Published online October 1, 2007
PEDIATRICS Vol. 120 No. 4 October 2007, pp. e1059-e1068 (doi:10.1542/peds.2006-3003)
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ARTICLE

Healthy Buddies: A Novel, Peer-Led Health Promotion Program for the Prevention of Obesity and Eating Disorders in Children in Elementary School

Suzanne Stock, MD, Charmaine Miranda, PhD, Stacey Evans, BA, Suzanne Plessis, MD, Julia Ridley, MD, Sophia Yeh, MD and Jean-Pierre Chanoine, MD, PhD

Endocrinology and Diabetes Unit, Department of Psychology, British Columbia's Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada

OBJECTIVE. We designed and tested a novel health promotion program for elementary schools that was based on peer teaching from older to younger schoolchildren ("Healthy Buddies").

SUBJECTS AND METHODS. This prospective pilot study compared the effect of our program (2–3 hours/week, 21 weeks) in 2 Canadian elementary schools (intervention: n = 232 children, the whole school implementing the program; control: n = 151). Older students (4th through 7th grade) were given direct instruction from 1 intervention teacher and were paired with younger students (kindergarten through 3rd grade) for the whole school year. Students in 4th through 7th grade then acted as teachers for their younger "buddies." All lessons included 3 components of healthy living: nutrition, physical activity, and healthy body image. The students first learned how to be positive buddies and learned the 3 components of a healthy life. Thereafter, they learned how to overcome challenges to living a healthy life. Outcome measures (intervention and control schools at the beginning and end of the school year) included validated questionnaires that assessed healthy-living knowledge, behavior and attitude, a 9-minute fitness run, self-competence, body satisfaction, disordered eating symptoms, and anthropometry (BMI, blood pressure, and heart rate).

RESULTS. Compared with control students, both older and younger intervention students showed an increase in healthy-living knowledge, behavior, and attitude scores and a smaller increase in systolic blood pressure. BMI and weight increased less in the intervention students in 4th through 7th grade and height more in the intervention students in kindergarten through 3rd grade.

CONCLUSIONS. Our student-led curriculum improved knowledge not only in older schoolchildren but also in their younger buddies. It also decreased weight velocity in the older students. Student-led teaching may be an efficient, easy-to-implement way of promoting a healthy lifestyle from kindergarten to 7th grade.

Key Words: Healthy Buddies • elementary school • prevention • lifestyle • peer-led promotion program • nutrition • physical activity • body image

Abbreviations: HLQ—Healthy Living Questionnaire • ChEAT—Children's Eating Attitude Test • EAT—Eating Attitude Text • CI—confidence interval • NS—not significant

Accepted Mar 14, 2007.


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