A child-promoter model (HPC) was more effective than conventional nutrition education in reducing nutritional risk in Mexican schoolchildren, with significant improvements in body fat percentage, cholesterol levels, and Healthy Eating Index.
Key Findings
Results
Body fat percentage was significantly lower in children after the HPC program compared to the reference group.
Body fat percentage: 33.9 ± 10.4 (HPC group) vs. 35.7 ± 9.7 (reference group), p = 0.001
The study was conducted in 36 public elementary schools across Hermosillo, Mexicali (Northwest Mexico), and Tuxtla Gutiérrez (Southeast Mexico)
Total population reached was approximately 10,800 children
Quantitative measures included anthropometrics, body composition, diet, and physical activity
Results
Total cholesterol improved significantly in the HPC program group compared to the reference group.
Change in total cholesterol: 18.93 ± 41.51 (HPC group) vs. 1.01 ± 41.45 (reference group), p = 0.019
Health promotion activities were implemented in parallel in program schools (through child promoters) and reference schools (using conventional methods such as talks and brochures)
Results
HDL cholesterol improved significantly in the HPC program group compared to the reference group.
Change in HDL cholesterol: 14.63 ± 11.54 (HPC group) vs. 6.56 ± 15.56 (reference group), p = 0.005
The HPC model involved schoolchildren as active health promoters within their communities
Results
The Healthy Eating Index (HEI) improved significantly in the HPC program group compared to the reference group.
Change in HEI: 3.5 ± 18.1 (HPC group) vs. -3.4 ± 15.7 (reference group), p = 0.026
Both quantitative data (diet) and qualitative data (focus groups and interviews with parents, teachers, and principals) were collected
Results
Key environmental barriers to healthy eating and physical activity were identified through qualitative methods.
Main barriers included unhealthy food supply at school and home, lack of promotion for regular physical activity, and family economic limitations
Qualitative data were collected through focus groups and interviews with parents, teachers, and principals
Despite challenges children face in exercising their agency in traditional interactions, the study found that children's participation yielded promising results
Background
The study used a Community-Based Participatory Research (CBPR) framework to develop and evaluate the schoolchildren health promoter model.
CBPR was described as a strategy that 'not only considers the community as a source of information but also empowers it to propose solutions tailored to local realities'
The study was conducted across three cities in Mexico: Hermosillo and Mexicali (Northwest) and Tuxtla Gutiérrez (Southeast)
36 public elementary schools participated in total
Both conventional and participatory health promotion methods were compared
González D, Bon K, Caballero A, Sabo S, Camarena B, Caire G, et al.. (2026). Schoolchildren as health promoters: a community strategy for healthy eating and physical activity to reduce nutritional risk.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1735714