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The involvement of nurses in healthcare policymaking and legislative decision-making is not new. From the e1800s, Florence Nightingale contributed significantly to the policymaking of issues related to sanitation, the Crimean War, and education (Anderson et al., 2020). Historically, nursing has been recognized as a helping profession in the clinical sciences. Nonetheless, the contribution of nurses to policymaking has increased in importance over the years (Miles & Scott, 2019).
Nursing has also experienced a revolution in its evolution, whereby the profession shifted from its early perception as essentially an auxiliary to physicians to independent advanced practice roles that began to appear in the 1970s and 1980s (Anderson et al., 2020).
These changes brought with them a growing necessity for nurses to become involved in the development of healthcare policy and delivery models (Risjord, 2011). Nurses have responded to the dynamism of healthcare by taking on entrepreneurial roles as decision-makers and being actively involved in policy advocacy (Anderson et al., 2020). Modern healthcare complexity requires innovative policy solutions to an ever-changing global healthcare environment.
Childhood obesity has seen a threefold increase over the past four decades, making it a global public health concern with rising prevalence rates that have reached pandemic levels (Anderson, Butcher, & Schanzenbach, 2019). The condition is linked to an elevated risk of various chronic diseases, including hypertension, diabetes, and other metabolic disorders (Mihrshahi, Drayton, Bauman, & Hardy, 2017).
As a result of the health crisis, nurses should leverage their credentials to guide policies that stop obesity in children. Apart from being held responsible for their patients, they should exercise duties such as upholding safe staffing policies, conducting bariatric patient care management, and guiding food and beverage standards within schools and insurance coverage policies for the treatment of obesity (Miles & Scott, 2019).
My nursing practice is guided by advocacy for policy intervention to address childhood obesity among the Texas population. Policies are public and private sector decisions that influence public health. Policies determine the environment in which healthcare practice is delivered (Anderson et al., 2020).
Through clinical and administrative practice, nurses understand that shaping healthcare policy is necessary for building clinical practice, patient advocacy, and the reputation of the nursing profession in the whole healthcare discipline (Giddens et al., 2014). To prevent childhood obesity, I arranged a phone interview with the significant policy actors in Texas to elaborate on possible legislative actions and local programs.
Throughout the discussion, five areas of priority of action were established: developing regulations for the food industry, more stringent labelling requirements for foods, healthy food in public places like schools, opportunities for physical activity, and support for individuals and families.
The stakeholders stressed that schools, communities, families, and individuals need to be involved in an attempt to create sustainable, long-term change. The debate also recognized the contribution of the local mayor to combatting childhood obesity, including their views and suggestions in policy debates.
The mayor targeted childhood obesity as one of the most critical public health concerns in the United States, calling for including school nutrition standards in national procurement and food specification procedures. The proposed guidelines align with the state’s action plan for childhood obesity (2016-2020) and emphasize big food groups like fruits, vegetables, proteins, and processed food ingredients (salt, saturated fats, and sugars).
Reforms to regulating audiovisual media were also suggested to restrict children’s access to the promotion of unhealthy foods and drinks. To reduce marketing influence, the goal is to apply more restrictive rules beyond children’s television shows, incorporating sports, music, and family programming. Promoting physical activity in school and at home was another priority.
The mayor favoured limiting screen time in schools and incorporating physical education into the curriculum. Further, community-level interventions were recommended to reverse the many environmental influences leading to childhood obesity. These interventions involve engaging all potential stakeholders in society, such as religious groups, parents, and schools, to combat obesity at the grassroots level while promoting healthy lifestyles among children.
The mayor also underscored the provision of childcare training to parents and guardians in childcare centres, pediatric hospitals, schools, and religious organizations. Acknowledging the vulnerability and dependence of the children on parental care, the mayor stated, “If the parents know the value of nutrition and exercise, their children will have a healthful foundation for the future.”
A significant portion of childhood obesity policy discussion was built around two prevailing frames: personal responsibility and environmental factors. These oppositional frames steer different policy strategies. While federal initiatives have stalled in enacting broad change, state and local policies—e.g., nutrition labelling campaigns and school meal program standards are already showing a more concrete effect in reversing childhood obesity trends.
Anderson, A. L., Waddell, A., Brennan, P., Burnett, C., Anderson, C., & Short, N. M. (2020). Advancing health policy education in nursing: American Association of Colleges of Nursing Faculty Policy Think Tank. Journal of Professional Nursing, 36(3), 100–105. https://doi.org/10.1016/j.profnurs.2019.09.002
Anderson, P. M., Butcher, K. F., & Schanzenbach, D. W. (2019). Understanding recent trends in childhood obesity in the United States. Economics & Human Biology, 34, 16–25. https://doi.org/10.1016/J.EHB.2019.02.002
Giddens, J. F., Lauzon-Clabo, L., Morton, P. G., Jeffries, P., McQuade-Jones, B., & Ryan, S. (2014). Re-envisioning Clinical Education for Nurse Practitioner Programs: Themes From a National Leaders’ Dialogue. Journal of Professional Nursing, 30(3), 273–278. https://doi.org/10.1016/j.profnurs.2014.03.002
Mihrshahi, S., Drayton, B. A., Bauman, A. E., & Hardy, L. L. (2017). Associations between childhood overweight, obesity, abdominal obesity and obesogenic behaviours and practices in Australian homes. BMC Public Health. https://doi.org/10.1186/s12889-017-4595-y
Miles, J. M., & Scott, E. S. (2019). A New Leadership Development Model for Nursing Education. Journal of Professional Nursing, 35(1), 5–11. https://doi.org/10.1016/J.PROFNURS.2018.09.009
Risjord, M. (2011). Nursing Science. Philosophy of Medicine, 489–522. https://doi.org/10.1016/B978-0-444-51787-6.50015-5
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