School nurses’ evaluations of their competence in counseling adolescents on physical activity and the use of digital technology: a cross-sectional study

Most adolescents are insufficiently physically active and technology use has become a crucial part of people's lives. School nurses have a key role in health promotion. The purpose of this study was to determine the associations between school nurses’ lifestyle counseling competence (specifically, their competence in counseling students on physical activity and technology use) and various potentially related factors (including the background of the nurses, the time spent on counseling during a working day, and the nurse’s education on physical activity and technology use). To our best knowledge, there is no up-to-date information about school nurses’ counseling concerning physical activity and technology use. A cross-sectional study design was used. Data were gathered by surveying nurses working in school or student healthcare (n = 116) in Finland during the autumn of 2017. The data were analyzed using descriptive statistics, non-parametric tests, and logistic regression analysis. The survey included one open-ended question which was analyzed by performing inductive content analysis. Over half (58.6%) of respondents assessed that the competence in physical activity and technology use counseling is overall good. 85.3% of the respondents evaluated their physical activity counseling skills and 62.9% technology use counseling skills to be good. Only 33% of the nurses knew how to identify adolescents needing counseling concerning technology use. Education on physical activity and recreational technology use was more relevant than age in explaining nurses' counseling knowledge and skills. School nurses reported that there is a need to develop skills and tools for counseling adolescents about the recreational use of technology. The results highlighted three factors which limited the development of couseling; a lack of resources; a need for more education; and a lack of clear, consistent policies and tools for adolescents’ lifestyle counseling. There is also a need for more multi-professional cooperation and time for counseling. The results presented herein could be used in designing targeted interventions and education in school and student healthcare and with it to improve the lifestyle counseling offered by school nurses.