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.

Effective Self-Management Interventions for Patients With Lupus: Potential Impact of Peer Mentoring

“…175–186 Table 2 shows that peer mentoring efforts have demonstrated improvements in quality of life, 187–189 adherence, 191–193 self-management 194–198 and disease activity 197,198 in a variety of conditions. For example, peer support has been shown in patients with diabetes mellitus (DM) to improve medication adherence, diet, exercise and blood glucose monitoring.…”

Child and youth participatory interventions for addressing lifestyle‐related childhood obesity: a systematic review

“…Six of 10 studies that reported a weight‐related measure as a primary outcome reported significant improvements. Three studies, including one 5‐month and two 10‐month interventions, reported significant decreases on measured body mass index (BMI) or BMI z ‐score . Also, one study each reported significant decreases in percent overweight or obese (at 11 months) , waist circumference (at 10 months) and weight (at 12 weeks) .…”

“…Among interventions that used a functional participatory approach, nine indicated that adult research team members, specialized trainers or school teachers provided training on curricula or specific approaches such as motivational interviewing. The studies provided limited details about the frequency or duration of the training sessions (28)(29)(30)(31)36,(39)(40)(41)(42). Of studies that did provide frequency and duration details, training ranged from 3 to 40 h (27, 37,38,43).…”

Factors Associated with Successful Mentoring of Parents Addressing Childhood Obesity: A Mixed Methods Approach

“…No difference was found between the community health worker group and the parent mentor group. The internal consistency of the data is reinforced by the finding that those above the self-efficacy median even despite the overall high scores were more likely to report higher confidence in making a behavioral change such as making healthier choices, finding resources, and believing that their child can achieve a healthy weight [24]. …”