Date of Award

5-2026

Degree Name

Doctor of Philosophy

Department

Interdisciplinary Health Sciences

First Advisor

Kieran Fogarty, Ph.D.

Second Advisor

Lisa Dechano-Cook, Ph.D.

Third Advisor

Teddie Potter, Ph.D.

Keywords

Climate change, education, nursing, sustainability

Abstract

Climate change is one of the most pressing public health emergencies of our time and nurses can have a great impact in their current practice and in the education of future nurses (The Alliance of Nurses for Healthy Environments, n.d.; American Nurses Association, 2023; Health Care without Harm, 2025). Deaths due to rising temperatures, vector-borne illness, and food insecurity related to drought and extreme weather are on the rise (WHO, 2024). It has been estimated that globally over 250,000 additional deaths will be attributed to climate related effects between 2030 and 2050 (Watts et al., 2020; WHO, 2023).

A primary data collection cross sectional study used the validated Sustainability Attitudes and Nursing Survey (SANS-2) (Richardson et al., 2015) focusing on a study sample of 144 U.S. community health nurse educators, Michigan public health nurses, and U.S. nurse educators. The variables of area of specialty were compared with the SANS-2 question 5, “I apply sustainability practices at home,” the non-SANS-2 question ranking common barriers, and the non-SANS-2 write in response to additional barriers related to implementing climate change and sustainability concepts into nursing curriculum. An independent T-test and one-way ANOVA were used to compare nursing specialty for the SANS-2 survey question 5, “I apply sustainability practices at home.” A Kruskal-Wallis H test was used to compare rank order responses to common barriers with specialty of nursing. A Mann-Whitney post hoc test was run in addition to the KruskalWallis H for significance. The qualitative analysis guided by Charmaz (2014) process for the write in response to barriers in implementing climate change sustainability into nursing curriculum.

There were 144 respondents that completed the survey during September 2023- November 2023. The largest respondent groups were nurse educators in an academic setting (n=73, 50%), followed by Michigan public health nurses (n=46, 31%), community health nurse educators (n=13, 9%), and acute care or other nurses (n=12, 8%). The study found that there is no reported statistical relationship between nurse’s specialty and the SANS-2 question 5 (p=.407), “I apply sustainability practices at home.” However, there was a reported positive statistical association between a nurse’s specialty and the barriers to climate change and sustainability in curriculum as a rank order response (p=< .001). The post hoc analysis found no significance between nursing specialties other than between “public health nurses” and “nursing educators in an academic setting.” The main themes that emerged in the write in response section were ‘continued gap in resources for nursing educators,’ ‘potential regional differences,’ and ‘polarizing nature of climate change and sustainability.’

Barriers are important to consider when working with nurses and these barriers may be different between nursing specialties. Understanding the unique barriers that different health care sectors face is important to determining a tailored approach to decreasing the barrier. Knowing that community health nurse educators have strong positive attitudes in climate change and sustainability and its importance to nursing education could be a starting point for implementing nursing education to these topics. By expanding research in this area, it will help inform future research, education, and policy development.

Access Setting

Dissertation-Open Access

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