Development and initial validation of the nursing practices, perceptions and barriers questionnaire for childhood obesity: A cross-sectional observational study

Aim To develop and preliminarily validate a questionnaire assessing primary care nurses' practices, perceptions, and perceived barriers in managing childhood obesity. Design Sequential exploratory study conducted in three phases: item development, content validation, and a cross-sectional observational study with an initial psychometric validation. Methods Items were generated through a literature review, focus groups, and adaptation of an existing adult obesity instrument. A panel of six experts assessed content validity, clarity, coherence, and item adequacy. The final version 39-item questionnaire was distributed online to primary care nurses in Madrid, Spain; 253 complete responses were analyzed. Descriptive statistics were calculated. A preliminary Exploratory Factor Analysis was conducted on selected items. Results The overall content validity index was 0.96. The final instrument identified three areas: training and experience, practices and barriers, and knowledge of childhood obesity. Factor analyses supported coherent underlying dimensions for selected items, with acceptable internal consistency. Nurses reported positive attitudes toward addressing pediatric obesity but identified barriers such as limited consultation time, low treatment adherence, and intervention complexity. Conclusion The NPPBQ-CO is a structured instrument with initial evidence of content validity, preliminary psychometric support and acceptable internal consistency. Further validation is warranted. Implications to practice •The questionnaire may serve as a tool to assess primary care nurses´ needs, attitudes, and barriers managing pediatric obesity. •It may inform the design of targeted educational and institutional strategies to enhance quality of care. •The instrument may serve as a useful tool for healthcare organizations to monitor changes in nursing practice following training initiatives.