The goal of this study was to assess the efficacy of an after-school, peer-led, healthy living program on adiposity, self-efficacy, and knowledge of healthy living behaviors in children living in a remote isolated First Nation.


A quasi-experimental trial with a parallel nonequivalent control arm was performed with 151 children in Garden Hill First Nation during the 2010–2011 and 2011–2012 school years. Fourth grade students were offered a 5-month, peer-led intervention facilitated by high school mentors between January and May of each school year; students in the control arm received standard curriculum. The main outcome measures were waist circumference (WC) and BMI z score. Secondary outcome measures included healthy living knowledge and self-efficacy.


Fifty-one children (mean ± SD age: 9.7 ± 0.4 years; BMI z score: 1.46 ± 0.84) received the intervention, and 100 children were in the control arm. At baseline, WC (79.8 vs 83.9 cm), BMI z score (1.46 vs 1.48), and rates of overweight/obesity (75% vs 72%) did not differ between arms. After the intervention, the change in WC (adjusted treatment effect: –2.5 cm [95% confidence interval (CI): –4.1 to –0.90]; P = .002) and BMI z score (adjusted treatment effect: –0.09 [95% CI: –0.16 to –0.03]; P = .007) were significantly lower in the intervention arm compared to the control arm. The intervention arm also experienced improvements in knowledge of healthy dietary choices (2.25% [95% CI: –0.01 to 6.25]; P = .02). Self-efficacy was associated with the change in WC after the intervention (β = –7.9, P = .03).


An after-school, peer-led, healthy living program attenuated weight gain and improved healthy living knowledge in children living in a remote isolated First Nation.

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