Abstract
Introduction Promotoras, Hispanic community health workers, are frequently employed to promote health behavioral change with culturally bound Hispanic lifestyle behaviors. Peer health mentors have been used in schools to promote healthy nutrition and physical activity behaviors among students. This study investigates the efficacy of combining these 2 approaches by training high school health mentors, called compañeros, to engage Hispanic middle school students in a school-based obesity intervention as a strategy to promote and sustain reductions in standardized body mass index (zBMI).MethodsHigh school compañeros were trained to participate in a 6-month obesity program alongside middle school students in Houston, Texas. Middle school students were randomized to participate in the program either with compañeros (n = 94) or without compañeros (n = 95). The intervention was conducted from 2013 through 2016 in 3 cohorts of students, 1 each school year. Students were followed for 12 months. The primary outcome was zBMI, which was analyzed at baseline, 6 months, and 12 months.ResultsSignificant differences were found between conditions across time (F = 4.58, P = .01). After the 6-month intervention, students in the condition with compañeros had a larger decrease in zBMI (F = 6.94, P = .01) than students in the condition without compañeros. Furthermore, students who received the intervention with compañeros showed greater sustained results at 12 months (F = 7.65, P = .01).ConclusionUsing high school compañeros in an obesity intervention for Hispanic middle school students could be effective in promoting and maintaining reductions in zBMI.
Highlights
Promotoras, Hispanic community health workers, are frequently employed to promote health behavioral change with culturally bound Hispanic lifestyle behaviors
After the 6-month intervention, students in the condition with compañeros had a larger decrease in zBMI (F = 6.94, P = .01) than students in the condition without compañeros
All students who provided verbal assent and had parental consent were given the opportunity to participate in the intervention, only those who were overweight or obese (n = 189), defined as having a body mass index (BMI, kg/ m2) at or above the 85th percentile for age and sex according to the guidelines of the Centers for Disease Control and Prevention (CDC) [11] were included in this analysis
Summary
Promotoras, Hispanic community health workers, are frequently employed to promote health behavioral change with culturally bound Hispanic lifestyle behaviors. This study investigates the efficacy of combining these 2 approaches by training high school health mentors, called compañeros, to engage Hispanic middle school students in a school-based obesity intervention as a strategy to promote and sustain reductions in standardized body mass index (zBMI). A cost-effective public health strategy frequently used in Hispanic communities is to train community health workers, called promotoras, to promote healthy lifestyle behaviors [3,4]. VOLUME 14, E92 OCTOBER 2017 middle school setting by training high school students as health mentors, called compañeros, may be one strategy to more effectively tailor weight management interventions for Hispanic adolescents. Our study aimed to examine whether the assistance of compañeros in the implementation of nutrition and physical activity lessons could be an effective strategy for delivering an obesity prevention program to middle school students in a predominantly Hispanic school system
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