Lessons learned: Developing and implementing a community-based participatory Training of Trainers intervention to promote physical activity among Latinos

Familias Sanas y Activas is a bilingual, community-based participatory research (CBPR) project designed to promote physical activity among Latinos living in the US-Mexico border town of San Ysidro. Its approach weaves together individual behavioral change, social support mechanisms, and community advocacy aimed at addressing environmental disparities. The project involves: (1) a Community Advisory Board, (2) collaborating agencies: a community health center, a public housing apartment complex, and a social service agency, (3) a Training of Trainers (TOT) on physical activity, program implementation, and community advocacy for 6 community agency Trainers and 18 community Networkers, (4) Trainer and Networker-led exercise programs for 500 community members, (5) toolkits containing such items as pedometers; pictorial exercise charts; a pictorial guide and GIS map of low-cost, community exercise resources; a community-muralist created calendar/resource map, (6) Trainer and Networker-led advocacy efforts, and (7) multiple evaluation levels. Outcome evaluation data are being collected to assess intervention efficacy on self-reported physical activity behaviors and measured fitness levels. Impact evaluation data are being collected using systematic observations to assess changes in neighborhood parks utilization as a result of both exercise programs and advocacy efforts. Process evaluation data have informed TOT curricula refinement to fit community cultural and linguistic needs and future in-depth interviews with community agencies will inform the potential for adoption of program elements. Lessons learned will help inform the sustainability of Familias Sanas y Activas and similar CBPR TOT interventions that combine behavioral change, social support, and environmental justice efforts to promote physical activity among Latinos.