NEW BRUNSWICK, N.J. — School nurses are more than just caretakers for scraped knees and fevers — they may hold the key to tackling childhood obesity, a recent study explains. Researchers at Rutgers University highlighted the impact of a family-centered, school-based intervention led by school nurses, utilizing parents and teachers as role models for promoting healthy eating habits and behaviors.
Elaine Elliott, a school nurse in Newark, New Jersey, teamed up with Professor Cheryl Holly and the late Sallie Porter from Rutgers University School of Nursing to implement and evaluate the intervention program. Elliott, who earned her doctor of nursing practice degree from Rutgers in 2019, emphasized the crucial role of trust between school nurses, parents, and teachers.
“An important reason for the success of this program was the trust nurses have with parents and teachers. I’ve developed a close relationship with the community that only a school nurse can have,” Elliott says in a university release.
The program invited parents and teachers from a public preschool in Newark, where high rates of childhood obesity were prevalent, to participate. A total of 37 parents, teachers, and classroom aides representing children between three and five took part in the study, which consisted of weekly 45-minute sessions over four weeks.
Modeled after Maine’s successful Let’s Go! program, the intervention focused on teaching parents and teachers how to encourage healthy behaviors in children, such as consuming at least five servings of vegetables, limiting screen time to two hours or less, engaging in at least one hour of physical activity, and avoiding sugary drinks. During the second week, participants were expected to implement what they learned at home and in the classroom. Elliott, as the school nurse, provided ongoing support both in-person and online.
The results, based on pre and post-survey data, were highly encouraging. Children’s fruit and vegetable consumption increased from an average of one serving to five servings per day. The frequency of children sharing meals with their families rose significantly from an average of two days to five days per week. Additionally, children reduced their consumption of takeout food by an average of two days per week. Furthermore, there was a notable two-hour decline in the time spent watching television or playing video games, from slightly over three-and-a-half hours on average to one-and-a-half hours.
The study’s outcomes surpassed those of previous studies based on the Let’s Go! program, thanks to the presence of a school nurse leading the intervention and offering support. The researchers attributed the success to the nurse’s familiarity with the environment and the children and their families. They also highlighted the use of accessible language and culturally relevant food examples to overcome socio-economic limitations.
Despite the critical role played by school nurses in promoting healthy habits, many schools across the country are reducing the number of nursing staff. Data from the National Association of School Nurses in 2017 revealed that a quarter of schools lacked a nurse. The COVID-19 pandemic has likely exacerbated this issue further, according to Cheryl Holly.
Highlighting the importance of preserving school nursing resources, the New Jersey administrative code requires at least one nurse per 300 preschool students. However, in some communities, even experienced nurses are being reassigned to larger elementary and high schools, potentially impacting the health of preschoolers. Future research should examine the potential negative effects of these changes on the well-being of young children, Elliott urged.
By leveraging their trust with parents and teachers, researchers say these healthcare professionals can make a significant impact on promoting healthier lifestyles and reducing obesity rates among the youngest members of society.
The study is published in the journal Pediatric Nursing.
