Lucine Francis

Background: Healthy diets can improve cognitive function; therefore, school nutrition policies may support academic performance. Prior systematic reviews documented positive associations between school nutrition‐related policies and academics, but less is known about their associations with academic inequities. This review updates the evidence while addressing the gap on academic inequities. Methods: Building on two prior systematic reviews (2021, 2023) of naturally‐occurring during‐school U.S. nutrition policies and academics (i.e., attendance, test scores, behavior), we conducted an updated systematic search using their established terms and synthesized evidence on academic equity (differences in subgroup outcomes, i.e., race, ethnicity, income). Results: This updated comprehensive review includes 33 studies (10 new, 23 from the prior reviews). Newly identified studies examined Universal Free School Meals (UFSM; n = 6), Breakfast After the Bell (BATB; n = 2), the School Breakfast Program ( n = 1), and Recess Before Lunch ( n = 1). Most reported positive or neutral academic associations. Most studies examining equity‐related outcomes found larger academic improvements among subpopulations. Implications for School Health Policy, Practice, and Equity: School nutrition policies can improve academic achievement while addressing educational equity. Conclusions: UFSM and BATB equitably improve academic performance. More research is needed for other promising policies.

Background: Cardiovascular disease (CVD) and CVD risk factors, including obesity and hypertension, are increasingly prevalent among children and youth, highlighting the need for early sustained prevention. Positioned at the intersection of health and education, school nurses are uniquely equipped to support cardiovascular health in everyday practice. Purpose: We propose a collaborative model linking school nurses with the cardiovascular nursing community, drawing on the American Heart Association’s Life’s Essential 8 for Kids framework, the National Association of School Nurses School Nursing Practice Framework, and principles of implementation science. This partnership, including researchers, clinicians, and professional organizations, is necessary to translate evidence on heart health prevention into school settings. Conclusions: Through coordinated care, leadership development, quality improvement, community engagement, and adherence to professional standards, this collaborative approach can support school nurses in promoting lifelong cardiovascular health for all children and youth. Clinical Implications: School nurses are a vital component of the cardiovascular healthcare team, with unique skills, knowledge, and access to students at risk for CVD in the community setting.

Objectives: This study examined early care and education (ECE) providers’ routine and pandemic-related use of digital technology for nutrition training and explored their attitudes and perceptions toward digital technology using the Technology Acceptance Model as a guiding framework to inform future training delivery. Methods: We employed a convergent mixed-methods design consisting of a national survey and semi-structured qualitative interviews with licensed ECE providers. Inclusion criteria were licensed/registered ECE providers, English-speaking, age ≥18, and currently caring for children for pay. Exclusion criteria included unlicensed providers and inactive programs. Survey data was analyzed using chi-square tests to examine differences by variable type and logistic regressions to examine predictors of digital technology use. Qualitative analysis underwent thematic analysis using a blended deductive/inductive approach guided by the Braun and Clarke multi-step method. Integrated analyses were conducted and shown through a joint display to contextualize the findings. Results: Most ECE providers (97.9%) had access to high-speed internet, and 95.1% used electronic devices for work-related purposes. Approximately 83.2% had received nutrition training since the COVID-19 pandemic began, with 53.2% accessing training via virtual platforms. ECE providers enrolled in the Child and Adult Care Food Program were more likely to receive nutrition training digitally than those not enrolled (OR = 24.0, p < .001). As ECE providers’ age increases, the odds of receiving training digitally decreased (OR = 0.52, p = .043). Providers reported that digital training improved accessibility and flexibility. However, the study also identified challenges such as reduced social connectedness, technical difficulties, and limited knowledge or awareness of digital nutrition training programming. Conclusion: Findings suggest that digital technology enhances access to nutrition training for ECE providers, yet barriers remain. Future efforts should focus on expanding digital training programming, improving technological support, and balancing digital and in-person training to optimize hands-on learning and social connectedness.

Aim: To provide guidance on food equity‐oriented nurse engagement in education, research, and practice and to develop a glossary of food equity terms to serve as a resource to nurse educators and to fuel nurse engagement in food equity work. Design: A discussion paper outlining guidance for nurse engagement in food equity efforts. Conclusions: We provide guidance for nurse engagement in three areas: Education, Research and Community Care. Additionally, through literature review, we created a glossary of food‐related terms that can be used in nurse advocacy for food equity. Although not an exhaustive list, we compiled and provided definitions of equity‐oriented food‐related concepts across three categories: food environment, consumer/community‐based and social safety net/anti‐hunger terms. Implications for the Profession: Nurses can be instrumental in advancing food equity, thereby helping to prevent chronic diseases related to poor nutrition, yet nutrition and food equity content are not typically integrated into nursing education. Patient or Public Contribution: No patient or public contribution.

School nurses are vital in addressing food insecurity affecting 6.5 million U.S. households with children, leveraging leadership and care coordination skills to tackle this adverse social determinant of health. As frontline advocates, they can bridge gaps in food access through key strategies: promoting universal school meal programs to ensure stigma-free access to nutritious meals and supporting Summer Electronic Benefit Transfer (EBT) to sustain families during summer breaks. They can advance produce prescription (PRx) programs for fresh produce access and Supplemental Nutrition Assistance Program (SNAP)-Ed to boost nutrition literacy. Implementing the Hunger Vital Sign screening tool allows early identification of food insecurity, linking families to SNAP, food pantries, and community resources. By forging partnerships with schools, policymakers, and local organizations, school nurses can integrate care coordination principles to address systemic inequities, improve child nutrition, and foster academic success. Their role as trusted health leaders positions them to drive equitable solutions, ensuring students thrive through holistic, community-centered, school-based interventions.

Most children and youth around the globe spend some time in school. Therefore, schools are essential for health, learning, and engaging families. School health models and programmes vary worldwide, some with strengths and weaknesses. This perspective highlights the strengths of school health in Brazil and identifies opportunities for global school health in the twenty-first century. We discuss implications for global school health practice, policy, and opportunities for school health innovation. Four opportunities were identified and discussed: (1) Standardizing the Role of Community Health Workers in Schools, (2) Accelerating School-Based Evidence-Based Programming, (3) Strengthening School-Based Care Coordination to Address Adverse Social Determinants of Health & Learning, and (4) Optimizing Health Information Systems in Schools and Data Sharing.

Early childhood education (ECE) settings are important for the development of children’s healthy eating and physical activity behaviors. Efforts to disseminate and implement health behavior promotion strategies in ECE settings have seldom optimized digital health, a missed opportunity highlighted by the COVID-19 pandemic. In this commentary, we discuss previous efforts to shift ECE-based health behavior programs to digital health modalities, notable opportunities for digital health in these settings, and a multilevel perspective to support future efforts. We propose future directions in digital health literacy, reaching various ECE settings, implementation science, and community partnerships to expand the use of digital interventions.

Overweight and obesity are common in school-age children. Policy, system, and environmental (PSE) approaches—which entail making upstream changes to a school's context—can be leveraged to reduce childhood obesity. Nurses can advance PSE approaches in schools to promote healthy living habits. This review examines the effect of nurse-involved PSE interventions globally to promote healthy nutrition and reduce obesity in schools. We conducted a literature search using multiple databases from 2010 to 2023 for nurse-involved studies that implemented interventions focused on PSE change related to promoting healthy nutrition or reducing obesity in school settings. Twenty interventions globally were included in the systematic review synthesis. Improvements in anthropometrics, health and nutrition knowledge, attitudes, and beliefs were observed. PSE interventions can be leveraged to promote healthy nutrition and reduce obesity in school settings. Nurses in varying roles are uniquely qualified to advocate for and implement school-based interventions focused on PSE change.

Aim: To conduct a discursive review on continuous glucose monitoring use among Black older adults and to address the issue of racial disparities in diabetes management and outcomes. Type 2 diabetes mellitus is a global health concern with significant complications and mortality rates. Black older adults are disproportionately affected. Initially designed for type 1 diabetes, continuous glucose monitoring has emerged as an innovative tool for type 2 diabetes mellitus management. Despite its potential, there are challenges related to adherence and digital literacy among Black older adults for managing Diabetes.Design: A discursive review.Methods: Searching literature in PubMed, Scopus, and Google Scholar for papers published from 2017 to 2023, we explored the use of continuous glucose monitoring in Black older adults with type 2 diabetes mellitus, examining barriers, facilitators and challenges.Discussion: We highlight recommendations from the literature which included barriers, facilitators, and cultural factors associated with continuous glucose monitoring use. Findings underscore the importance of addressing these challenges to reduce racial–ethnic disparities in type 2 diabetes mellitus management among Black older adults. Nurses and advanced practice registered nurses are at the forefront and can play a pivotal role in exploring and implementing interventions to promote access and proper use of continuous glucose monitoring among Black older adult patients with type 2 diabetes mellitus.