Researchers in Tunisia tested whether a special training program could help school nurses better prevent obesity in teenagers. They taught 95 school nurses about nutrition, exercise, and how to talk with students about healthy habits. After six months, the nurses who received the training felt much more confident helping students make healthy choices. They also realized they needed more help with certain skills, like motivating families to change. This study shows that investing in nurse training is an important step toward keeping teenagers healthier.

The Quick Take

  • What they studied: Does a special training program help school nurses feel more confident and skilled at preventing obesity in teenagers?
  • Who participated: 116 school nurses (mostly women) working in schools in Sousse, Tunisia. About one-third were between 40-49 years old. All had at least six months of experience working in school health services.
  • Key finding: After six months of training, nurses who received the program felt significantly more confident teaching students about exercise, healthy eating, and weight management compared to nurses who didn’t receive training. However, they also identified that they needed more training in family counseling and motivating behavior change.
  • What it means for you: If you work in schools or care about teen health, this suggests that training programs for school nurses can make a real difference in helping teenagers develop healthy habits. The findings suggest ongoing training is important for long-term success.

The Research Details

This was a randomized controlled trial, which is one of the strongest ways to test if something works. Researchers randomly divided school nurses into two groups: one group received special training (the intervention group), and the other group continued with their regular work (the control group). This random assignment helps ensure the groups were similar at the start, so any differences afterward are likely due to the training.

The training lasted nine months, from January to September 2024. The intervention group attended sessions led by experts in nutrition, communication, physical activity, and obesity prevention. These experts taught nurses how to educate teenagers about healthy eating and exercise, and how to confidently address weight-related concerns. The control group did not receive this special training.

Researchers measured three main things: how confident the nurses felt in their skills, their attitudes toward obesity prevention, and what challenges they faced in their work.

This study design is important because it helps prove that the training actually caused the improvements, rather than other factors. By comparing a trained group to an untrained group, researchers can see the real impact of the program. This type of evidence is what doctors and health officials use to decide which programs to recommend.

This study has several strengths: it used random assignment, included a control group for comparison, and followed participants for a reasonable length of time (six months). However, there are some limitations to consider. The study was conducted in only one region of Tunisia, so results may not apply everywhere. Also, the researchers couldn’t hide which nurses received training from which group, which could have influenced how people responded to surveys. The sample size was moderate (95 nurses in the training group), which is adequate but not huge.

What the Results Show

The main finding was that nurses who received the training felt much more confident in their skills after six months. Specifically, they reported significant improvements in three areas: teaching teenagers about physical activity, promoting healthy eating habits, and addressing obesity-related concerns with confidence. The difference between the trained group and the untrained group was very clear statistically (p = 10-3, which means there’s less than a 0.1% chance this happened by random luck).

Interestingly, at the very beginning of the study, the nurses who were assigned to receive training actually reported feeling less confident than the control group. This suggests the researchers did a good job randomly assigning people, and the improvement in the training group was real.

The training also had an unexpected but positive effect: nurses in the training group became more aware of what they didn’t know. They expressed a greater need for further training, especially in counseling techniques and motivational interviewing (helping people want to change their behavior). This awareness is actually a sign that the training was working—it helped them understand the complexity of their job.

Beyond the main findings, the study revealed that nurses in the training group identified specific areas where they needed more help. Family dynamics and behavioral management were mentioned as particularly challenging areas. This suggests that while the training improved general skills, more specialized training is needed for helping families and changing long-term behaviors. The fact that trained nurses recognized these gaps shows the program successfully increased their professional awareness.

This study adds to growing evidence that training healthcare workers improves their ability to prevent obesity in young people. Previous research has shown that professional development programs can boost confidence and skills, and this study confirms that finding in the specific context of school nurses in a lower-income country. The finding that nurses need ongoing training aligns with what other research has shown—that one-time training isn’t enough; sustained support is necessary.

Several limitations should be considered when interpreting these results. First, the study was conducted only in Sousse, Tunisia, so the findings may not apply to other countries or regions with different healthcare systems and cultures. Second, researchers couldn’t blind participants (hide who got training and who didn’t), which could have influenced how nurses answered survey questions. Third, the study measured changes after six months, but we don’t know if improvements lasted longer. Fourth, the study relied on nurses’ self-reported confidence rather than directly observing whether they actually helped students better. Finally, the sample size, while adequate, was relatively modest, which means results might not be as reliable as studies with larger groups.

The Bottom Line

Based on this research, schools and health departments should consider investing in training programs for school nurses focused on obesity prevention. The evidence suggests these programs can meaningfully improve nurses’ confidence and skills. However, training should be ongoing rather than a one-time event, and should include specialized modules on family counseling and behavior change techniques. Confidence level: Moderate to High (this is a well-designed study, but limited to one region).

School administrators, health department officials, and policymakers in countries working to prevent childhood obesity should pay attention to these findings. School nurses themselves would benefit from knowing that structured training can improve their effectiveness. Parents and students may indirectly benefit from having better-trained nurses in their schools. However, these findings are most relevant to settings similar to Tunisia (lower-middle-income countries with school health services). People in very different healthcare systems should be cautious about assuming the same results would occur.

Based on this study, meaningful improvements in nurse confidence and skills appeared within six months of training. However, this doesn’t mean students will see health benefits immediately. Building healthy habits takes time—typically several months to a year or more to see changes in weight or fitness. The study suggests that ongoing training is needed to maintain and build on initial improvements.

Want to Apply This Research?

  • If you’re a school nurse or health educator, track your confidence level monthly using a simple 1-10 scale for three specific skills: (1) teaching students about physical activity, (2) promoting healthy eating, and (3) addressing weight concerns. Also note which topics you feel you need more training in.
  • Use the app to set a goal to complete one professional development activity per month related to obesity prevention—this could be a webinar, article, or training session. Log which topics you complete and rate how helpful each was. Share your learning goals with colleagues to create accountability.
  • Create a long-term tracking system that measures both your confidence levels and the actual health behaviors you’re promoting. Every three months, review which training topics had the biggest impact on your work. Identify one area each quarter where you need deeper training, and use the app to find and schedule relevant professional development opportunities.

This research describes a training program for school nurses in Tunisia and should not be considered medical advice for individuals. The findings are based on a study in one specific region and may not apply to all settings or populations. If you have concerns about a young person’s weight or health, please consult with a qualified healthcare provider. This summary is for educational purposes and does not replace professional medical guidance. Always discuss any health concerns with appropriate medical professionals.