Physical activity change after a promotora-led intervention in low-income Mexican American women residing in South Texas

Abstract

Background The purpose of this study was to determine physical activity (PA) preferences associated with increases in moderate-to-vigorous physical activity (MVPA) and decrease in sedentary time in Mexican American (MA) women participating in a Promotora (community health worker)-led intervention on the U.S.-Mexico border. Methods Enlace (‘to link’ in Spanish) was a randomized clinical trial to increase PA in low-income, MA women living in South Texas on the U.S.-Mexico border. A total of 620 participants were recruited into the study. The primary outcome was increase in moderate to vigorous physical activity (MVPA) using the Actigraph GT3X 16 Mb accelerometer. A modified version of the Community Health Activities Model Program for Seniors Physical Activity (CHAMPS) instrument was used to predict MVPA. Adjusted and unadjusted logistic regression models predicted change in MVPA by change in CHAMPS activities. ANOVA analysis determined the variance explained in change in MVPA by change in time engaged in activity. Individual effect sizes were then calculated for significant activity type change on MVPA increase. Results There were significant increases in all CHAMPS activities except aerobic machines and errand walking. An increase in leisure walking (O.R. = 2.76, p = .046), errand (O.R. = 3.53, p = .051), and brisk walking (O.R. = 4.74, p = .011), dance (O.R. = 8.22, p = .003), aerobics class (O.R. = 32.7, p = .001), and light housework (O.R. = 6.75, p = .000), were associated with a decrease in sedentary time. Significant effect sizes for MVPA were observed for jogging (1.2, p = .050), general exercise (1.6, p = .024), and other exercise not specified (2.6, p = .003). Significant effect sizes for sedentary time were detected for leisure time (.031, p = .036), errands (.017, p = .022), brisk walking (.022, p = .003), dance (.042, p = .005), and aerobics class (.013, p = .009). Discussion Participants who engaged in walking and aerobic activities through this intervention significantly increased their engagement in MVPA and decreased their sedentary time. These findings are novel, since preferences have not been examined in relation to MVPA or sedentary time in MA women. Conclusion PA preferences need to be considered when aiming to promote activities that reduce sedentary time and increase PA participation among marginalized groups, such as MA women. Trial registration NCT02046343 .

Identifying barriers, facilitators, and implementation strategies for a faith-based physical activity program

“…The 2-year evidence-based intervention consists of the following core components: six group PA classes offered each week (cardio dance, strength training, and walking groups) led by promotoras at participating churches and MI calls consisting of identifying barriers to PA and goal-setting every 4 months. Promotoras , also known as community health workers, lay health advisors, and peer educators, have shown to be effective in promoting health and providing health education for underserved populations in many parts of the world [ 21 – 23 ], particularly among Latino populations [ 24 – 27 ]. Given their connection to the community, promotoras are uniquely able to integrate health promotion activities and connect culturally and linguistically with members of the target population [ 28 – 30 ].…”

Physical activity outcomes from a randomized trial of a theory- and technology-enhanced intervention for Latinas: the Seamos Activas II study

“…Results showed that at 12-months, participants in the PA intervention had approximately 66% higher odds of meeting the 2008 national PA guidelines compared to the cancer screening control arm (Arredondo et al, 2017). In another study, Enlace, a 16-week promotora-led PA intervention for Mexican-American women 18-67 years, results showed significant improvements in aerobic activities (Salinas & Parra-Medina, 2019).…”

“…A few recent RCTs have shown promising results for improving PA in Latinas. For example, interventions involving promotora-led PA classes produced significant improvements in jogging and exercise at 16-weeks in low-income Mexican-American women in Enlace (Salinas & Parra-Medina, 2019) and self-report and accelerometer recorded moderate-to-vigorous PA (MVPA) at 12-months in Fe en Acción (Arredondo et al, 2017). In fact, Fe en Accion, participants even demonstrated 66% higher odds of meeting aerobic PA guidelines (i.e., more than half of participants met aerobic MVPA guidelines at 12 months) compared to the comparison group.…”

Identifying barriers, facilitators, and implementation strategies for a faith-based physical activity program

“…Promotoras, also known as community health workers, lay health advisors, and peer educators, have shown to be effective in promoting health and providing health education for underserved populations in many parts of the world [21][22][23] , particularly among Latino populations. [24][25][26][27] Given their connection to the community, promotoras are uniquely able to integrate health promotion activities and connect culturally and linguistically with members of the target population. [28][29][30] The effectiveness of Faith in Action was tested using a cluster randomized controlled trial in 16 churches.…”