BIENESTAR HEALTH PROGRAM

 

OVERVIEW

 

The Bienestar Health Program is a school-based intervention developed to prevent the development of diabetes in low-income Mexican American children.  In an experimental study in which 27 school were randomly assigned, students from schools assigned to implement the Bienestar program were compared with students from schools that received no intervention.  Following the intervention, Bienestar students had significantly lower fasting glucose levels than control students.  Bienestar students also had higher physical fitness scores and greater dietary fiber intake.  The intervention did not have an impact on saturated fat intake, however.

 

DESCRIPTION OF PROGRAM

 

Target population: low-income Mexican American children

 

Mexican Americans children are at increased risk for type two diabetes mellitus.  The Bienestar Health Program was developed to combat this risk by encouraging healthful lifestyle changes among children.  This intervention, based on social cognitive theory and social ecological theory, is designed to address students’ knowledge, beliefs, and behavior; to alter students’ environment; and to be culturally appropriate for Mexican Americans.

 

The curriculum consists of 50 lessons to be taught over the course of seven months.  Lessons transmit three main health behavior messages shown to be associated with diabetes mellitus control: decreased dietary saturated fat intake, increased dietary fiber intake, and increased physical activity.  The classroom curriculum is reinforced by activities in the home, school cafeteria, and after-school care program.  Students are encouraged to set health goals and to track their progress toward those goals.  Incentives are provided for parents and students who practice targeted behaviors.

 

EVALUATION(S) OF PROGRAM

 

Trevino, R. P., Yin, Z., Hernandez, A., Hale, D. E., Garcia, O. A., & Mobley, C.  (2004).  Impact of the Bienestar School-Based Diabetes Mellitus Prevention Program on Fasting Capillary Glucose Levels: A Randomized Controlled Trial.  Archives of Pediatric & Adolescent Medicine, 158, 911-917.

 

Evaluated population: 1419 4th graders from 27 schools in inner-city San Antonio, Texas served as the study sample for this investigation.  80% of students were Mexican American, 10% were African American, 6% were Asian, and the remaining 4% were of other ethnicities.  94% of students came from economically disadvantaged households.

 

Approach: The 27 schools were randomly assigned to the treatment group (13 schools) or to the control group (14 schools).  Control schools received no intervention.  Treatment schools implemented the Bienestar program over the course of the 2001-2002 school year.  Lessons were taught by school staff as well as Bienestar project staff. 

 

All students underwent health and fitness evaluations at the beginning and end of their 4th grade year.  Students were also screened for diabetes (via a test of fasting glucose level) and completed 24-hour diet recalls.

 

Results: On average, students in the treatment schools attended 32 of the 50 Bienestar sessions.  At baseline, fasting glucose levels at intervention schools did not differ significantly from fasting glucose levels at control schools.  Over the course of the intervention, however, fasting glucose levels decreased in intervention schools and increased in control schools.  These different patterns produced a statistically significant impact.

 

The intervention also had an impact on intervention students’ physical fitness levels.  At baseline, students from intervention schools had lower average fitness scores than students from control schools.  Over the course of the intervention, however, intervention students increased their physical fitness and the physical fitness of control students decreased.  These different patterns also produced a statistically significant impact.

 

Positive changes were also observed in intervention students’ intake of dietary fiber.  Students from intervention schools did not significantly differ from students in control schools on dietary fiber intake at baseline, but, at follow-up, diet recall data reflected significantly greater intake of dietary fiber. 

 

There were no significant differences between intervention students and control students on measures of body fat or saturated fat intake at follow-up. 

 

SOURCES FOR MORE INFORMATION

 

Curriculum materials available for purchase at:

http://www.sahrc.org/products.php

 

References:

 

Trevino, R. P., Yin, Z., Hernandez, A., Hale, D. E., Garcia, O. A., & Mobley, C.  (2004).  Impact of the Bienestar School-Based Diabetes Mellitus Prevention Program on Fasting Capillary Glucose Levels: A Randomized Controlled Trial.  Archives of Pediatric & Adolescent Medicine, 158, 911-917.

 

Program categorized in this guide according to the following:

 

Evaluated participant ages: 9-11

Evaluated participant grades: 4th

Program age ranges in the guide: Middle Childhood

Program components: School-Based, Parent or Family Component

Measured outcomes: Physical Health

 

KEYWORDS: children, conditions, elementary, hispanic/latino, middle childhood, nutrition, parent or family component, school-based, urban

 

Program information last updated on 7/23/07.

 

 

© Child Trends 2003