ENLACE: A Promotora-Delivered Community-Based Physical Activity Intervention for Mexican-Origin Latinas

ENLACE was a multi-site pilot intervention study designed to foster community participation and enhance physical activity (PA) among low-income Mexican-origin Latinas in the Lower Rio Grande Valley, Texas and the South Carolina Midlands. The promotora-delivered model aimed to enhance cultural congruence and receptivity, build and enhance community trust, and improve participant reach and retention. Using formative community assessment data from both sites we developed and implemented a 12-week promotora-delivered PA intervention, evaluated using a group randomized controlled design with repeated measures. The four promotoras were Mexican-origin women with prior experience in community outreach. At each site promotoras recruited and enrolled 60 Mexican-origin women ≥18 years who did not meet current PA guidelines. The sample was predominantly Mexican-born (92%) with less than a high school education (67.5%). We measured self-reported PA using the 41-item Community Health Activities Model Program for Seniors (CHAMPS) physical activity questionnaire. At baseline, control and intervention groups did not differ in levels of self-reported leisure-time moderate-to-vigorous PA (LTMVPA). Regression analysis of follow-up LTMVPA adjusted for baseline and education revealed a significant difference between groups (p=.045) with intervention participants reporting an average 2.1 more hours per week LTMVPA. The 84% retention rate reflected the strength of the promotoras' engagement. Promotoras participated in the entire research process, mobilizing, recruiting, screening and enrolling participants and delivering the intervention. Although certain aspects of the research design posed challenges for the promotoras, their insights and perspectives on program development and implementation enhanced the reach and social and cultural appropriateness of the intervention.