Addressing the Social Determinants of Health: A Call to Action for School Nurses

Schroeder, Krista; Malone, Susan Kohl; McCabe, Ellen; Lipman, Terri H.

doi:10.1177/1059840517750733

Cited by 33 publications

(34 citation statements)

References 76 publications

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“…As a result, the SDoH are being integrated into operational strategic plans, health professions education curricula, programs of research, and policy advocacy activities. Nurse leaders have called on the profession to become more engaged in addressing the SDoH through their practice, research, education, and policy advocacy (Lathrop, 2013; Marone, 2017; Persaud, 2018; Schroeder, Malone, McCabe, & Lipman, 2018; Williams, Phillips, & Koyama, 2018).…”

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confidence: 99%

Integrating the Social Determinants of Health into Nursing Practice: Nurses' Perspectives

Phillips

Angélique

Mayer

et al. 2020

J of Nursing Scholarship

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Purpose The purpose of this study was to assess nurses’ knowledge, perceived self‐efficacy, and intended behaviors relative to integrating the social determinants of health (SDoH) into clinical practice. Design and Methods A cross‐sectional study was completed with 768 nurses working in three hospitals within a large regional healthcare system located in the Midwest. Data were collected using an adapted 71‐item SDoH Survey, which measured nurses’ confidence in and frequency of discussing the SDoH with patients, general knowledge of the SDoH, familiarity with patients’ social and economic conditions, and awareness of their institution’s health equity strategic plan to achieve health equity. The institution’s health equity strategic plan reflects the organization’s commitment to improving the health of individuals and neighborhoods by addressing the SDoH known to influence health status and life expectancy. Finally, participants were asked to describe barriers to incorporating the SDoH into practice along with completing five demographic items. Descriptive statistics were used to describe the findings. Findings Of the 768 respondents, 63% had a baccalaureate degree in nursing and 33.1% reported more than 20 years in nursing. Fifty percent of respondents reported feeling more knowledgeable or confident in their ability to discuss access to care issues with patients compared to the other SDoH. Identified barriers to discussing the SDoH included insufficient time to address identified needs and unfamiliarity with internal and external resources. Respondents stressed the need for interdisciplinary education and collaboration along with more information on the role of social workers. Conclusions Nurses are more confident in discussing certain determinants of health and could benefit from more skill development in discussing SDoH issues and stronger collaborative partnerships to address identified needs. Clinical Relevance Findings from the study have implications for supporting the educational and resource needs of front‐line nurses employed in hospitals and health systems seeking to address broader societal issues influencing the health status and outcomes of patients and communities.

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confidence: 99%

Integrating the Social Determinants of Health into Nursing Practice: Nurses' Perspectives

Phillips

Angélique

Mayer

et al. 2020

J of Nursing Scholarship

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“…By using both approaches of adjustment during the process of health visits, challenges known in advance (such as language barriers) could be acknowledged and reduced, and the health visit could be guided by the child’s needs and wishes. These adjustments are related to school nurses recognizing children’s culture and language proficiency as social determinants of health impacting the health outcomes of children [ 50 ]. Social determinants of health also need to be considered and explored in health visits since the social environment and social context influence how children become involved and actively contribute in the health visit [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…School nurses need to continuously reflect on the adjustments used and how these will contribute to the children’s participation and equity in health. Such reflections include considering social determinants of health when preparing for, conducting and following up on the health visit [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Adjusting and doing the same: school nurses’ descriptions of promoting participation in health visits with children of foreign origin

et al. 2021

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Background School nurses in the school health services are assigned to promote health and participation among children when conducting health visits. Still, for children of foreign origin this promotion of participation might be hampered by challenges related to cultural diversity and language barriers. Therefore, knowledge needs to be developed regarding how these children’s participation can be promoted, to support them in sharing and describing matters important for their health. The aim was to investigate school nurses’ descriptions of promoting participation for children of foreign origin in health visits. Methods A content analysis of 673 Swedish school nurses’ answers to eight open-ended questions regarding promotion of participation for children of foreign origin was conducted. The open-ended questions were part of a larger web-based cross-sectional survey distributed to school nurses in Sweden. Results The results show that school nurses use three main approaches during the health visit: adjusting according to the child’s proficiency in Swedish and/or cultural or national background, adjusting according to the child’s individual needs, and doing the same for all children regardless of their origin. Yet, adjustments according to the child’s proficiency in Swedish and/or cultural or national background were the most common. Conclusions By combining the approaches of adjusting, a child-centered care that contributes to children’s participation in health visits and equity in health could be provided.

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“…District-level support is necessary for implementation of health policies, and individualizing supports to the target social determinants of health that impact individual schools may better facilitate policy implementation (Darlington et al, 2018;Walsh et al, 2014). School nurses understand how to assess the social determinants of health for students, families, and communities (NASN, 2018;Schroeder, Malone, McCabe, & Lipman, 2018). School nurses can use this expertise on a district level to help identify specific supports that may benefit schools who struggle to implement policy due to the social determinants of health.…”

Section: Implications For School Nursesmentioning

confidence: 99%

School Health Policy Implementation: Facilitators and Challenges

Cygan

Tribbia

Tully

2019

The Journal of School Nursing

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Schools are uniquely positioned to impact student health and academic outcomes through health and wellness policies. The purpose of this study was to describe factors influencing implementation of school health and wellness policies, specifically those focused on physical activity and nutrition. In-depth, stakeholder interviews were conducted with key informants at eight Chicago Public Schools (K–eighth grade). Data were analyzed using summative content analysis. Two themes were identified, facilitators and challenges to policy implementation. Facilitators included district support and motivation (internal and external). Challenges included limited school nurse availability, breaking tradition and budget. The external community and wellness team composition fell within both themes. Specific strategies are suggested to build upon policy implementation facilitators and overcome challenges. While school nurses play an integral role in student health and wellness, further research is needed to understand school nurse impact on student health and academic outcomes through school health policy.

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Addressing the Social Determinants of Health: A Call to Action for School Nurses

Cited by 33 publications

References 76 publications

Integrating the Social Determinants of Health into Nursing Practice: Nurses' Perspectives

Integrating the Social Determinants of Health into Nursing Practice: Nurses' Perspectives

Adjusting and doing the same: school nurses’ descriptions of promoting participation in health visits with children of foreign origin

School Health Policy Implementation: Facilitators and Challenges

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