With the significant increase in the number of racial/ethnic minority youth with obesity and type 2 diabetes mellitus (T2DM), effective approaches are urgently needed. Although previous school-based studies have demonstrated that programs combining environmental, behavioral and educational components can be successful in preventing cardiovascular disease in youth such studies have not focused on youth at higher risk for T2DM-inner city, racial/ ethnic minority youth. Engaging in regular

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... activity is widely accepted as an effective preventative measure for a variety of obesity-related chronic diseases including diabetes and metabolic syndrome. Disparities exist where racial/ethnic minority and low-income youth do not meet these physical activity recommendations. Schools, through the provision of culturally and developmentally appropriate healthy lifestyle programs, have the power to decrease body mass index (BMI) and increase physical activity, especially for racial/ethnic, inner-city at youth at risk for T2DM. The present clustered, randomized controlled trial study utilized a community-based participatory research approach to evaluate the impact of a family-centered, culturally sensitive, comprehensive school health program, called Kids N Fitness © , on BMI z-scores and physical activity behaviors of the youth participant from baseline to the 12-month followup among a sample of Mexican-American, inner-city elementary school youth (N = 97) in Los Angeles County at risk for T2DM. Results: Youth who participated in the KNF © program had significant decreases in BMI (p = 0.05), BMI body mass index z-scores (p = 0.03), vigorous daily physical activity (p = 0.01) and PE class attendance (p = 0.02) from baseline to the 12 month follow-up. Conclusions: These results suggest that a culturally appropriate, comprehensive school health program may have promise for decreasing BMI and BMI z-scores and increasing activity in this high risk sample. Clinicians and teachers can incorporate the approaches used in this study to reduce the risk of T2DM in youth at risk.