BIENESTAR: A SCHOOL BASED DIABETES PREVENTION PROGRAM

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The Third (1988-1994) National Health and Nutrition Examination Survey reported that Mexican-American adults had higher age- and sex- standardized prevalence of diagnosed and undiagnosed diabetes and other U.S. racial/ethnic populations. Recently investigators have reported the increasing frequency of type 2 diabetes in Mexican-American youth. Diabetes risk factors also have been identified in non-diabetic Mexican- American youth. Since diabetes is highly prevalent in Mexican-American adults, diabetes is increasing in Mexican-American youth and diabetes risk factors are more common in Mexican-American children, a prudent measure would be to explore health education programs aimed at preventing diabetes in this population at risk. We propose an intervention, the Bienestar health program, a school-based risk factor prevention program that targets 4th grade Mexican-American children residing in poor neighborhoods. The Bienestar health program's learning activities are based on Social Cognitive Theory. Learning activities were developed for the four social systems that conceptually should have the most influence on children's health behaviors-parents, school classroom, school cafeteria and after school care. The San Antonio Independent School District will be the host for the intervention and the University of Texas at San Antonio division of education, and the University of Texas Health Science Center at San Antonio (Department of Pediatrics, Division of Endocrinology and South Texas Health Research Center) will be collaborators in the implementation and evaluation of the intervention. For this study the hypothesis is that children exposed to Bienestar intervention will significantly reduce their risk factors for developing diabetes compared to children in schools not yet receiving the intervention. If differences exist, the study will examine if diabetes risk factors differences are maintained over time (3 years post-intervention). Study outcomes will be behavioral and biological endpoints. Behavioral outcomes will be percent body fat, dietary fat intake, fruit and vegetable intake and physical fitness. Biological outcomes will fasting capillary glucose levels. Ultimately, we would like to delay or prevent the onset of type 2 diabetes.