Date of Award
Open Access Dissertation
Doctor of Philosophy (PhD)
Laura L. Hayman
The increase in prevalence of childhood obesity has prompted child health authorities to propose mandates focusing on population health efforts that may be implemented in public schools. In 2010, the federal government passed the Healthy, Hunger-Free Kids Act, reinforcing the 2004 regulations to guide school districts in development and implementation of school wellness policies.
The purpose of this secondary data analysis was an examination of the association between implementation of the school wellness policy and school nurse activities to the absolute change in percent of students with body mass index in the obese weight category between the school years 2005-2006 and 2008-2009. The methodological approach used correlational and ordinary least squares regression analyses. The Conceptual Model of Nursing and Health Policy guided this study. The data sources were the Massachusetts Departments of Public Health and Elementary and Secondary Education.
Results indicated that school nurse activities were significantly associated with the absolute change in percent of students with body mass index in the obese weight category between the 2005-2006 and 2008-2009 school years. After adjusting for demographic variables, for every point increase in school nurse activities there was 0.16% (p < .05) absolute change in percent obese, indicating a reduction in the percent of students in the obese weight category. The upper fourth quartile school nurse activities was associated with a nearly 3% (p < .05) absolute change in percent of students with body mass index in the obese weight category when compared to the first quartile.
The level of implementation of the school wellness policy was not significantly associated with the absolute change in percent of students in the obese weight category during the study years. School nurse ratio and promotional climate for implementation of the school wellness policy were not significantly associated with change in the level of implementation of the school wellness policy or school nurse activities.
Childhood obesity is a public health problem that requires a multifactorial approach in treatment. The implications for research are to define, identify and investigate school nurse practices that may be associated with school policy implementation and reduction in childhood obesity.
O'Brien, Mary Jane F., "The Associations of the Level of School Wellness Policy Implementation and School Nurse Activities to Weight Status of School Children in Massachusetts" (2012). Graduate Doctoral Dissertations. 92.