The Journal of School Nursing

Soft drink consumption has increased by 300% in the past 20 years, and 56–85% of children in school consume at least one soft drink daily. The odds ratio of becoming obese among children increases 1.6 times for each additional can or glass of sugar-sweetened drink consumed beyond their usual daily intake of the beverage. Soft drinks currently constitute the leading source of added sugars in the diet and exceed the U.S. Department of Agriculture’s recommended total sugar consumption for adolescents. With the increase in adolescent obesity and the concurrent increase in consumption of sugar-sweetened beverages (SSB), the assumption infers a relationship between the two variables. SSB, classified as high–glycemic index (GI) liquids, increase postprandial blood glucose levels and decrease insulin sensitivity. Additionally, high-GI drinks submit to a decreased satiety level and subsequent overeating. Low-GI beverages stimulate a delayed return of hunger, thereby prompting an increased flexibility in amounts and frequencies of servings. Single intervention manipulation, elimination, or marked reduction of SSB consumption may serve to decrease caloric intake, increase satiety levels, decrease tendencies towards insulin resistance, and simplify the process of weight management in this population.

Teenage pregnancy outcomes have become an increasing concern in the United States. Education and support of pregnant teens are critical factors that may determine good or poor pregnancy outcomes. Poor outcomes may include low birth weight, developmental delays, and poor academic performance. Although the number of teenagers experiencing pregnancy and parenting has declined in the U.S., school-based health clinics can be used to provide support and guidance designed to avoid the negative outcomes associated with teenage pregnancy and parenting. By having school-based health clinics, nurse practitioners and school nurses can provide much needed services to pregnant and parenting teens. These services should include educational support, counseling, and community resources. This inquiry provides a metasynthesis of the literature and will review, examine, and summarize the literature relating to the effect of school-based clinics on teenage pregnancy and parenting outcomes.

School nurses who work with adolescents are in an ideal position to promote smoking cessation. This opportunity is important because research suggests teens who smoke are likely to become habitual smokers. This study characterizes adolescents’ patterns and levels of smoking, describes adolescents’ perceptions toward smoking, and delineates quit strategies that may prove helpful for adolescents who attempt smoking cessation. Results suggest adolescent smokers have highly variable patterns and levels of smoking. They fail to consider their future health and continue to be unaware of the harmful effects of smoking and the addictive nature of tobacco. Among adolescent smokers, there are few gender differences in perception of smoking. Therefore, gender specific cessation programs may not be necessary. The most effective quit strategy was the acquisition of information on contents of cigarettes and the health effects of smoking. Armed with these strategies, school nurses can provide leadership in the design and implementation of school based smoking cessation programs.

This article describes the development and growth of Lifestyle Improvements in the Family Environment (L.I.F.E.), a school-based heart-health screening and intervention program. The primary goals of L.I.F.E. through three rounds of grant funding remained constant: (a) to identify cardiovascular risk factors in students and their families and (b) to provide counseling, education, and opportunities to change lifestyle routines that contribute to those risk factors. The program began with direct ties to a university-based research program and grew with evidence-based successes and development of community partnerships. Waves of growth were influenced by capacity-building efforts, partnership development, and resource availability. School nurses managed the screening component and partnered with appropriate others in the intervention programming. School nurses are appropriately positioned to assist families as well as school and community partners in decreasing the incidence of obesity and promoting healthy lifestyle behaviors.

Peer influence has been found to be correlated with a host of harmful health behaviors. However, little research has been conducted investigating the relationship between peer influence and disordered eating. The present study surveyed 6th-, 7th-, and 8th-grade girls and boys using the Eating Disorder Inventory (EDI) and Inventory of Peer Influence (I-PIEC). This study found a significant positive correlation between peer influence and disordered eating. Multiple regression analyses revealed that peer influence was equally present in both males and females. There were no significant differences between males and females and EDI or I-PIEC scores. The likeability construct of peer influence was the most significant predictor of disordered eating in this study. School nurses are in a unique position to educate both male and female students about the dangers of disordered eating behaviors as well as identify students who may be at risk for these behaviors.

The Institute of Medicine recommends school-based body mass index (BMI) screening as an obesity prevention strategy. While school nurses have provided height/weight screening for years, little has been published describing measurement reliability or process. This study evaluated the reliability of height/weight measures collected by school nurses and the privacy of the measurement process. Interrater reliability for height/weight measures was computed on 70 elementary students, comparing measurements collected by a trained researcher to those collected by 7 school nurses. Students arrived in small groups to private measurement spaces. Height agreement was 80% for younger and 85% for older students. Agreement for weight was 97% and 100%, respectively. Reliability for weight was very good. Reliability for height was good, but results suggest careful attention to the collection process is required. Nurses may benefit from regular training on measurement procedures. The results of this study suggest that school nurses provide BMI screening that is private and reliable.

The effects of a school nursing service on health complaints and mood were investigated in a Norwegian high school. The school nursing service was delivered to students in 1 high school, and students in a comparable high school served as the comparison group. There were 41 students in the treatment group and 63 in the comparison group. All students completed a survey at the beginning of 2 successive fall terms. The survey had items on common health complaints, perceived stress, efforts to cope, moods, and sense of humor. Results from multivariate analyses of variance found that test–retest variance was stable for all measures. Level of complaints tended to be reduced as an effect of access to the school nursing service. Sense of humor at follow-up tended to buffer health complaints and negative moods.