title: Peer mentoring for type 2 diabetes prevention in first nations children.
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.
authors.affiliation: Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada;Faculty of Kinesiology and Recreation Management.
authors.forename: Pinar
authors.initials: P
authors.lastname: Eskicioglu
authors.affiliation: Faculty of Kinesiology and Recreation Management.
authors.forename: Joannie
authors.initials: J
authors.lastname: Halas
authors.affiliation: Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada;Department of Pediatrics and Child Health, Faculty of Medicine, and.
authors.forename: Martin
authors.initials: M
authors.lastname: Sénéchal
authors.affiliation: Garden Hill First Nation Health Authority, Garden Hill First Nation, Manitoba, Canada.
authors.forename: Larry
authors.initials: L
authors.lastname: Wood
authors.affiliation: Garden Hill First Nation Health Authority, Garden Hill First Nation, Manitoba, Canada.
authors.forename: Elma
authors.initials: E
authors.lastname: McKay
authors.affiliation: Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada;
authors.forename: Stephanie
authors.initials: S
authors.lastname: Villeneuve
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; and.
authors.forename: Garry X
authors.initials: GX
authors.lastname: Shen
authors.affiliation: Manitoba Institute of Child Health, Winnipeg, Manitoba, Canada;Department of Pediatrics and Child Health, Faculty of Medicine, and.
authors.forename: Heather
authors.initials: H
authors.lastname: Dean
authors.affiliation: 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.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: McGavock
mesh_terms: D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007198:Indians, North American / Q000193:education* / Q000523:psychology; D008297:Male; D008350:Manitoba; D008611:Mentors; D010043:Outcome and Process Assessment, Health Care; D050177:Overweight / Q000517:prevention & control* / Q000523:psychology; D063766:Pediatric Obesity / Q000517:prevention & control* / Q000523:psychology; D010379:Peer Group; D012424:Rural Population; D012572:School Health Services; D020377:Self Efficacy; D012934:Social Isolation
keywords: Aboriginal health; obesity; type 2 diabetes