Defense Date


Graduation Date

Fall 12-16-2022

Submission Type

DNP Manuscript

Degree Name

Doctor of Nursing Practice (DNP)


Doctor of Nursing Practice (DNP) Program


School of Nursing

Faculty Mentor

Dr. Mary C. Loughran


Veteran, pre-diabetes, prevention, 9/11 Veterans, telehealth, PACT, VA/VHA:nurse practitioner


Diabetes Type II (T2DM) prevalence is rising in America, becoming a focus for disease prevention. The American Diabetes Association (ADA) has highlighted the need to tackle the increased T2DM precursor, prediabetes, which ultimately leads to T2DM if risk factors remain unaddressed. One group of the American population with a high rate of prediabetes is the 9/11 Veteran cohort. The Veterans Affairs (VA) system has numerous health promotion missions. This system has highlighted its initiatives to address the development of T2DM. Specific to the 9/11 group, their primary T2DM contributory risk factor is obesity paired with the low utilization of already established evidence-based, comprehensive VA programs. Also, literature has shown that this group is limited in their knowledge of diabetes and prevention techniques. A quality improvement (QI) project was formulated to explore this clinical problem. Methods to address consisted of evidence-based literature findings and intervention of applications of proven programs paired with telehealth, care coordination, and a support person. Pre- and post-project implementation of risk factors of obesity, sedentary position, and lifestyle choices were evaluated through the application of resources. Results, findings, and interpretation suggest a definite decrease in the development of T2DM by decreasing T2DM risk factors based on laboratory findings, weight loss, and increasing physical activity.

Keywords: Veteran, pre-diabetes, prevention, 9/11 Veterans, telehealth, PACT,VA/VHA:nurse practitioner