Table 3.

Key Findings from Focus Groups Assessing Perceptions of Stakeholders Regarding a School Nurse Delivered Intervention to Treat Adolescent Overweight and Obesity

Teen Specific Issues
Challenges/Barriers	Strategies/Recommendation
Dealing with peer pressure	ask for healthier foods when at a friend’s home bring your own snack or healthy alternative just say no to unhealthy foods if they are offered avoid situations where you feel pressured ignore the peer pressure
Avoiding emotional eating	do some form of physical activity talk about your feelings listen to or playing music
Gaining support from friends	ask friend to join the study with the teen tell only certain friends you are in the study
Family Support Issues
Challenges/Barriers	Strategies/Recommendation
Addressing concerns that involving families may result in counterproductive responses or the teen being teased	allow teen to choose extent of parental involvement tell parents teen wants to make a change and need parents’ help
Gaining family support	ask the family to eat healthily with teen tell parents how important their support is to teen’s success
Finding helpful ways parents can become involved	exercise more with their teen buy healthier foods for the home take the teen food shopping with them offer supportive feedback to their teen
Intervention Implementation Related Issues
Challenges/Barriers	Strategies/Recommendation
Confidentiality	maintain confidentiality during recruitment and intervention sessions to avoid stigma of being identified as overweight or obese conduct sessions in a private room be prepared with response if asked why going to nurse meet at the beginning rather than end of class
Competing demands for time (after school jobs, class schedules)	Not Applicable
Identification of eligible overweight and obese teens for recruitment	recruit through school website suggesting teens contact nurse to get more information include additional staff in recruitment effort so teen can be approached by staff members they feel closest to
Curriculum Content Issues
Not Applicable	Recommendations regarding nutrition education
	information on portion sizes
	information on healthier food choices
	how to read food labels
	health benefits of weight loss
	the science of weight regulation
	Recommendations regarding education on physical activity and weight control
	menu of potential physical activities to choose from
	ideas for increasing physical activity
	list of how many calories are burned for a given physical activity