School nurses' perceptions and experiences of delivering a universal health-promotion program targeting both children and parents in the Swedish primary school context

Abstract

Background: Schools are important settings for universal child health promotion. Understanding the experiences of providers of interventions targeting both children and their parents is crucial for designing feasible and sustainable school-based health promotion programs.

Aim: The aim of this study was to explore school nurses' perceptions and experiences of delivering a health-promotion program focusing on healthy lifestyle habits in primary schools in Sweden.

Methods: This study employed an explorative qualitative design with an inductive approach. Interviews were conducted with school nurses using a semi-structured interview guide. The data were audio-recorded, transcribed and analysed using thematic analysis.

Results: School nurses had insights regarding the acceptability and appropriateness of the program as well as reflections regarding implementation and perceived impact. School nurses appreciated the evidence-based content and structure of the program and experienced improved collaboration with teachers. Moreover, positive changes were noted in relation to both children and parents such as improved knowledge and relations. Declining interest from school principals over the school year and lack of involvement among some parents were highlighted as implementation challenges.

Conclusion: This study sheds light on the complexities faced by school nurses in delivering health-promotion interventions in collaboration with teachers in primary schools. Evidence-based practices, sustained leadership support and culturally sensitive strategies are essential for successful health promotion within schools. Our findings underscore the critical role of school nurses as health advocates, educators, and facilitators.

Keywords: Health promotion; Healthy school start; Parental support; School nurse.