From leadership research to district action: School nurses’ perceptions and experiences of delivering a universal health-promotion program targeting both children and parents in the Swedish primary school context

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

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. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-025-03806-2. Keywords: School nurse, Health promotion, Healthy school start, Parental support

Study methods

In this study, an explorative qualitative design with an inductive approach was used [16]. Qualitative methods are useful for exploring participants’ perceptions and experiences. The reporting checklists Consolidated framework for Reporting Qualitative research (COREQ) [17] was followed.

Limitations

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A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Choose one school improvement question with teachers. Protect a short shared planning cycle, agree an instructional change and use a common rubric for examining student work. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Review implementation fidelity, teacher time and independently scored student work against a recorded baseline. Examine access differences and competing explanations before attributing changes to leadership. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Marianna Moberg; Åsa Norman; Liselotte Schäfer Elinder; Susanne Andermo. School nurses’ perceptions and experiences of delivering a universal health-promotion program targeting both children and parents in the Swedish primary school context. BMC Nursing (2025-09-02). https://doi.org/10.1186/s12912-025-03806-2

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.