Companeros: High School Students Mentor Middle School Students to Address Obesity Among Hispanic Adolescents

Introduction Promotoras, Hispanic community health workers, are frequently employed to promote health behavioral change with culturally bound Hispanic lifestyle behaviors. Peer health mentors have been used in schools to promote healthy nutrition and physical activity behaviors among students. This study investigates the efficacy of combining these 2 approaches by training high school health mentors, called companeros, to engage Hispanic middle school students in a school-based obesity intervention as a strategy to promote and sustain reductions in standardized body mass index (zBMI). Methods High school companeros were trained to participate in a 6-month obesity program alongside middle school students in Houston, Texas. Middle school students were randomized to participate in the program either with companeros (n = 94) or without companeros (n = 95). The intervention was conducted from 2013 through 2016 in 3 cohorts of students, 1 each school year. Students were followed for 12 months. The primary outcome was zBMI, which was analyzed at baseline, 6 months, and 12 months. Results Significant differences were found between conditions across time (F = 4.58, P=.01). After the 6-month intervention, students in the condition with companeros had a larger decrease in zBMI (F = 6.94, P=.01) than students in the condition without companeros. Furthermore, students who received the intervention with companeros showed greater sustained results at 12 months (F = 7.65, P=.01). Conclusion Using high school companeros in an obesity intervention for Hispanic middle school students could be effective in promoting and maintaining reductions in zBMI.