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Bienestar: A School-Based Diabetes and Obesity Prevention Program

An Evidence-Based Practice

Description

The Bienestar Health Program was developed to reduce or prevent type 2 diabetes mellitus in low-income children. High levels of modifiable risk factors associated with type 2 diabetes mellitus have been reported in low-income children and especially among low-income Mexican-American children. Latino children tend to store more belly fat, consume less dietary fiber, fewer fruits and vegetables and engage in physical activity less than their African American or non-Hispanic white peers. Culturally relevant intervention programs are needed to curb the rising rates of diabetes among Mexican-American youth.

The Bienestar Health Program consists of a health class and physical education curriculum, a family program, a school cafeteria program, and an after-school health club. The health curriculum covers nutrition, physical activity, self-esteem, self-control, and diabetes. The physical education curriculum promotes an active lifestyle and the after-school program promotes leisure time physical activity. Bienestar involves the child's entire community in the program by offering cooking classes for the parents and educating cafeteria staff and after-school caretakers to encourage consumption of lower-fat, higher fiber snacks. All materials are produced in Spanish.

Goal / Mission

The objectives of Bienestar are to decrease dietary saturated fat intake, increase dietary fiber intake, and increase physical activity among low-income Mexican-American elementary and middle school children.

Impact

The Bienestar Health Program statistically significantly increases fitness scores and dietary fiber intakes levels among low-income, Mexican-American fourth-graders. A second randomized control trial conducted from 6th to 8th grade showed reductions in various indexes of adiposity.

Results / Accomplishments

Findings from a randomized controlled trial showed that the program statistically significantly increased fitness scores and dietary fiber intakes levels among low-income, Mexican-American fourth-graders. Moreover, the trial found decreased fasting capillary glucose levels after the children participated in the Bienestar program. Because fasting capillary glucose is a measure of blood sugar, this finding suggests that the present risk of developing type 2 diabetes was decreased after participation in Bienestar.

A second randomized control trial conducted from 6th to 8th grade showed a reduction in BMI z scores, percentage of students with waist circumference at or above the 90th percentile, fasting insulin levels (P=0.04 for all comparisons), and prevalence of obesity (P=0.05). Both intervention and control schools saw a decrease in the combined prevalence of overweight and obesity.

These findings may reduce the risk of childhood-onset type 2 diabetes.

About this Promising Practice

Organization(s)
Social and Health Research Center, Texas
Primary Contact
Roberto P. Treviño, MD
Social and Health Research Center
1302 S St Mary's St
San Antonio, TX 78210
rptrevino07@msn.com
http://www.sahrc.org/
Topics
Health / Diabetes
Health / Children's Health
Health / Physical Activity
Organization(s)
Social and Health Research Center, Texas
Source
National Institutes of Health-National Institute of Diabetes and Digestive and Kidney Disease
Location
Texas
For more details
http://archpedi.ama-assn.org/cgi/content/full/158/...
http://www.nejm.org/doi/full/10.1056/NEJMoa1001933
Target Audience
Children, Families, Racial/Ethnic Minorities

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An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.