Nurse-Involved Policy, Systems, and Environmental School-Based Interventions for Supporting Healthy Nutrition and Obesity Prevention Among Children and Adolescents: A Systematic Review.

Only 5 of the 20 included studies were randomized controlled trials, and 12 were quasi-experimental studies. Many interventions were single-site and had small samples, so results may not apply to other schools or populations. Some measurement tools lacked reliability and validity documentation. Several studies had significant loss to follow-up or poor participation in after-school activities. None of the studies addressed food insecurity. Only 9 of 20 studies stated a theoretical or conceptual framework. Only 40% of the studies were published within the past 5 years. Nurse involvement was defined broadly, including authorship, design, implementation, or evaluation, so the contribution of nursing itself is unclear. Interventions often added policy, systems, or environmental changes to nutrition education, counseling, workshops, or motivational interviewing, so the effect of any single component cannot be separated.

The authors declared no potential conflicts of interest. The publication types list NIH extramural research support, but the article text does not state a funding source for this review.

Do not conclude that nurse-involved school policy, systems, and environment programs reliably reduce obesity. Only 4 of 10 studies that measured BMI reported significant reductions, and many programs also included education, counseling, workshops, or motivational interviewing, so the effect of any single component cannot be separated.