The development and evaluation of a measure assessing school nurses' perceived barriers to addressing pediatric weight-related health

Abstract

Pediatric obesity is common and is linked with numerous negative physical and mental health outcomes. Health care professionals play an important role in interventions for pediatric obesity. School nurses, who are the primary health care professionals in the school setting, represent an important but underutilized resource for addressing pediatric obesity and weight-related health. However, school nurses may perceive numerous barriers, including barriers within multiple systems, 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 barriers to addressing pediatric weight-related health. The measure was evaluated using exploratory and confirmatory factor analyses and examination of nurses' perceived barriers following an intervention. The results indicated that school nurses perceive a range of barriers to addressing student's weight, including skills-based, job-related, and higher-level (e.g., societal) barriers, some of which had not been identified in the previous literature. The results also provided evidence for the validity and reliability of the measure. The findings suggest that nurses' perceptions of barriers related to addressing pediatric weight issues in the school setting are modifiable on several ecological levels. In addition, future efforts to prevent or treat pediatric weight problems, which incorporate school nurses, should assess for and consider addressing these barriers.