Pinar Eskicioglu1, Joannie Halas2, Martin Sénéchal3, Larry Wood4, Elma McKay4, Stephanie Villeneuve5, Garry X Shen6, Heather Dean3, Jonathan M McGavock7. 1. Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada;Faculty of Kinesiology and Recreation Management. 2. Faculty of Kinesiology and Recreation Management. 3. Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada;Department of Pediatrics and Child Health, Faculty of Medicine, and. 4. Garden Hill First Nation Health Authority, Garden Hill First Nation, Manitoba, Canada. 5. Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada; 6. Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; and. 7. Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada;Faculty of Kinesiology and Recreation Management,Department of Pediatrics and Child Health, Faculty of Medicine, and jmcgavock@mich.ca.
Abstract
OBJECTIVE: The goal of this study was to assess the efficacy of an after-school, peer-led, healthy living program on adiposity, self-efficacy, and knowledge of healthy living behaviors in children living in a remote isolated First Nation. METHODS: A quasi-experimental trial with a parallel nonequivalent control arm was performed with 151 children in Garden Hill First Nation during the 2010-2011 and 2011-2012 school years. Fourth grade students were offered a 5-month, peer-led intervention facilitated by high school mentors between January and May of each school year; students in the control arm received standard curriculum. The main outcome measures were waist circumference (WC) and BMI z score. Secondary outcome measures included healthy living knowledge and self-efficacy. RESULTS:Fifty-one children (mean ± SD age: 9.7 ± 0.4 years; BMI z score: 1.46 ± 0.84) received the intervention, and 100 children were in the control arm. At baseline, WC (79.8 vs 83.9 cm), BMI z score (1.46 vs 1.48), and rates of overweight/obesity (75% vs 72%) did not differ between arms. After the intervention, the change in WC (adjusted treatment effect: -2.5 cm [95% confidence interval (CI): -4.1 to -0.90]; P = .002) and BMI z score (adjusted treatment effect: -0.09 [95% CI: -0.16 to -0.03]; P = .007) were significantly lower in the intervention arm compared to the control arm. The intervention arm also experienced improvements in knowledge of healthy dietary choices (2.25% [95% CI: -0.01 to 6.25]; P = .02). Self-efficacy was associated with the change in WC after the intervention (β = -7.9, P = .03). CONCLUSIONS: An after-school, peer-led, healthy living program attenuated weight gain and improved healthy living knowledge in children living in a remote isolated First Nation.
RCT Entities:
OBJECTIVE: The goal of this study was to assess the efficacy of an after-school, peer-led, healthy living program on adiposity, self-efficacy, and knowledge of healthy living behaviors in children living in a remote isolated First Nation. METHODS: A quasi-experimental trial with a parallel nonequivalent control arm was performed with 151 children in Garden Hill First Nation during the 2010-2011 and 2011-2012 school years. Fourth grade students were offered a 5-month, peer-led intervention facilitated by high school mentors between January and May of each school year; students in the control arm received standard curriculum. The main outcome measures were waist circumference (WC) and BMI z score. Secondary outcome measures included healthy living knowledge and self-efficacy. RESULTS: Fifty-one children (mean ± SD age: 9.7 ± 0.4 years; BMI z score: 1.46 ± 0.84) received the intervention, and 100 children were in the control arm. At baseline, WC (79.8 vs 83.9 cm), BMI z score (1.46 vs 1.48), and rates of overweight/obesity (75% vs 72%) did not differ between arms. After the intervention, the change in WC (adjusted treatment effect: -2.5 cm [95% confidence interval (CI): -4.1 to -0.90]; P = .002) and BMI z score (adjusted treatment effect: -0.09 [95% CI: -0.16 to -0.03]; P = .007) were significantly lower in the intervention arm compared to the control arm. The intervention arm also experienced improvements in knowledge of healthy dietary choices (2.25% [95% CI: -0.01 to 6.25]; P = .02). Self-efficacy was associated with the change in WC after the intervention (β = -7.9, P = .03). CONCLUSIONS: An after-school, peer-led, healthy living program attenuated weight gain and improved healthy living knowledge in children living in a remote isolated First Nation.
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