School nurse, childhood obesity prevention, perceptions, practices
Approximately one-third of children in the United States are overweight or obese with increased risks for numerous physical and psychosocial comorbidities. Schools are ideal environments to address this serious health crisis and school nurses are uniquely positioned qualified healthcare providers to actively participate in childhood obesity prevention (COP). A review of the literature provided findings to identify a gap in the knowledge regarding the association between school nurse COP perceptions and practices. A modified theoretical framework based on Bandura’s health promotion by social cognitive theory guided this study. The purpose of this study was to identify the key perceptions (self-efficacy, perceived benefits and perceived barriers) influencing school nurse participation in COP practices and determine associations between school nurse characteristics and COP perceptions and practices. Preliminary research was conducted to determine content validity for modified perception scales, clarity of instructions and questions, data collection and retrieval procedures, and refinement of recruitment strategies. Adequate reliability and validity was determined for modified scales measuring school nurse self-efficacy, perceived benefits, perceived barriers, and COP practices targeting individual children (child-level) and the entire school population (school-level). Florida RN school nurses (n = 171) completed self-administered anonymous questionnaires from an emailed weblink or a paper version offered at two Florida Association of School Nurses conferences. School nurses with characteristics reflecting more education engaged in more COP practices (p < .05) than those without education-related characteristics. School nurses with > 8 hours of COP education reported higher COP self-efficacy than those with none (p < .01). Linear regressions showed that a model comprised of self-efficacy, perceived benefits, and perceived barriers significantly explained 12.0% of the variance in child-level practices (p < iv .001) and 9.1% of school-level practices (p < .001). Self-efficacy explained the most variance of school nurse child-level and school-level practices (p < .001), and perceived barriers were inversely associated with child-level practices (p < .05). Four series of regressions showed that only perceived barriers partially mediated the influence of self-efficacy on child-level practices. Data analyses indicated self-efficacy and perceived barriers were key determinants of school nurse COP practices. Therefore, policy changes and educational interventions to increase selfefficacy and reduce perceived barriers may be effective in mobilizing school nurses to actively engage in COP practices
Doctor of Philosophy (Ph.D.)
College of Nursing
Length of Campus-only Access
Doctoral Dissertation (Open Access)
Dissertations, Academic -- Nursing, Nursing -- Dissertations, Academic
Quelly, Susan, "Perceptions Influencing School Nurse Practices To Prevent Childhood Obesity" (2012). Electronic Theses and Dissertations. 2500.