title: School nurses' perceived barriers to discussing weight with children and their families: a qualitative approach.
abstract: BACKGROUND
  Previous studies have documented the presence of specific barriers to school nurses' communications with families about weight-related health. The purpose of the present study was to contribute to the literature by further analyzing, using focus group methodology, school nurses' perceived barriers to addressing weight-related health issues with children and their families.
  
  
  METHODS
  Twenty-two school nurses from urban and rural school districts in the Midwestern United States participated in 7 focus groups during the spring semester of 2008. Sessions were recorded and transcribed in their entirety. Study authors reviewed the focus group content and identified themes of perceived barriers. NVivo 8 was used to code and evaluate themes.
  
  
  RESULTS
  Consistent with the extant literature, nurses identified a lack of knowledge and resources, personal weight challenges, lack of institutional support, and lack of time as barriers to weight-related communications with families. However, in addition to these previously identified barriers, nurses also identified family characteristics, child motivation, fear of reactions, and difficulty establishing relationships with children as barriers that impeded their communication with families about weight-related health.
  
  
  CONCLUSIONS
  As expected, the use of focus group methodology yielded evidence of barriers to communication that had not been previously identified in the literature, as well as those that had been well documented. Consistent with a socioecological view of pediatric healthcare, results suggest a number of systems that could be targeted to improve nurses' weight-related communications with families.
authors.affiliation: Clinical Child Psychology Program, University of Kansas, 2011 Dole Human Development Center, 1000 Sunnyside Ave., Lawrence, KS 66045, USA. rsteele@ku.edu
authors.forename: Ric G
authors.initials: RG
authors.lastname: Steele
authors.forename: Yelena P
authors.initials: YP
authors.lastname: Wu
authors.forename: Chad D
authors.initials: CD
authors.lastname: Jensen
authors.forename: Sydni
authors.initials: S
authors.lastname: Pankey
authors.forename: Ann M
authors.initials: AM
authors.lastname: Davis
authors.forename: Brandon S
authors.initials: BS
authors.lastname: Aylward
mesh_terms: D001291:Attitude of Health Personnel; D001835:Body Weight; D002983:Clinical Competence; D017144:Focus Groups; D006801:Humans; D015146:Midwestern United States; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology*; D009765:Obesity / Q000517:prevention & control / Q000523:psychology*; D011368:Professional-Family Relations; D012572:School Health Services; D012573:School Nursing / Q000379:methods