Healthy Buddies™ Reduces Body Mass Index Z-Score and Waist Circumference in Aboriginal Children Living in Remote Coastal Communities

Authors

  • Rebecca Ronsley BSc,

    1. Medical Student, (rebecca.ronsley@gmail.com), Faculty of Medicine, University of Toronto, 77 Gerrard Street West, Toronto, Ontario M5G2A1, Canada.
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  • Andrew S. Lee MSc,

    1. Medical Student, (andrewstl@gmail.com), Faculty of Medicine, University College Dublin, 67 Baroness Crescent, Toronto, Ontario M2J3K4, Canada.
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  • Boris Kuzeljevic MA,

    1. Statistical consultant, (bkuzeljevic@cw.bc.ca), Clinical Research Support Unit, Child & Family Research Institute, 950 28th Ave West, Vancouver, British Columbia V5Z4H4, Canada.
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  • Constadina Panagiotopoulos MD, FRCPC

    Corresponding author
    1. Associate Professor, (dpanagiotopoulos@cw.bc.ca), Department of Pediatrics, University of British Columbia, 4480 Oak Street, ACB K4-213, Vancouver, British Columbia V6H3V4, Canada.
    2. Endocrinologist, Department of Pediatrics, British Columbia Children's Hospital, 4480 Oak Street, ACB K4-213, Vancouver, British Columbia V6H3V4, Canada.
    3. Clinician Scientist, Diabetes Research Program, Child & Family Research Institute, 4480 Oak Street, ACB K4-213, Vancouver, British Columbia V6H3V4, Canada.
    • Medical Student, (rebecca.ronsley@gmail.com), Faculty of Medicine, University of Toronto, 77 Gerrard Street West, Toronto, Ontario M5G2A1, Canada.
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  • Dr. Panagiotopoulos receives Clinician Scientist salary support from the Canadian Diabetes Association and the Child & Family Research Institute. This work was funded by the Canadian Diabetes Association. Ms. R. Ronsley received a summer student grant from the American Pediatrics Society, and Mr. A. S. Lee received a summer student grant from the Child & Family Research Institute to work on this project. We would like to thank Dr. Sue Stock, Dr. Jean-Pierre Chanoine, and Ms. Valerie Ryden, the developers of the original Healthy Buddies™ program (www.healthybuddies.ca), for supporting the modifications required to create the Healthy BuddiesTM-First Nation version. We would also like to thank Dr. Charmaine Miranda for contributing to the development of the HB questionnaire; Ms. Stacey Ishkanian for her assistance in conducting the focus groups and coordinating the program modifications; and Mr. David Barnum for coordinating the final production of the program bins and for providing the training sessions to the schools. We would like to acknowledge the invaluable contributions of the band council, chiefs, school staff, and students of the communities that participated in this project. We would also like to thank Ms. Kathryn Morrison and Mr. Matthew Kriese for their assistance with participant recruitment. Finally, we would like to thank the baseline and follow-up Healthy Buddies research teams for their immense contributions to data collection.

Address correspondence to: Constadina Panagiotopoulos, Endocrinologist, (dpanagiotopoulos@cw.bc.ca), Department of Pediatrics, British Columbia Children's Hospital, 4480 Oak Street, ACB K4-213, Vancouver, British Columbia V6H3V4, Canada.

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.

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