A School-based intervention for diabetes risk reduction

The HEALTHY Study Group

Research output: Contribution to journalArticle

222 Citations (Scopus)

Abstract

BACKGROUND: We examined the effects of a multicomponent, school-based program addressing risk factors for diabetes among children whose race or ethnic group and socioeconomic status placed them at high risk for obesity and type 2 diabetes. METHODS: Using a cluster design, we randomly assigned 42 schools to either a multicomponent school-based intervention (21 schools) or assessment only (control, 21 schools). A total of 4603 students participated (mean [±SD] age, 11.3±0.6 years; 54.2% Hispanic and 18.0% black; 52.7% girls). At the beginning of 6th grade and the end of 8th grade, students underwent measurements of body-mass index (BMI), waist circumference, and fasting glucose and insulin levels. RESULTS: There was a decrease in the primary outcome - the combined prevalence of overweight and obesity - in both the intervention and control schools, with no significant difference between the school groups. The intervention schools had greater reductions in the secondary outcomes of BMI z score, 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). Similar findings were observed among students who were at or above the 85th percentile for BMI at baseline. Less than 3% of the students who were screened had an adverse event; the proportions were nearly equivalent in the intervention and control schools. CONCLUSIONS: Our comprehensive school-based program did not result in greater decreases in the combined prevalence of over weight and obesity than those that occurred in control schools. However, the intervention did result in significantly greater reductions in various indexes of adiposity. These changes may reduce the risk of childhood-onset type 2 diabetes.

Original languageEnglish (US)
Pages (from-to)443-453
Number of pages11
JournalNew England Journal of Medicine
Volume363
Issue number5
DOIs
StatePublished - Jul 29 2010

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Risk Reduction Behavior
Students
Obesity
Body Mass Index
Waist Circumference
Type 2 Diabetes Mellitus
Fasting
Insulin
Adiposity
Hispanic Americans
Ethnic Groups
Social Class
Weights and Measures
Glucose

ASJC Scopus subject areas

  • Medicine(all)

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A School-based intervention for diabetes risk reduction. / The HEALTHY Study Group.

In: New England Journal of Medicine, Vol. 363, No. 5, 29.07.2010, p. 443-453.

Research output: Contribution to journalArticle

The HEALTHY Study Group. / A School-based intervention for diabetes risk reduction. In: New England Journal of Medicine. 2010 ; Vol. 363, No. 5. pp. 443-453.
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abstract = "BACKGROUND: We examined the effects of a multicomponent, school-based program addressing risk factors for diabetes among children whose race or ethnic group and socioeconomic status placed them at high risk for obesity and type 2 diabetes. METHODS: Using a cluster design, we randomly assigned 42 schools to either a multicomponent school-based intervention (21 schools) or assessment only (control, 21 schools). A total of 4603 students participated (mean [±SD] age, 11.3±0.6 years; 54.2{\%} Hispanic and 18.0{\%} black; 52.7{\%} girls). At the beginning of 6th grade and the end of 8th grade, students underwent measurements of body-mass index (BMI), waist circumference, and fasting glucose and insulin levels. RESULTS: There was a decrease in the primary outcome - the combined prevalence of overweight and obesity - in both the intervention and control schools, with no significant difference between the school groups. The intervention schools had greater reductions in the secondary outcomes of BMI z score, 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). Similar findings were observed among students who were at or above the 85th percentile for BMI at baseline. Less than 3{\%} of the students who were screened had an adverse event; the proportions were nearly equivalent in the intervention and control schools. CONCLUSIONS: Our comprehensive school-based program did not result in greater decreases in the combined prevalence of over weight and obesity than those that occurred in control schools. However, the intervention did result in significantly greater reductions in various indexes of adiposity. These changes may reduce the risk of childhood-onset type 2 diabetes.",
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T1 - A School-based intervention for diabetes risk reduction

AU - The HEALTHY Study Group

AU - Foster, Gary D.

AU - Linder, Barbara

AU - Baranowski, Tom

AU - Cooper, Dan M.

AU - Goldberg, Linn

AU - Harrell, Joanne S.

AU - Kaufman, Francine

AU - Marcus, Marsha D.

AU - Treviño, Roberto P.

AU - Hirst, Kathryn

AU - Adams, L.

AU - Canada, A.

AU - Cullen, K. W.

AU - Dobbins, M. H.

AU - Jago, R.

AU - Oceguera, A.

AU - Rodriguez, A. X.

AU - Speich, C.

AU - Tatum, L. T.

AU - Thompson, D.

AU - White, M. A.

AU - Williams, C. G.

AU - Cusimano, D.

AU - DeBar, L.

AU - Elliot, Diane

AU - Grund, H. M.

AU - Kuehl, Kerry

AU - McCormick, S.

AU - Moe, Esther

AU - Roullet, Jean-Baptiste

AU - Stadler, Diane

AU - Brown, J.

AU - Creighton, B.

AU - Faith, M.

AU - Ford, E. G.

AU - Glick, H.

AU - Kumanyika, S.

AU - Nachmani, J.

AU - Rosen, J.

AU - Rosen, L.

AU - Sherman, S.

AU - Solomon, S.

AU - Virus, A.

AU - Volpe, S. L.

AU - Willi, S.

AU - Bassin, S.

AU - Bruecker, S.

AU - Ford, D.

AU - Galassetti, P.

AU - Greenfield, S.

PY - 2010/7/29

Y1 - 2010/7/29

N2 - BACKGROUND: We examined the effects of a multicomponent, school-based program addressing risk factors for diabetes among children whose race or ethnic group and socioeconomic status placed them at high risk for obesity and type 2 diabetes. METHODS: Using a cluster design, we randomly assigned 42 schools to either a multicomponent school-based intervention (21 schools) or assessment only (control, 21 schools). A total of 4603 students participated (mean [±SD] age, 11.3±0.6 years; 54.2% Hispanic and 18.0% black; 52.7% girls). At the beginning of 6th grade and the end of 8th grade, students underwent measurements of body-mass index (BMI), waist circumference, and fasting glucose and insulin levels. RESULTS: There was a decrease in the primary outcome - the combined prevalence of overweight and obesity - in both the intervention and control schools, with no significant difference between the school groups. The intervention schools had greater reductions in the secondary outcomes of BMI z score, 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). Similar findings were observed among students who were at or above the 85th percentile for BMI at baseline. Less than 3% of the students who were screened had an adverse event; the proportions were nearly equivalent in the intervention and control schools. CONCLUSIONS: Our comprehensive school-based program did not result in greater decreases in the combined prevalence of over weight and obesity than those that occurred in control schools. However, the intervention did result in significantly greater reductions in various indexes of adiposity. These changes may reduce the risk of childhood-onset type 2 diabetes.

AB - BACKGROUND: We examined the effects of a multicomponent, school-based program addressing risk factors for diabetes among children whose race or ethnic group and socioeconomic status placed them at high risk for obesity and type 2 diabetes. METHODS: Using a cluster design, we randomly assigned 42 schools to either a multicomponent school-based intervention (21 schools) or assessment only (control, 21 schools). A total of 4603 students participated (mean [±SD] age, 11.3±0.6 years; 54.2% Hispanic and 18.0% black; 52.7% girls). At the beginning of 6th grade and the end of 8th grade, students underwent measurements of body-mass index (BMI), waist circumference, and fasting glucose and insulin levels. RESULTS: There was a decrease in the primary outcome - the combined prevalence of overweight and obesity - in both the intervention and control schools, with no significant difference between the school groups. The intervention schools had greater reductions in the secondary outcomes of BMI z score, 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). Similar findings were observed among students who were at or above the 85th percentile for BMI at baseline. Less than 3% of the students who were screened had an adverse event; the proportions were nearly equivalent in the intervention and control schools. CONCLUSIONS: Our comprehensive school-based program did not result in greater decreases in the combined prevalence of over weight and obesity than those that occurred in control schools. However, the intervention did result in significantly greater reductions in various indexes of adiposity. These changes may reduce the risk of childhood-onset type 2 diabetes.

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DO - 10.1056/NEJMoa1001933

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