School Nurses as Social Justice Leaders: Advancing Health Equity in New Jersey Schools – A Mixed Methods

Abstract

This dissertation examines the perceptions, leadership practices, and challenges of school nurses in New Jersey as they advocate for health equity in educational settings. Using a mixed- methods design, the study integrates quantitative survey data (n = 101) and qualitative interviews (n = 6) to assess how school nurses evaluate health equity efforts, identify barriers and facilitators, and lead change through a social justice lens. Grounded in the School Nursing Practice Framework™, Health Equity Promotion Model, and Social Justice Leadership Theory, the research highlights the dual roles of school nurses as care providers and systemic advocates. Quantitative findings show alignment in equity perspectives across school types, but significant variation by grade level served. Cronbach’s alpha values ranged from 0.81 to 0.92, confirming strong internal consistency across the five equity-related scales. However, over 60% of respondents reported minimal training and limited administrative support. Thematic analysis of interviews yielded four themes: leadership in equity, addressing disparities, professional development, and post-pandemic priorities. Together, findings reveal a strong personal commitment among nurses to advance health equity despite structural limitations. The study calls for systemic reforms including culturally responsive training, stronger interdisciplinary collaboration, and policy integration. It positions school nurses as key leaders in public health and equity within school communities.