FANtastic Kids: A peer-led community-based fitness and nutrition intervention to address pediatric overweight

An overweight epidemic and associated co-morbidities are affecting youth with disproportionate impacts on minorities. At Boston Medical Center, predominantly serving low income communities of color, 45% of pediatric patients are above healthy weight. Many overweight children reject school-based physical fitness and athletics, fearing negative judgments from fellow students. The FANtastic Kids (Fitness and Nutrition) Program engages and trains teen peer leaders from five communities as educators in health center and YMCA settings. Leaders facilitate 9-12-week physical activity (PA) and nutrition interventions using a participatory learning approach. With parental consent and physician approval, participants (ages 8-12 years, BMI>=85%ile) engage in two hours of moderate-to-vigorous PA (nutrition-based games, other traditional forms of exercise such as soccer and dance) and two hours of interactive nutrition learning per week. Parents engage through family-based activities and lifestyle-change. Program goals include: stabilizing BMI, developing healthier nutrition and PA habits, without specifically emphasizing "weight loss". BMI and Knowledge, Attitude and Behavior (KAB) data are collected pre and post intervention. Of children with complete BMI data (n=182), 99 (54.4%) had decreases in BMI (mean = -0.74 BMI points), and 83 (45.6%) had increases (mean = +0.65 BMI points), though absolute values of these changes were not statistically significantly different (P=0.30). Overall average post-intervention KAB score of 83% (n=250) is statistically significantly greater than the average pre-intervention score of 73% (n=365; P<0.01). Significant improvements were found in knowledge and attitude but not behavior component scores in a recent subsample (n=51; P<0.01).