To develop a novel delivery scheme to bridge the Mexican health system with highly isolated indigenous communities by involving naturally occurring social links: households and boarding schools. This was a school-based placebo-controlled trial with a follow-up period of 16 weeks. Children whose mothers fulfilled the inclusion criteria for anemia acted as iron supplement carriers between schools and homes. Adherence was measured based on teachers' and mothers' records. An effectiveness sub-analysis assessed changes in biochemical profiles according to random allocation to either supplementation or placebo groups. There was an overall high adherence in both groups. Analyses revealed that schooling years, literacy, and walking times played a role in high adherence. Logistic regression showed that women had higher adherence odds on the basis of household size, walking times, and previous inclusion in supplement distributions. Adherence significantly decreased the proportion of anemia by 48.2% in the intervention group. The difference at baseline and endpoint significantly reduced the number of iron-deficient anemic women by 67.7% in the supplementation group. This delivery method is a valid alternative to the conventional efforts used to reach Tarahumara indigenous communities, and could also have the potential to be piloted to tackle other health issues hindering these marginalized communities.

中文翻译：

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一个新颖的基于学校的间歇性补铁系统，用于墨西哥北部育龄的高边际Tarahumara土著妇女。

通过参与自然发生的社会联系（家庭和寄宿学校），开发一种新颖的交付计划，以将墨西哥的卫生系统与高度孤立的土著社区联系起来。这是一项基于学校的安慰剂对照试验，随访期为16周。母亲达到贫血纳入标准的孩子充当学校和家庭之间的铁补充载体。依从性是根据教师和母亲的记录进行衡量的。有效性子分析根据对补充剂或安慰剂组的随机分配评估了生化特征的变化。两组的总体依从性都很高。分析表明，上学时间，识字率和步行时间在高遵守率中发挥了作用。Logistic回归显示，根据家庭人数，步行时间和以前在补给品中的分布，女性的依从性更高。坚持干预组的贫血比例显着降低了48.2％。在补充组中，基线和终点的差异显着降低了缺铁性贫血女性的数量，降低了67.7％。这种提供方法可以有效替代塔拉胡马拉土著社区的传统努力，也有可能被试用于解决阻碍这些边缘化社区的其他健康问题。在补充组中，基线和终点的差异显着降低了缺铁性贫血女性的数量，降低了67.7％。这种提供方法可以有效替代塔拉胡马拉土著社区的传统努力，也有可能被试用于解决阻碍这些边缘化社区的其他健康问题。在补充组中，基线和终点的差异显着降低了缺铁性贫血女性的数量，降低了67.7％。这种提供方法可以有效替代塔拉胡马拉土著社区的传统努力，也有可能被试用于解决阻碍这些边缘化社区的其他健康问题。