Feasibility and Outcomes of a Promotora-Delivered Healthy Lifestyle Intervention for Overweight Immigrant Latinas

Promoting healthy lifestyle behaviors among overweight/obese Latino women is an important public health strategy to decrease their risk for cardiovascular disease, diabetes and other morbidities. This community-based randomized controlled trial evaluated the effects of a culturally-tailored lifestyle behavior intervention (LSBI) that included group education (8 classes based upon an adapted Su Corazón) and 8 follow-up contacts (home visits and telephone calls). Immigrant Latinas were recruited from community settings and randomly assigned to the 6-month LSBI or a comparable length control (Disaster Preparedness & Home Safety). Both conditions were delivered by trained promotoras (lay health workers). The 223 participants, aged 35-64 years (mean=45), were Mexican (85%), poor, partnered (72%), and unemployed (75%) with little education and low acculturation. Evaluations were conducted 6- and 9-months following the baseline assessment. Results of mixed model analyses revealed significant group differences in lifestyle behaviors of women in the two groups (F[2, 262]=4.99, p=.007), with those in the LSBI showing improvements in dietary habits at both evaluations. Significant effects also were found for physical activity (baseline to 9-month, t[201]=1.99, p=.048). Waist size significantly decreased (approximately 3 cm) among LSBI participants only (p=.041). Other clinical measures were nonsignificant. Our findings support the positive short-term impact that a promotora-led intervention may have on lifestyle behaviors and waist circumference of a non-clinical sample of overweight Latinas but suggest the need for further strategies to promote weight loss. To ensure program success and scientific rigor, researchers working with promotoras need to provide extensive training and ongoing, close supervision.