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School of Nursing Annual Spring Research Day April 21, 2006 Martha Y. Kubik, PhD RN

School-based obesity prevention: Opinions, beliefs & current practices of licensed school nurses. Findings from the Minnesota School Nurse Survey. School of Nursing Annual Spring Research Day April 21, 2006 Martha Y. Kubik, PhD RN School of Nursing, University of Minnesota

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School of Nursing Annual Spring Research Day April 21, 2006 Martha Y. Kubik, PhD RN

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  1. School-based obesity prevention: Opinions, beliefs & current practices of licensed school nurses. Findings from the Minnesota School Nurse Survey School of Nursing Annual Spring Research Day April 21, 2006 Martha Y. Kubik, PhD RN School of Nursing, University of Minnesota Mary Story PhD, RD School of Public Health, University of Minnesota

  2. Problem: Childhood Obesity • Institute of Medicine (2004) • Critical public health threat • National public health priority • Prevalence of @risk of overweight & overweight among 2-19 year olds (NHANES: 2003-2004)* • All: 34% (17%) • Non-Hispanic Whites: 33% (16%) • Non-Hispanic Blacks: 35% (20%) • Mexican Americans: 37% (19%) * Ogden et al, JAMA, 2006 ( ) = % > 95th %

  3. Schools • In US, 95% children & youth enrolled in school • Considerable time spent at school • 6 hours/day • 5 days/week • 36 weeks/year • 13 years • Primary location to reach ALL children & youth

  4. School Nurses: Primary Providers of School Health Services • Nationwide, 45,000 school nurses provide care to more than 53 million school children • Opportunity to intervene at multiple levels of prevention • 1 prevention: • Promote healthy lifestyle practices for ALL • 2  prevention: • Case finding & referral for targeted programs • Well-positioned to assume a lead role in school-based obesity prevention • Are school nurses ready & prepared to assume role?

  5. Study Overview: Minnesota School Nurse Survey • Purpose: • To determine current roles and responsibilities of MN school nurses in delivering school-based services that target the prevention & treatment of overweight among students • To assess school nurses’ knowledge, beliefs & attitudes about school-based preventive health services targeting obesity prevention that include both individual & population level strategies

  6. Study Overview:Minnesota School Nurse Survey • Sample: • School Nurse Organization of Minnesota (SNOM) • Licensed school nurses • Active members • Data Collection: • Mailed self-administered survey • 64 items • 10-15 minutes to complete • $1 bill incentive • Fall 2005 • Response rate: 80% (221/275)

  7. Study Overview:Minnesota School Nurse Survey • Sample Characteristics: • Mean age: 50 (SD 7.3); range: 25-66 • Gender: 97% female • Race/Ethnicity: 99% Caucasian • Education: • 65% bachelor’s degrees • 31% master’s degrees • Median Yrs Current Position: 6 (range: 0.08-30) • Median Total Yrs School Nursing: 9 (range: 1-40) • Median Total Yrs Nursing Experience: 25 (range: 2-41.5)

  8. School Nursing Practice • Assessment of non-acute health conditions (MOST COMMON) • Case management of students with chronic health needs • Assessment of acute health conditions • Supervision of ancillary staff • Medication administration • Immunization monitoring • Hearing & vision screening • Skilled care • Health education in group setting • Paperwork • Height & weight screening (LEAST COMMON)

  9. Health Screening • 77% provided on an annual basis

  10. Obesity Prevention:Student-level intervention

  11. Obesity Prevention:School-level intervention

  12. Obesity Prevention:School Health Services & Nursing

  13. Overall Findings:Nursing & School-based Obesity Prevention • Most reported limited involvement in delivering school-based services that target the prevention & treatment of overweight among students • Student level: > 50% never or rarely reported contact or counseling with parents or teachers about student-related weight concerns, checking BP or BMI in overweight child or using BMI% as an assessment tool • School level: > 65% never or rarely monitored school nutrition and physical activity practices or assessed nutrient quality of food & beverages sold to students at school

  14. Overall Findings:Nursing & School-based Obesity Prevention • Most (73%) believed school health services should be used for obesity prevention. • Subset of schools nurses currently providing student & school-level interventions sometimes • Need for time & preparation to oversee & monitor obesity prevention efforts at school. • Clarification & development of role & responsibilities • Support from school & nursing leaders

  15. Research:Strengths & Limitations • Strengths: • First survey to assess school nursing & obesity prevention • Statewide sample of licensed school nurses • 80% response rate • Limitations: • Self-report • Response Bias • Generalizeable beyond MN LSNs?

  16. Conclusions:School Nursing & Childhood Obesity • Well-positioned to assume a key role in school-based obesity prevention efforts • Local • State • National • Require support to develop, integrate & sustain role • Time • Education & training • Administrative • School • Nursing • Further research • Formative • Intervention

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