Peer mentoring for type 2 diabetes prevention in first nations children

Pediatrics. 2014 Jun;133(6):e1624-31. doi: 10.1542/peds.2013-2621. Epub 2014 May 12.


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.

Trial registration: NCT01820377.

Keywords: Aboriginal health; obesity; type 2 diabetes.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Diabetes Mellitus, Type 2 / psychology
  • Female
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Indians, North American / education*
  • Indians, North American / psychology
  • Male
  • Manitoba
  • Mentors*
  • Outcome and Process Assessment, Health Care
  • Overweight / prevention & control*
  • Overweight / psychology
  • Pediatric Obesity / prevention & control*
  • Pediatric Obesity / psychology
  • Peer Group*
  • Rural Population*
  • School Health Services
  • Self Efficacy*
  • Social Isolation

Associated data