title: Healthy Buddies™ reduces body mass index z-score and waist circumference in Aboriginal children living in remote coastal communities.
abstract: BACKGROUND
  Aboriginal children are at increased risk for obesity and type 2 diabetes. Healthy Buddies™-First Nations (HB) is a curriculum-based, peer-led program promoting healthy eating, physical activity, and self-esteem.
  
  
  METHODS
  Although originally designed as a pilot pre-/post-analysis of 3 remote Aboriginal schools that requested and received HB training, one school did not implement the program and was used as a control group. Outcomes included changes in body mass index z-score (zBMI), waist circumference (WC), blood pressure (BP), self-esteem, health behavior, and knowledge over 1 school year in kindergarten to grade 12 children.
  
  
  RESULTS
  There was a significant decrease in zBMI (1.10 to 1.04, p = .028) and WC (77.1 to 75.0 cm, p < .0001) in the HB group (N = 118) compared with an increase in zBMI (1.14 to 1.23, p = .046) and a minimal WC change in the control group (N = 61). Prevalence of elevated BP did not change in the HB group, but increased from 16.7% to 31.7% in the control group (p = .026). General linear model analysis revealed a significant interaction between time, group, and zBMI (p = .001), weight status (p = .014), nutritious beverage knowledge (p = .018), and healthy living and self-esteem score (p = .005).
  
  
  CONCLUSIONS
  The HB program is a promising school-based strategy for addressing obesity and self-esteem in Aboriginal children.
authors.affiliation: Faculty of Medicine, University of Toronto, 77 Gerrard Street West, Toronto, Ontario M5G2A1, Canada. rebecca.ronsley@gmail.com
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ronsley
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Lee
authors.forename: Boris
authors.initials: B
authors.lastname: Kuzeljevic
authors.forename: Constadina
authors.initials: C
authors.lastname: Panagiotopoulos
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001955:British Columbia; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D005247:Feeding Behavior; D001068:Feeding and Eating Disorders / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D009765:Obesity / Q000517:prevention & control*; D010379:Peer Group; D015397:Program Evaluation; D012424:Rural Population / Q000706:statistics & numerical data*; D012572:School Health Services / Q000458:organization & administration; D012649:Self Concept; D012959:Socioeconomic Factors; D055105:Waist Circumference
keywords: Aboriginal; First Nations; children; diabetes; obesity; prevention; school