Characteristics Associated With School Nurse Childhood Obesity Prevention Practices

Susan B. Quelly

Disclosures

Pediatr Nurs. 2017;43(4):193-199. 

In This Article

Results

Characteristics

Variations were found in professional (see Figure 1, Figure 2, Figure 3), personal, and job-related characteristics of school nurses (see Table 1 and Table 2). The mean number of years of nursing experience was 25.2 (SD = 11.8), which was more than double the mean number of years of school nursing experience at 9.5 (SD = 7.4), indicating that many school nurses had numerous years of experience working in other nursing specialties. The study sample represented 43% of Florida counties. A response rate of 33% was approximated because it was impossible to determine an exact response rate due to the need to estimate the total number of potential participants by accounting for those who may have received more than one recruitment message if they were members of both the FASN and FSHA and/or worked in one of the participating school districts.

Figure 1.

Highest Nursing Degree

Figure 2.

Hours of Childhood Obesity Prevention Education

Figure 3.

National Certified School Nurse

COP Practices

School nurse child-level and school-level COP practices scores ranged from 1 to 4, with a higher score indicating more participation in COP practices. The mean scores were 2.35 (SD = 0.63) for child-level practices and 2.31 (SD = 0.67) for school-level practices.

Considerable variation was found between different school nurse COP practices. For example, approximately half of school nurse participants reported that they sometimes or often contacted a parent about a child's weight and recommended that the parent contact a healthcare provider about this concern. Yet most school nurses reported never or rarely providing counseling to a parent regarding a child-related weight concern. Almost two-thirds of participants reported that they sometimes or often provide consultation to school administrators about health-related school policy, but most of these school nurses never or rarely monitored school nutrition practices involving fundraising and incentives/rewards or school physical activity practices, such as access to space and equipment for play before and after school.

Characteristics With Child-level COP Practices

Several significant associations were found between school nurse characteristics and participation in child-level COP practices. Significant positive correlations were demonstrated between child-level COP practices and years of nursing experience, school nursing experience, years in current position, and age (see Table 3). A significant positive correlation was also found between the numbers of students for whom care was provided and performance of child-level practices. School nurses who provided care to greater numbers of students engaged in more child-level practices. A significant inverse relationship was also found between the socioeconom-ic level of the school population and child-level practices. As the socioeconomic level of schools increased (indicated by a lower percentage of students who qualified for free or reduced lunches), school nurses performed significantly fewer child-level COP practices.

A significant difference with participation in child-level COP practices was found between the highest nursing degrees earned by school nurses (F[2,163] = 3.78). Tukey post hoc tests revealed that school nurses with a MSN/doctoral nursing degree engaged in significantly more child-level practices (M = 2.69, SD = 0.51) than those school nurses with an associate/diploma as their highest nursing degree (M = 2.25, SD = 0.59). Significant differences were found between school nurse groups with different amounts of COP education (F[2, 162] = 24.15, p < 0.001). Tukey post hoc tests showed that school nurses completing more than 0 to 2 hours (M = 2.51, SD = 0.55) or more than 2 hours of COP education (M = 2.65, SD = 0.52) conducted significantly more child-level practices than those with no COP education (M = 1.94, SD = 0.58). FASN or FSHA members performed significantly more child-level practices than non-members (see Table 4). School nurses with a National Certified School Nurse (NCSN) certification also engaged in significantly more child-level practices (p < 0.001) than school nurses without this certification. Further, White participants conducted significantly more child-level practices than non-White school nurses.

Characteristics With School-Level COP Practices

Fewer significant associations were evident between characteristics and school-level practices than child-level practices. School nurses with a MSN/doctoral nursing degree performed significantly more school-level practices (F[2, 163] = 4.73) than those with an associate/diploma nursing degree, with a Tukey post hoc test showing that school nurses with an associate/diploma degree (M = 2.11, SD = 0.62) engaged in school-level practices less often than participants with a MSN/doctoral nursing degree (M = 2.61, SD = 0.60). School nurses completing any hours of COP education (F[2, 162] = 9.89, p < 0.001) participated in significantly more schoollevel practices than those without this additional continuing education. A Tukey post hoc test revealed that school nurses with no COP education (M = 2.03, SD = 0.66) conducted significantly fewer school-level practices than those with more than 0 to 2 hours (M = 2.38, SD = 0.62) or more than 2 hours (M = 2.60, SD = 0.66) of COP continuing education. Moreover, participants with the NCSN credential and FASN members engaged significantly more often in school-level practices than those without this certification or were not FASN members (see Table 5). Only a weak positive significant correlation was shown between years of school nursing experience and school-level COP practices (see Table 3). Other characteristics describing school nurse BMI, school setting, grade levels of school(s), and job description, were not significantly associated with school nurse engagement in child-level or school-level COP practices.

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