The Development and Evaluation of a Measure Assessing School Nurses' Perceived Barriers to Addressing Pediatric Obesity

Abstract

School nurses represent an important resource for addressing pediatric obesity and weight-related health. However, school nurses perceive numerous barriers that prevent them from addressing the weight-related health of students. The current study developed and tested a new, comprehensive measure of nurses' perceptions of 10 types of barriers to addressing pediatric weight in a nationally representative sample of 214 school nurses. The measure was developed in the context of Bronfenbrenner’s (1979) ecological systems theory and includes subscales assessing nurses' perceptions of skills-based, job-related, and societal barriers. Confirmatory factor analyses (CFAs) provided evidence for the validity of the measure, including the three barrier subscales. In addition, the subscales demonstrated adequate internal consistencies. Results indicate that school nurses perceive barriers to addressing weight-related health on multiple ecological levels, which may inform intervention or continuing education efforts. Future pediatric weight programs that involve school nurses might consider using the measure to assess nurses' perceptions of barriers.

Keywords

obesity school nurse knowledge/perceptions/self-efficacy continuing education school nurse characteristics

Get full access to this article

View all access options for this article.

References

Becker

M. H.

(Ed.). (1974). The health belief model and personal health behaviors. Thorofare, NJ: Charles B. Slack.

Bronfenbrenner

(1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.

Brown

T. A.

(2006). Confirmatory factor analysis for applied research. New York, NY: Guilford.

Buhi

E. R.

Goodson

Neilands

T. B.

(2008). Out of sign, not out of mind: Strategies for handling missing data. American Journal of Health Behavior, 32, 83–92.

Cowell

J. M.

(2011). Childhood obesity research: Directions for school health researchers and school nurses. The Journal of School Nursing, 27, 7–12.

DeVellis

R. F.

(2003). Scale development. Thousand Oaks, CA: Sage.

Hendershot

Telljohann

S. K.

Price

J. H.

Dake

J. A.

Mosca

N. W.

(2008). Elementary school nurses' perceptions and practices regarding body mass index measurement in school children. The Journal of School Nursing, 24, 298–309.

Holmbeck

G. N.

Devine

K. A.

(2009). Editorial: An authors' checklist for measure development and validation manuscripts. Journal of Pediatric Psychology, 34, 691–696.

Huang

T. K.

Glass

T. A.

(2008). Transforming research strategies for understanding and preventing obesity. Journal of the American Medical Association, 300, 1811–1813.

10.

Jelalian

Steele

R. G.

Jensen

C. D.

(2008). Future directions in pediatric obesity prevention and intervention: Research and practice. In Jelalian

Steele

R. G.

(Eds.), Handbook of childhood and adolescent obesity (pp. 461–470). New York, NY: Springer.

11.

Jöreskog

K. G.

Sörbom

(2004). LISREL for Windows (Version 8.7) [Computer software]. Lincolnwood, IL: Scientific Software International.

12.

Kazak

A. E.

Rourke

M. T.

Crump

T. A.

(2003). Families and other systems in pediatric psychology. In Roberts

M. C.

(Ed.), Handbook of pediatric psychology (3rd ed., pp. 159–175). New York, NY: Guilford.

13.

Kubik

M. Y.

Story

Davey

(2007). Obesity prevention in schools: Current role and future practice of school nurses. Preventive Medicine, 44, 504–507.

14.

Morrison-Sandberg

L. F.

Kubik

M. Y.

Johnson

K. E.

(2011). Obesity prevention practices of elementary school nurses in Minnesota: Findings from interviews with licensed school nurses. The Journal of School Nursing, 27, 13–21.

15.

Moyers

Bugle

Jackson

(2005). Perceptions of school nurses regarding obesity in school-age children. The Journal of School Nursing, 21, 86–93.

16.

Murphy

Polivka

(2007). Parental perceptions of the schools' role in addressing childhood obesity. The Journal of School Nursing, 23, 40–46.

17.

National Association of School Nurses. (2002). Overweight children and adolescents. NASN Position Statement. Retrieved July 22, 2008, from http://www.nasn.org/Default.aspx?tabid=236

18.

Nauta

Byrne

Wesley

(2009). School nurses and childhood obesity: An investigation of knowledge and practice among school nurses as they relate to childhood obesity. Issues in Comprehensive Pediatric Nursing, 32, 16–30.

19.

Ogden

C. L.

Carroll

M. D.

Curtin

L. R.

Lamb

M. M.

Flegal

K. M.

(2010). Prevalence of high body mass index in U.S. children and adolescents, 2007-2008. Journal of the American Medical Association, 303, 242–249.

20.

Pender

N. J.

(1982). Health promotion in nursing practice. Norwalk, CT: Appleton-Century-Crofts.

21.

Preacher

K. J.

Coffman

D. L.

(2006, May). Computing power and minimum sample size for RMSEA [Computer software]. Retrieved from http://quantpsy.org/

22.

Price

J. H.

Desmond

S. M.

Ruppert

E. S.

Stelzer

C. M.

(1987). School nurses' perceptions of childhood obesity. Journal of School Health, 57, 332–336.

23.

Rogers

E. M.

(2003). Diffusion of innovations (4th ed.). New York, NY: The Free Press.

24.

Stalter

A. M.

Chaudry

R. V.

Polivka

B. J.

(2010). Facilitating factors and barriers to BMI screening in schools [Electronic version]. The Journal of School Nursing. Retrieved June 2, 2010, from http://jsn.sagepub.com/cgi/rapidpdf/1059840510368524v1.pdf

25.

Steele

R. G.

Y. P.

Jensen

C. D.

Pankey

Aylward

B. S.

Davis

A. M.

(2011). School nurses' perceived barriers to discussing weight with children and families: A qualitative approach. Journal of School Health, 81, 128–137.