A School Nurse-Delivered Intervention for Overweight and Obese Adolescents


  • Support for this research (#R21 HD053371) came from the National Institute of Child Health and Human Development. The sponsor had no role in the design, data collection, management, analysis, or interpretation of the study, nor in the preparation, review, or approval of the manuscript. We thank the research assistants who collected the data, the schools, and school nurses who graciously took part in this study, and the youth who participated.

Address correspondence to: Lori Pbert, Professor, (lori.pbert@umassmed.edu), Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655.



Models are needed for implementing weight management interventions for adolescents through readily accessible venues. This study evaluated the feasibility and efficacy of a school nurse-delivered intervention in improving diet and activity and reducing body mass index (BMI) among overweight and obese adolescents.


Six high schools were randomized to either a 6-session school nurse-delivered counseling intervention utilizing cognitive-behavioral techniques or nurse contact with provision of information. Eighty-four overweight or obese adolescents in grades 9 through 11 completed behavioral and physiological assessments at baseline and 2- and 6-month follow-ups.


At 2 months, intervention participants ate breakfast on more days/week (difference = 1.01 days; 95% CI: 0.11, 1.92), and had a lower intake of total sugar (difference = −45.79 g; 95% CI: −88.34, −3.24) and added sugar (difference = −51.35 g; 95% CI: −92.45, −10.26) compared to control participants. At 6 months, they were more likely to drink soda ≤ one time/day (OR 4.10; 95% CI: 1.19, 16.93) and eat at fast food restaurants ≤ one time/week (OR 4.62; 95% CI: 1.10, 23.76) compared to control participants. There were no significant differences in BMI, activity, or caloric intake.


A brief school nurse-delivered intervention was feasible, acceptable, and improved selected obesogenic behaviors, but not BMI.