Abstract
BACKGROUND: Pediatric obesity is a major public health concern worldwide. In Saudi Arabia, school nurses can play a pivotal role in prevention, yet their practices are influenced by multiple contextual factors. This study explored the factors shaping school nurses' attitudes and behaviors toward pediatric obesity prevention. METHODS: A constructivist grounded theory approach was used. Semi-structured interviews were conducted with 11 school nurses working in private primary schools in Saudi Arabia. Data were analyzed using Charmaz's process, with theoretical sampling to refine emerging categories. A focus group with three experts was conducted to confirm and validate the generated theory. RESULTS: Eleven participants contributed to the analysis. Three categories (Struggling, Avoiding, and Competing Priorities) and one core category (Lacking Support) emerged to collectively represent the social process, Jumping Hurdles: A Pathway to Professional Growth. CONCLUSIONS: This substantive theoretical model advances understanding of the factors shaping school nurses' roles in pediatric obesity prevention in Saudi Arabia. Findings highlight the need for actionable policies and school-level support to strengthen nurses' contributions. For policymakers and school administrators, investing in structural support, targeted training, and resource allocation may enhance nurses' capacity to engage effectively in obesity prevention and ultimately improve student health outcomes.