliminate health disparities where possible.

Planning and communication of change will be the best change management strategy that will improve care outcomes (Asif et al., 2019). Therefore, communication, collaboration, coordination, and active participation are essential leadership strategies that will ensure high-quality patient-centered care.


The health problem in this capstone problem is diabetes mellitus type 2 among adult African Americans. I selected this population because of the documented evidence of the high prevalence of diabetes among this group. Literature evidence has attributed this health problem to the selected propagation with health disparities and other determinants of health such as culture, genetics, health literacy, and health-seeking behavior.

The sources used were of good quality and value to assess the problem. Policies at the local, state, and federal levels impact diabetes management indirectly by impacting the scope of nursing practice, access to care, and addressing health disparities. Therefore, nurses require participative leadership as a strategy to address this health problem through policy making, communication, collaboration, and coordination.


  • Ajuwon, A. M., & Love, R. (2020). Type 2 diabetes and depression in the African American population. Journal of the American Association of Nurse Practitioners32(2), 120–127.
  • Alshammari, M., Windle, R., Bowskill, D., & Adams, G. (2021). The role of nurses in diabetes care: A qualitative study. Open Journal of Nursing11(08), 682–695.
  • Ard, D., Tettey, N.-S., & Feresu, S. (2020). The influence of the family history of type 2 diabetes mellitus on positive health behavior changes among African Americans. International Journal of Chronic Diseases2020, 8016542.
  • Asif, M., Jameel, A., Sahito, N., Hwang, J., Hussain, A., & Manzoor, F. (2019). Can leadership enhance patient satisfaction? Assessing the role of administrative and medical quality. International Journal of Environmental Research and Public Health16(17), 3212.
  • CDC. (2022, January 24). The facts, stats, and impacts of diabetes. Centers for Disease Control and Prevention.
  • Ellis, K. R., Hecht, H. K., Young, T. L., Oh, S., Thomas, S., Hoggard, L. S., Ali, Z., Olawale, R., Carthron, D., Corbie-Smith, G., & Eng, E. (2020). Chronic disease among African American families: A systematic scoping review. Preventing Chronic Disease17(190431), E167.
  • Hu, J., Mion, L. C., Tan, A., Du, Y., Chang, M.-W., Miller, C., & Joseph, J. J. (2021). Perceptions of African American adults with type 2 diabetes on family support: Type, quality, and recommendations. The Science of Diabetes Self-Management and Care47(4), 302–311.
  • Hurt, T. R., Francis, S. L., Seawell, A. H., Krisco, M. P., Flynn, M. H., O’Connor, M. C., Rudolph, C. S., & Hill, A. (2020). Revising diabetes programming for black men and their families. Global Qualitative Nursing Research7, 2333393620960183.
  • King, C. J., Moreno, J., Coleman, S. V., & Williams, J. F. (2018). Diabetes mortality rates among African Americans: A descriptive analysis pre and post-Medicaid expansion. Preventive Medicine Reports12, 20–24.
  • Nikitara, M., Constantinou, C. S., Andreou, E., & Diomidous, M. (2019). The role of nurses and the facilitators and barriers in diabetes care: A mixed-methods systematic literature review. Behavioral Sciences9(6), 61.
  • Shiyanbola, O. O., Ward, E., & Brown, C. (2018a). Sociocultural influences on African Americans’ representations of type 2 diabetes: A qualitative study. Ethnicity & Disease28(1), 25.
  • Shiyanbola, O. O., Ward, E. C., & Brown, C. M. (2018b). Utilizing the common-sense model to explore African Americans’ perception of type 2 diabetes: A qualitative study. PloS One13(11), e0207692.
  • Skrine Jeffers, K., Cadogan, M., Heilemann, M. V., & Phillips, L. R. (2019). Assessing informal and formal diabetes knowledge in African American older adults with uncontrolled diabetes. Journal of Gerontological Nursing45(2), 35–41.
  • Torrens, C., Campbell, P., Hoskins, G., Strachan, H., Wells, M., Cunningham, M., Bottone, H., Polson, R., & Maxwell, M. (2020). Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: A scoping review. International Journal of Nursing Studies104(103443), 103443.

Leadership Collaboration Communication Change Management and Policy Considerations Instructions

  • In a 5–7 page written assessment, define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective. Plan to spend approximately 2 direct practicum hours meeting with a patient, family, or group of your choice to explore the problem and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
  • This assessment lays the foundation for the work that will carry you through your capstone experience and guide the practicum hours needed to complete the work in this course. In addition, it will enable you to do the following:
  • Develop a problem statement for a patient, family, or population that’s relevant to your practice.
  • Begin building a body of evidence that will inform your approach to your practicum.
  • Focus on the influence of leadership, collaboration, communication, change management, and policy on the problem.
  • In this assessment, you’ll assess the patient, family, or population health problem that will be the focus of your capstone project. Plan to spend approximately 2 hours working with a patient, family, or group of your choice to explore the problem from a leadership, collaboration, communication, change management, and policy perspective. During this time, you may also choose to consult with subject matter and industry experts about the problem (for example, directors of quality or patient safety, nurse managers/directors, physicians, and epidemiologists).
  • To prepare for the assessment, complete the following:
  • Identify the patient, family, or group you want to work with during your practicum The patient you select can be a friend or a family member. You’ll work with this patient, family, or group throughout your capstone project, focusing on a specific health care problem.
  • Begin surveying the scholarly and professional literature to establish your evidence and research base, inform your assessment, and meet scholarly expectations for supporting evidence.

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