Date of Scholarly Project Submission


Degree Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)



Faculty Chairperson

Dr. Melissa Romero

Second Committee Member

Dr. Nanci Gasiewicz

Third Committee Member

Dr. Anne Stein


Gout is a well understood, yet poorly treated condition that is associated with many co-morbidities including hypertension, renal and cardiac disease, metabolic syndrome, central obesity and type-2 diabetes. The American Indian population is at risk for gout due an increased incidence of type-2 diabetes, chronic kidney disease, hypertension, and alcohol abuse. The purpose of this scholarly project was to implement the 2012 American College of Rheumatology (ACR) guidelines in a sample of Tribal members within mid-western portions of the United States. This scholarly project utilized a quasi-experimental research design with pretest – posttest methods to measure uric acid levels at baseline and at six months after implementation of the ACR guidelines. The Cox (2003) interaction model of client health behavior was used as a theoretical framework to guide the scholarly project. A paired t-test was used to compare mean uric acid levels (6.41 mg/dL) prior to the intervention with uric acid levels (6.36 mg/dL) after the intervention. Results from the statistical analysis did not yield statically significant results (p = 0.52). The findings of the study support the conclusion that gout is poorly managed by healthcare providers and additional support and resources are needed to improve patient care outcomes.