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Project Description

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Physical inactivity and childhood obesity are dominant pediatric public health concerns in Canada, and several provinces have enacted school-based policies aimed at increasing physical activity levels among children and adolescents. British Columbia co-piloted a peer-supported healthy living curriculum (Healthy Buddies©), designed to prevent unhealthy weight gain among elementary school students. While successful (1), this pilot initiative was based on a small sample of participants in a non-experimental design.
In 2009/10, Manitoba Health partnered with Manitoba Education and the Healthy Child Manitoba Office, to implement the first province-wide cluster randomized controlled trial (RCT) of Healthy Buddies© in Canada. The program involved intermediate grade students receiving regular training about the benefits of healthy eating, physical activity, and peer support. These students, in turn, provided weekly sessions to primary students, for 21 weeks. Anthropometric (height and weight for BMI, waist and hip circumferences), physical fitness (blood pressure, resting heart rate, 20 meter shuttle Beep test), physical activity (7 day pedometer records, logged daily by teachers), self-reported dietary intake, and healthy living knowledge data were collected on consenting students during both baseline and follow-up. Analyses of these data demonstrated a positive main effect of the Healthy Buddies© curriculum (e.g., with time, BMI remained stable in the intervention group, but increased in the control group (Healthy Child Manitoba, personal communication)).
 
The current study will extend the analyses using an equity lens. The dispersion of schools that expressed interest (and that were randomly selected to participate) in Healthy Buddies© will be evaluated, using measures such as urban/rural status, smaller geographical areas and SES. Using primary data outcomes, benefits of the Healthy Buddies© curriculum will also be evaluated for equity across urban/rural, geography, gender and SES. Analyses will be extended to measure the impact of this program on longer term educational and healthcare outcomes, both overall health and health inequity by SES, gender and geography. 
 

Research Question

Does participation in the Healthy Buddies© program improve health and educational outcomes for children, and is this improvement equitable for all children (across geography, SES and gender)?
 

Hypotheses

1. The Healthy Buddies© curriculum will result in improved BMI and long term educational and health outcomes compared to controls.

2. School-based interest in the Healthy Buddies© curriculum will be equitable across Manitoba geographical districts and SES

3. Benefits of the Healthy Buddies© curriculum will be equitable across geography, SES, and baseline student characteristics.  These benefits include primary (e.g., BMI) and longer-term study outcomes
 

References

(1) Stock S, Miranda C, Evans S et al. Healthy Buddies: a novel, peer-led health promotion program for the prevention of obesity and eating disorders in children in elementary school. Pediatrics 2007 October; 120(4): e1059-e1068.