Peer Review Publications

The Healthy Study Group

The National Institute of Health (NIH) awarded 7 field sites to conduct a randomized, cluster-design study in 42 schools.  Schools were the unit for randomization, intervention, and analysis.  To be included in the study, at least 50% of the children in the school had to be eligible for federally subsidized, free or reduced-price meals or at least 50% of its students had to be African American or Hispanic. African American and Hispanic children of lower socioeconomic status were oversampled, given the fact that these children are at a high risk for both obesity and type 2 diabetes. The purpose of the HEALTHY study was to evaluate the effects of a 3-year, multicomponent, school-based program on risk factors for type 2 diabetes.  The journal article “A School-Based Intervention for Diabetes Risk Reduction”  describes the major outcomes among more than 4600 children who were followed from 6th grade through 8th grade. 


In response to increasing rates of obesity and type 2 diabetes in children, the Blake, Kymberly and George Rapier lll Lead Unitrust charitable foundation (BKGR) and WellMed Medical Management funded the Proyecto Bienestar South San Antonio (PBSSA): Translating Knowledge and Experience into Practice for three school years beginning 2008 through 2011.  The Study evaluated the program’s impact through the implementation of the Bienestar/NEEMA coordinated school health program.  The Social and Health Research Center (SHRC) in San Antonio, Texas is the coordinating center.  

This study was conducted in 10 elementary and 4 middle schools in South San Antonio ISD.  The implementation of the Bienestar/NEEMA school health program is from kindergarten to 8th grade and selected only the 6th grade cohort of students to evaluate its implementation.  The goal of the intervention is to reduce or modulate risk for type 2 diabetes.  The study focuses on reducing modifiable risk factors related to adiposity (excess body fat) and glycemic regulation (or control of blood sugar).  The risk factors are BMI percentile > 95, indicating obesity, and levels of fasting capillary glucose screenings at > 100 mg/dL, indicating pre-diabetes and/or increased diabetes risk level.  
Results of the baseline health screening data collected at the beginning of the school year 2008 -2009 showed an 18.96% prevalence of positive screen for type-2 diabetes (At-Risk).  Of the 44 children with positive screen for hyperglycemia 54.5% are obese (Insulin Resistance).  At first follow-up (Spring of 2009), after only 4.5 months of Bienestar/NEEMA intervention these numbers were seen to decline by 9.12 % and 8.25 %, respectively for diabetes and obesity rates.  The Bienestar/NEEMA health program consists of four components: health curriculum, physical education activities, cafeteria curriculum, and family/community component. 
A special thank you to WellMed Medical Management for their generous contribution to fund the PBSSA Program.


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