The multiple intervention ists (student nurses) for the coaching sessions may have resulted in varying styles of interaction with the children and thus varying impact. While the students
were offered training, next steps will standardize the training and supervision of student nurses. Assuring routine coaching sessions with the children is an important lesson. Onsite sessions at the school under supervision are recommended based on the current findings. This approach also requires creative opportunities for engaging parents given the influence parents ultimately have on children’s health habits. Offering parent events at a convenient time such as evenings with opportunities to model and teach healthy nutrition and physical activity and engage parent and teachers in discussions will be an important future strategy. Measurement tools that do not rely on child self report or that are validated with parent report are needed.
Additionally, measuring changes over a longer period of time to examine sustainability is essential.