The Journal of School Nursing2023, Vol. 39(6) 487–495© The Author(s) 2021Article reuse guidelines:sagepub.com/journals-permissionsDOI:10.1177/10598405211043126journals.sagepub.com/home/jsn
This study explored relationships between school nurses’ diabetes-related attitudes, self-efficacy in diabetes management and education, and care practices. One-hundred fourteen school nurses who have taken care of students with type 1 diabetes in public schools comprised this descriptive study sample. Participants completed online surveys. School nurses’ diabetes-related attitudes were not related to their self-efficacy in diabetes education, but nurses’ attitudes towards the psychosocial impact of diabetes were significantly related to their self-efficacy in diabetes management, and the number of students with diabetes was a significant contributor to this relationship. Nurses’ full-time status and the type of school they worked in were significantly related to their self-efficacy in providing diabetes education. School nurses’ positive attitudes about providing care for students with diabetes were related to having a higher level of self-efficacy in providing diabetes management. Based on the findings, recommendations are made for health consolidated schools and full-time school nurses.
Keywordsdiabetes, school nurse knowledge/perceptions/self-efficacy, school nurse, diabetes education, diabetes management
The prevalence of type 1 diabetes (T1D) among populations who are younger than age 20 was 1.93 per 1,000 in 2009 (Dabelea et al., 2014; Pettitt et al., 2014). The majority of people with T1D are often diagnosed during childhood (Sperling, 2014). Diabetes management is a challenge for youth with T1D and their parents, as well as for the school nurses who care for them (de Cássia Sparapani et al., 2017; Edwards et al., 2014; Kelo et al., 2011). Students with T1D frequently visit school nurses, with an average of 2.9 diabetes care or management-related nurse visits per day occur among elementary schoolers (Bobo et al., 2011). School nurses are available to support children in school settings by providing necessary diabetes care (National Association of School Nurses [NASN], 2016). However, there is little information about school nurses who primarily provide nursing care to students with T1D. This study aimed to explore integrated views of school nurses’ diabetes-related attitudes and self-efficacy in diabetes management and diabetes education. Such information can be used to formulate recommendations related to school nursing practices.
The role of school nurses includes providing care for individual health needs; supplying education for school staff and students; and acting as bridges for communities, schools, families, and healthcare professionals (Council on School Health, 2016; NASN, 2016). School nurses are also expected to assist with students’ normal development and health needs by coordinating care between different stakeholders, facilitating safe school environments, contributing to the development of school policies, and providing direct care and education (Council on School Health, 2016; NASN, 2016). As a significant part of their role, school nurses take care of students with chronic health conditions, such as diabetes, to enhance student health, safety, and academic success (NASN, 2017).
Over the decades, several studies reported that health care professionals’ attitudes influence their care practices and patients’ health outcomes (Anderson et al., 1993, 1998; Gagliardino et al., 2007; Nordfeldt et al., 2012; Williamson et al., 1996). Anderson et al. (1998) reported that nurses rated the psychosocial impact of diabetes on patients significantly higher compared with dietitians and physicians, and the scores significantly increased for all professionals as they spent more time providing care to patients with diabetes. Siminerio et al. (2007) reported that nurses had higher perceived needs to gain a better understanding of psychosocial issues in patients with diabetes and improve patient communication than did physicians in a study with U.S. healthcare providers. Nurses were eager to take on more responsibilities for diabetes management, although specialists had more involvement in diabetes management compared to generalists (Siminerio et al., 2007). Nurses also perceived that their roles included providing therapeutic environments for patients in order to improve diabetes care (Siminerio et al., 2007). However, these studies presenting nurses’ attitudes toward diabetes included nurses in hospitals and/or clinic settings, not in schools.
School nurses reported high levels of confidence in the knowledge of diabetes (Allen et al., 2012) and moderately confidence in diabetes care and education (Fisher, 2006). In studies measuring school nurses’ confidence levels in diabetes care, the results revealed that school nurses had moderate levels of confidence in their own ability to provide diabetes education (mean ± SD = 36.30 ± 9.99; Fisher, 2006, Williams et al., 2019). Three factors were positively correlated with school nurses’ self-efficacy in providing diabetes care and education: participation in the care of children with diabetes, children with T1D in the school system, and supervision of children during blood glucose meter testing (Fisher, 2006).
Although some school nurses initially feared taking care of students with a continuous subcutaneous insulin infusion pump, Darby (2006) found that they gained confidence in providing care to students through continuous learning processes. In an online survey with 2,049 current or former school nurses, school nurses expressed high levels of confidence in handling glucagon (Allen et al., 2012). These studies identified that most school nurses had a high amount of knowledge about diabetes and medication administration for intervening in potentially life-threatening events, utilized available resources, and gained more knowledge and hands-on experience while managing equipment (Allen et al., 2012).
While school nurses provide care to children with T1D, little research has been conducted regarding school nurses’ diabetes-related attitudes and their self-efficacy in diabetes management and education. School nurses meet with students with diabetes more frequently than with other students (Bobo et al., 2011), but their diabetes-related attitudes influencing their practice are not well known. Studies examining school nurses’ experiences in diabetes care address diabetes management, but generally do not address the relationships among school nurses’ attitudes toward the disease, or self-efficacy related to managing and educating students about diabetes. Therefore, the purpose of this study was to explore relationships between school nurses’ diabetes-related attitudes, their self-efficacy in diabetes management and education, and their care practices.
This descriptive study aimed to explore the relationships between school nurses’ attitudes about diabetes and self-efficacy in diabetes management and education for students with T1D. This study consisted of two parts: (1) responses to online surveys and (2) interviews conducted with a subsample of the survey participants to gain a broad understanding of school nurses’ roles in diabetes management, with a specific focus on diabetes education and transitional care for students with T1D. Interview results will be reported elsewhere. The study was approved by the University of Washington Institutional Review Board (IRB).
School nurses who had taken care of students with T1D in public school districts in Washington (WA) state were eligible for the study. Convenience sampling was used to recruit participants. The inclusion criteria for the study included (1) current employment as a school nurse, (2) experience providing diabetes care to students with T1D, and (3) English speaking. Study participants were recruited from local school districts in WA and the National Association of School Nurses (NASN) affiliate chapter in WA by using the listserv between February 2016 and June 2016. An IRB-approved email with a flyer and an information statement, which also served as a consent form, was sent to potential participants up to three times.
Data were collected from March 2016 to July 2016 using the Research Electronic Data Capture (REDCap) system. A total of 117 school nurses participated in the surveys. One was excluded because they did not meet eligibility criteria, and two were excluded from the analyses due to the completion of demographic questions only. The total final sample for analysis was 114.
Diabetes Attitude Scale. The third version of the Diabetes Attitude Scale (DAS-3) was developed to measure attitudes related to diabetes in healthcare professionals and patients with diabetes (Anderson et al., 1998). It consists of 33 items rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree) with five subscales (the need for special training in education, seriousness of type 2 diabetes (T2D), the overall value of tight glucose control in diabetes care, psychosocial impact of diabetes on patients, and attitude toward patient autonomy). The range of possible scores of each subscale is from 1 to 5, with a high score representing positive attitudes toward diabetes. The range of subscale reliability scores was between 0.65 (psychosocial impact of diabetes) and .80 (seriousness of T2D). In this study, the reliability coefficient for each subscale ranged from 0.51 (needs for special training) to 0.65 (seriousness of T2D and psychosocial impact of diabetes).
Self-efficacy in Diabetes Education. This scale measures self-efficacy levels of school nurses in diabetes care and education based on Bandura’s Social Cognitive Theory (Fisher, 2006, p. 225). It consists of 11 items, rated using a 5-point Likert scale (1 = not at all confident to 5 = completely confident). The range of possible scores is from 11 to 55, with higher scores representing higher confidence in providing diabetes care and diabetes education. The reliability coefficients were 0.88 at the initial validation in the developmental phase, and 0.94 in a study with 70 school nurses (Fisher, 2006). Cronbach’s alpha for the current study sample was 0.90.
Self-efficacy Questions for Insulin Pumps, Glucagon, and Carbohydrate Counting. Three questions were developed by the first author to identify self-efficacy levels of school nurses related to nursing practice in operating insulin pumps, administering glucagon, and counting carbohydrates in food. The items are rated using a 5-point Likert scale and confidence levels increase as the scores increase (1 = Not at all confident to 5 = Completely confident). One diabetes expert, one diabetes educator, two nurse practitioners, and one school nurse reviewed the questions to establish face validity. Cronbach’s alpha was 0.62 in this study.
School Nurse Role in Care and Management of the Children With Diabetes in the School Setting. This 37-item survey was developed by West and Holmes (2014) to assess school nurses’ nursing care for students with diabetes based on the criteria of the 2006 NASN position statement on diabetes care. The survey consists of three parts and employs a simple branching logic: demographic information questions (6 items), daily diabetes management and services-related questions (19 items), and care plan-related questions (12 items). Twenty-eight of the 37 items are rated on a 5-point Likert scale (A = Do Not Agree to E = Strongly Agree) to examine school nurses’ levels of implementation of diabetes management. This survey was reviewed by the NASN officers (West & Holmes, 2014), but no psychometric properties and scoring guidelines were established by the developers. With permission from the developers, the alphabetical order of 5-point Likert scale (A to E) was transformed into the numerical order of 5-point Likert scale (1–5). Due to the insufficient sample size for factor analysis, an attempt was made to categorize items based on their concepts to calculate a Cronbach’s alpha in this study. As a result, a total of nine categories were generated and three categories (Access to support systems and equipment, Support from school staff, and Health care plans) were used to compute reliability that ranged from 0.60 (Access to support systems) to 0.80 (Health care plans).
Supplemental Questions on School Nurse Role in Care and Management of Children With Diabetes in the School Setting. Eight supplemental questions were developed by the first author to measure information about additional staff, nursing time per visit, cognitive levels of students with T1D, preferred educational formats for diabetes care, and management of students with T1D. It was reviewed for content validity by three experts: a school nurse supervisor, a diabetes expert, and a pediatric nurse practitioner.
All survey data were analyzed by using STATA/IC (STAT Corp. LP, College Station, TX). The collected data were reviewed for valid responses, missing data, and outliers. Descriptive analyses were applied to demographic data. Pearson’s correlation coefficients were computed. To describe relationships between demographic data and each measure, Chi-squared-tests, Fisher’s exact tests, t-tests, one-way ANOVAs, and logistic regressions were performed depending on the types of variables. To describe relationships between school nurses’ diabetes attitudes, their self-efficacy in diabetes education and management, multivariate regression models were constructed through an approach involving three steps. First, univariate regression models were constructed between two instruments. Second, backward-stepwise regressions with covariates were estimated. Lastly, final models were selected after adjusting models based on the results from univariate analyses and backward-stepwise estimations. All statistical tests utilized a 95% confidence interval (CI).
A total of 114 participants from 22 out of a total of 39 public school districts in WA were included in the final data analyses. Participants were highly demographically homogeneous: most were female (97.37%), non-Hispanic (94.74%), White (90.35%), and registered nurses (RNs; 95.61%, Table 1). Most participants were responsible for up to three schools (84.35%) and six school nurses covered more than six schools (5.26%).
Descriptive statistics for the DAS-3, SNR, SEDE, and SEQ-IGC are presented in Table 2. The results indicated that school nurses had positive diabetes-related attitudes, a moderate level of confidence in diabetes education and diabetes care (M = 36.16, SD = 6.70), and moderate confidence overall in managing insulin pumps, glucagon, and carbohydrate counting. School nurses also had lower confidence in insulin pump operation than in glucagon administration and carbohydrate counting. The number of students with diabetes that nurses provided care for varied: 27.8% of school nurses provided care for fewer than three students with diabetes, while the remaining nurses provided care for more than three students with diabetes. A total of 53 school nurses received the Although there were some differences in the mean scores among items, school nurses’ practice mostly adhered to diabetes care recommendations by NASN.
The three subscales (need for special training, value of tight control, and patient autonomy) were not significantly related to demographic variables (p > .05). School nurses working full time had higher scores on the psychosocial impact of diabetes scale (M = 4.56, SD = 0.05) than did those working part-time (M = 4.36, SD = 0.08), t(110) = -2.01, p = .047). Also, school nurses taking care of six or more students with diabetes were more likely to have higher scores on the psychosocial impact of diabetes than those taking care of five or fewer students (p < .05).
Nurses working full time had higher SEDE scores (M = 37.27, SD = 6.21) than did those working part-time (M = 32.96, SD = 7.64), t(109) = 2.73, p = .007. The number of students with diabetes in the nurse’s caseload was also significantly related to the mean SEDE score (p < .05). A Tukey-Kramer post hoc test indicated that the mean SEDE score was significantly higher in nurses taking care of more than eight students with diabetes, compared to nurses taking care of fewer than three students with diabetes (p <.05).
The main effect of the number of students with diabetes was significant, F(3,102) = 4.61, p = .005. A post hoc analysis using the Tukey-Kramer criterion indicated that the mean SEG-IGC score was significantly lower in nurses caring for five or fewer students with diabetes than in those caring for six to eight (p < .05) and in those caring for more than eight students with diabetes (p = .01). Nurses working in elementary schools had higher scores on self-efficacy in managing insulin pumps (M = 3.15, SD = 1.02) than did those working in middle and/or high schools (M = 2.50, SD = .85), t(66) = −2.19, p = .03. However, other demographic factors were not significantly related to SEG-IGC.
Diabetes-Related Attitudes and Self-efficacy in Diabetes Education. The need for special training and patient autonomy were not significant predictors of school nurses’ self-efficacy in diabetes education in the univariate models. Value of tight control and psychosocial impact of diabetes were not significant predictors of school nurses’ self-efficacy in diabetes education in the multivariate models that included their job status and types of schools at which they worked (p > .05).
Diabetes-Related Attitudes and Self-efficacy in Diabetes Management. Nurses’ attitudes toward the need for special training, value of tight control, and patient autonomy were not significant predictors of their self-efficacy in diabetes management with insulin pumps, glucagon, and carbohydrate count (p > .05). The final regression model for psychosocial impact of diabetes was significant, F(5, 100) = 4.53, R2 = .170. Nurses having more positive attitudes towards the psychosocial impact of diabetes was associated with having higher self-efficacy in managing insulin pumps, glucagon, and carbohydrate counting, after controlling for the number of students with diabetes and type of schools (p = .027, Table 3). Nurses caring for six or more students with diabetes were also more likely to have higher SEQ-IGC scores, representing higher self-efficacy in diabetes management (p < .05). However, the type of school worked in was only marginally significant contributor to self-efficacy in diabetes management in multiple F-tests (p = .08).
Insulin Pumps. Nurses placing a higher value on tight control were more likely to have higher self-efficacy in managing pumps than those reporting the lower value of tight control (p = .03, Table 4). Also, nurses having positive attitudes towards the psychosocial impact of diabetes were more likely to have higher self-efficacy levels in managing insulin pumps (p < .05, Table 4).
Glucagon and Carbohydrate Counting. In each multivariate model, taking care of six or more students with diabetes had a significant positive relationship with nurses’ self-efficacy in managing glucagon and counting carbohydrate in school nurses, although nurses’ attitudes and their self-efficacy in managing glucagon in hypoglycemic situations and carbohydrate count was not significant (p > .05).
The present study explored the relationships between diabetes-related attitudes, school nurse self-efficacy in diabetes education, and management in school nurses. Findings indicate that school nurses had the highest attitude scores on the psychosocial impact of diabetes and the lowest scores on patient autonomy. These results are consistent with the findings from previous studies that report that nurses tended to have higher scores on the psychosocial impact of diabetes on patients’ lives than other health care professionals, and that low scores on patient autonomy were common among health care professionals (Anderson et al., 1993, 1998; Siminerio et al., 2007; Williamson et al., 1996).
Findings also indicate that school nurses’ self-efficacy in providing diabetes education had a significant relationship with their work status (full- vs. part-time) and the type of school in which they worked. Their self-efficacy in diabetes management was also associated with the number of students with diabetes in their care. Specifically, nurses taking care of six or more students with diabetes were more likely to have higher self-efficacy in diabetes management with handling insulin pumps, administering glucagon, and counting carbohydrates. This finding is consistent with previous findings that reported that more hands-on practice contributed to higher confidence in diabetes management (Allen et al., 2012; Darby, 2006; Fisher, 2006). In particular, Fisher (2006) concluded that more experiences in caring for students with diabetes might be a key factor influencing higher self-efficacy regarding diabetes management in school nurses. The present study provides evidence to support the assumption made by Fisher (2006) that school nurses taking care of more students with diabetes had higher scores on self-efficacy in diabetes education (p < .05).
In terms of associations between diabetes-related attitudes and self-efficacy in diabetes management and education, the present study found no relationship between nurses’ diabetes-related attitudes and self-efficacy in diabetes education, but attitudes were a significant predictor of self-efficacy in diabetes management. These findings are partially consistent with previous studies indicating that having positive attitudes toward diabetes might influence better healthcare practices (Anderson et al., 1993, 1998). Although nurses’ self-efficacy in diabetes education and self-efficacy in diabetes management were positively correlated (p < .05), the present study findings only indicated a relationship between attitudes toward diabetes and the psychosocial impact of diabetes and self-efficacy in managing insulin pumps, glucagon, and carbohydrate count, and did not include diabetes education. Therefore, further studies are needed to investigate relationships between school nurses’ self-efficacy in diabetes education and self-efficacy in diabetes management to identify any discrepancy between the two, as well as examine their relationship with diabetes attitudes.
It is already known that adolescents and children tend to maintain higher blood glucose levels than the recommended ranges (West & Holmes, 2014). In this study, school nurses only somewhat agreed that their students had tightly controlled blood glucose levels while in school despite placing a high value on maintaining tightly controlled glucose levels. This finding is consistent with the previous study. One likely reason for this finding is that in light of physical development changes in adolescents, the increasing autonomy of the adolescent in managing their own diabetes creates challenges for the school nurse to help maintain tightly controlled glucose levels. In addition, the findings suggest the importance of school nurses’ roles to help students with diabetes explore the reasons why they have poor control of blood glucose levels in schools and who placed a high value on tight glucose control. Therefore, further studies are needed to identify possible variables influencing this gap between the nurses’ attitudes and their practice in managing students’ blood glucose levels in school settings, so that nursing interventions in school can support students in maintaining blood glucose levels close to the recommended ranges.
School nurses reported positive attitudes about students’ independence in diabetes management, and their scores on patient autonomy provide possible evidence to support nursing practice promoting students’ self-management behaviors. There is limited information about school nurses’ attitudes toward diabetes, but compared to studies of nurses caring for adult patients, school nurses seem to have more positive attitudes about students’ autonomy in diabetes management (Anderson et al., 1998; Gagliardino et al., 2007). This might be because promoting diabetes self-management is highly important among school nurses taking care of children and adolescents who must achieve their developmental milestones as they become adults, compared to nurses taking care of adult diabetes patients. For this reason, school nurses might have higher scores on patient autonomy in attitudes toward diabetes. Also, in prior studies, differences in attitudes toward diabetes among different health care professionals were significant (Anderson et al., 1993, 1998; Williamson et al., 1996), and relationships between self-efficacy in management and diabetes-related attitudes were significant (Siminerio et al., 2007).
The Helping Administer to the Needs of the Student with Diabetes in Schools (H.A.N.D.S.) training has been developed by NASN as a continuing education program of 1-day on-site or online education to promote diabetes knowledge among school nurses (Breneman et al., 2015). After receiving the training, school nurses reported that the training would improve their ability to diabetes management for students with diabetes (Breneman et al., 2015). However, in this study, the H.A.N.D.S. training was not a significant predictor for school nurses’ attitudes toward diabetes and self-efficacy in diabetes management. This result was inconsistent with previous studies (Bachman & Hsueh, 2008; Bobo et al., 2011; Breneman et al., 2015; Kaufman et al., 2012). One possible reason for this inconsistency is the difference in the time between nurses receiving diabetes training and evaluating the effects of diabetes training on diabetes-related attitudes and self-efficacy in diabetes care. Previous studies evaluated the effectiveness of diabetes training by administering post-tests immediately after completing training programs, without investigating long-term effects over one year (Bachman & Hsueh, 2008; Bobo et al., 2011; Breneman et al., 2015; Rhodes et al., 2019). However, in the present study, the effects of nurses’ diabetes training on attitudes toward diabetes and self-efficacy in diabetes education and management were not evaluated after completing diabetes training. This inconsistency might also indicate a lack of long-term retention of diabetes training content over three years. Therefore, continuing education might be necessary, perhaps annually, to maintain educational effects on school nurses’ self-efficacy in diabetes care.
Study findings have direct applicability concerning school nurses’ roles in diabetes management and education for students with T1D. First, having a full-time nurse in a school is essential for providing better diabetes management and education to students with diabetes. The results indicate that nurses spending more time with students with diabetes are more likely to have higher confidence in providing quality diabetes education and diabetes management. With high confidence in their ability to provide diabetes care, school nurses could potentially anticipate or immediately respond to hypoglycemic emergency situations which require glucagon injections. In addition, school nurses could provide better management of insulin pumps and nutritional education for counting carbohydrates to establish lifelong habits in wellcontrolled diabetes. Second, it is important for school nurses to participate in continuing education about diabetes regardless of their job status. The study findings did not identify significant relationships between the number of school nurses participating in diabetes training, their attitudes toward diabetes, and self-efficacy in diabetes management and education. However, gaining the latest diabetes management information during diabetes training could help school nurses provide diabetes management and education to students, especially when nurses take care of more than six students with diabetes.
This study has several limitations. First, the study focused on school nurses from one state, which may limit the generalizability of the findings. The findings need to be replicated with a large number of school nurses across different geographic regions. Second, the study has a highly homogeneous sample of female, White, full-time school nurses with registered nurse (RN) credentials. Although these characteristics of school nurses are consistent with the results of the national surveys about school nurses in the United States (Willgerodt et al., 2018), it may limit the generalizability of the findings to RN-prepared nurses. Third, some of the study measures did not demonstrate an acceptable level of reliability (α>.80) for psychometric tests, potentially limiting confidence in the findings. This limitation is counterbalanced by the fact that these measures have established validity with experts in the field or reliability with different populations in previous studies (Anderson et al., 1993, 1998; West & Holmes, 2014) and that the majority of the measures did demonstrate adequate reliability. Additional studies are needed with a large number of school nurses to establish the reliability and to validate whether there is a need to revise the questions in the measures.
The study findings of diabetes-related attitudes and self-efficacy in diabetes management and education are important contributions to nursing science, especially school nursing. Relationships between diabetes-related attitudes and self-efficacy in diabetes management and diabetes education have not been explored previously with school nurses who take care of students with T1D. These findings address a new scope of school nurses’ practices along with the individual attitudes of school nurses toward diabetes management and diabetes education. Therefore, these findings can help researchers and school nurses evaluate and improve, as appropriate, current school nursing practices.
We gratefully acknowledge the assistance of Dr. Kathleen Johnson, Patricia Schwimer, CPNP, RN, Chvette Silver, CPNP, RN, and Dr. Peggy Odegard, who reviewed the study measures, Dr. Ken Pike, who provided statistical analysis consultation, and Terri-Helm-Remund, RN, who assisted in the recruitment.
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Hester McLaws Nursing Dissertation Scholarship and the Nursing Graduate Education Enhancement Fund from the University of Washington School of Nursing, and the Scientific Scholarship from the Global Korean Nursing Foundation in the United States of America.
Mee Kyung Lee https://orcid.org/0000-0002-0368-5311
Mayumi Willgerodt https://orcid.org/0000-0002-9874-3739
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Mee Kyung Lee, PhD, RN, is an Affiliate Instructor in the Department of Child, Family, and Population Health Nursing at the University of Washington. Her research interests involve improving self-management behaviors and facilitating care for transitions in students with chronic diseases, especially diabetes, through nursing interventions in school settings, based on her clinical experience in pediatric nursing. Dr. Lee has worked with children, adolescents, and their families in hospital, community, and school settings. She hopes to build a foundation of understanding about school nurses’ roles in caring for students with diabetes to develop developmentally appropriate diabetes educational programs.
Elaine Walsh, PhD, RN, PMHCNS-BC, FAAN, is an ANCC-Certified Clinical Specialist in Child and Adolescent Psychiatric and Mental Health Nursing. She has a Master of Nursing from UCLA and a PhD in Nursing from the University of Washington. Dr. Walsh’s research interests include prevention of suicide and co-occurring behaviors, program evaluation, and translation of research interventions to community settings. She is a member of the King County Suicide Prevention Coalition and an affiliate faculty member of Forefront: Innovations in Suicide Prevention, based at the UW’s School of Social Work. Dr. Walsh has extensive experience working with youth and families in hospital, school, and community settings.
Mayumi Willgerodt, PhD, MPH, FAAN, FNASN, RN, is an Associate Professor and Vice-Chair for Education in the Department of Child, Family, and Population Health Nursing at the University of Washington and affiliate faculty in the Center for Health Sciences Interprofessional Education Research and Practice (CHSIE). Dr. Willgerodt’s research and scholarly foci are centered around school health, school nursing, and interprofessional (IP) education and collaborative practice (CP) as a means to impact health outcomes in youth, particularly with vulnerable and minority populations. In 2018, Dr. Willgerodt and colleagues published the first nationally representative study on the school nursing workforce which illuminated the need for leveraging the professional expertise of school nurses to strengthen interprofessional care coordination and maximize efficiencies across systems of care. In addition to school nursing workforce and services delivery, Dr. Willgerodt has led several teams on HRSA-funded grants to increase the nursing workforce with an emphasis on IPCP. She has developed, facilitated, and led IP curricula and training activities for students and faculty and provides consultation nationally and internationally on integrating IP curricula into both didactic and clinical settings.
Rebecca O’Connor’s, PhD, RN, research, teaching, and service reflect her commitment to diversity, equity, and inclusion. She recognizes that multiple historical and structural barriers in the USA prevent many minority populations from achieving health equity and dissuade their participation in clinical research, further exacerbating inequities. To address the former, her research seeks to reduce type 1 diabetes (T1D)-related disparities in youth by describing and ultimately mitigate factors that negatively affect health care providers’ decision-making. Her previous research explored disparities in T1D prevalence rates among minority youth and identified barriers/facilitators to pediatric clinical research participation in the East African community. To address the latter (a lack of diversity among clinical research participants), she works with Seattle Children’s and the Institute of Translational Health Sciences as they partner with communities to ensure that future research benefits us all. She is a member of the School’s Diversity Committee, helped lead the development of the School’s Diversity, Equity, and Inclusion Strategic Plan, and represent the School on the University of Washington Diversity Council. She received the School of Nursing’s student nominated Excellence in Promoting Diversity Through Teaching in 2016.
1 University of Washington School of Nursing, Seattle, Washington, USA
Corresponding Author:Mee Kyung Lee, University of Washington School of Nursing, Health Sciences Building, Room T-405A, 1959 NE Pacific Street, Seattle, WA 98195, USA.Email: mkl9@uw.edu