Two-year outcomes of Faith in Action/Fe en Acción: a randomized controlled trial of physical activity promotion in Latinas.

BACKGROUND: Latina women are less likely to report engaging in leisure-time physical activity (PA) than non-Latina white women. This study evaluated the 24-month impact of a faith-based PA intervention targeting Latinas. METHODS: The study is a cluster randomized controlled trial of a PA intervention or cancer screening comparison condition, with churches as the randomization unit. A total of 436 Latinas (aged 18-65 years) from 16 churches who engaged in low levels of self-report and accelerometer-based PA were enrolled. The experimental condition was a 24-month PA intervention, with in-person classes, social support, and environmental changes, led by community health workers (i.e., promotoras). At baseline, 12-, and 24 months, we assessed changes in accelerometer-based and self-reported moderate to vigorous physical activity (MVPA; primary outcomes). Secondary outcomes were light intensity activity, sedentary time, body mass index (BMI), and waist circumference. RESULTS: After adjusting for sociodemographic factors, a mixed effects analysis found significant increases in self-reported leisure time MVPA (p < 0.005) and marginal increases in accelerometer-assessed MVPA (p < 0.08) 24 months post-baseline in the intervention compared to the attention-control condition. Data showed significant associations between PA class attendance and engaging in MVPA as assessed by self-report and accelerometry. No significant changes were found for light activity, sedentary time, BMI, or waist circumference. CONCLUSIONS: Participants who attended the PA classes at least once a month engaged in significantly higher MVPA compared to those who did not. Maximizing engagement and maintenance strategies to enhance PA maintenance could contribute to important long-term health benefits. TRIAL REGISTRATION: NCT01776632 , Registered March 18, 2011.

Comparing Latino Community Members' and Clinical Staff's Perspectives on Barriers and Facilitators to Colorectal Cancer Screening.

Latinos in the United States have low rates of colorectal cancer (CRC) screening even though CRC is the third leading cause of cancer death among Latinos. This qualitative study aimed to understand and compare the perspectives of clinical staff (CS) and Latino community members (LCMs) in an urban Southern California community regarding barriers and facilitators of CRC screening. Through purposive sampling, 39 LCMs (mean age: 59.4 years, 79.5% female) were recruited to participate in one of five focus groups, and 17 CS (mean age: 38.8 years, 64.7% female) were recruited to participate in semi-structured in-depth interviews, along with a demographic survey. Interviews and focus group recordings were transcribed verbatim, translated, and analyzed using direct content analysis. Demographic data were summarized using descriptive statistics. Findings suggest that CS and LCMs have both similar and opposing perspectives with regard to barriers and facilitators of CRC screening. Themes discussed included attitudes towards CRC screening, CRC knowledge, access to resources, commitments and responsibilities, social support, vicarious learning, patient-provider communication, trust, and social relationships. Study findings can be used to guide interventions and policies to improve access to CRC screening among LCMs.

Psychosocial Correlates of Meeting National Guidelines for Muscle-Strengthening Activities in Latinas.

BACKGROUND: Performing regular muscle-strengthening activity has numerous health benefits, including improvements in blood pressure, hemoglobin A1c, and lean body mass. Despite the disproportionate prevalence of lifestyle-related chronic disease in Latinas (diabetes, hypertension, obesity), most do not report meeting the national guidelines for muscle-strengthening activity. Existing physical activity (PA) research in Latinas has focused almost exclusively on aerobic PA. Our study examined Latinas' sociodemographic and psychosocial correlates of meeting muscle-strengthening PA guidelines that can inform future PA interventions. METHOD: A cross-sectional study of participants (N = 436) enrolled in a randomized controlled trial promoting PA and cancer screening in Latinas was conducted, and t tests examined the associations between sociodemographic and psychosocial factors with self-reported muscle-strengthening activities. Hierarchical regression was conducted in separate blocks guided by the socioecological model (sociodemographic, individual, and interpersonal factors) to examine the independent contribution of each block to the outcome of meeting national guidelines for muscle-strengthening PA. RESULTS: Participants who met the national PA guidelines of ≥2 days/week of muscle-strengthening activities reported significantly higher social support for PA (p < .001), greater use of behavioral strategies for PA (p < .001), and lower barriers to PA (p < .03) than those who did not meet the guidelines. Hierarchical binary logistic regression indicated behavioral strategies for PA was the only significant correlate of meeting the national guidelines for muscle-strengthening PA (odds ratio = 1.39, 95% confidence interval [1.18, 1.65], p < .001). DISCUSSION/CONCLUSION: Results support a hypothesis that instructing Latinas to use behavior change strategies could help them increase muscle-strengthening PA.

A Promotor-Led Pilot Study to Increase Colorectal Cancer Screening in Latinos: The Juntos Contra El Cáncer Program.

Background. Latinos have lower colorectal cancer (CRC) screening rates compared to other racial/ethnic groups in the United States, despite an overall increase in CRC screening over the past 10 years. To address this disparity, we implemented a promotor-led intervention to increase CRC screening test adherence in community-based settings, connecting community members with a partnering federally qualified health center. Purpose. To evaluate the Juntos Contra el Cáncer/Together Against Cancer (JUNTOS) intervention, by assessing pre-post changes in (1) CRC screening test adherence and (2) CRC knowledge and perceived barriers to CRC screening. We also assessed the feasibility and acceptability of program activities. Method. JUNTOS was a group-based intervention, delivered by promotores (community health workers), to promote CRC screening test adherence among Latino adults. The intervention consisted of a culturally tailored 2½-hour interactive workshop followed by an appointment scheduling assistance from a promotor. Workshop participants were Latino adults (males and females) aged 50 to 75 years who were not up-to-date with CRC screening guidelines. We conducted interviews before and 6 to 9 months after the workshop to assess program outcomes. Results. Of the 177 participants included, 118 reported completing the CRC screening test (66.7%) by 6 to 9 months postintervention. We observed baseline to 6- to 9-month increase in CRC knowledge and lower perceived barriers to obtaining CRC screening. Furthermore, the intervention was found to be feasible and acceptable. Conclusion. Results suggest that JUNTOS can be feasibly implemented in partnership with a federally qualified health center. The current study supports group-based CRC interventions in community and clinic settings.

Fe en Acción: Promoting Physical Activity Among Churchgoing Latinas.

OBJECTIVES: To evaluate the impact of a faith-based intervention to promote physical activity in Latinas. METHODS: We randomized 16 churches in San Diego County, California, to a physical activity intervention or cancer screening comparison condition (n = 436). The intervention followed an ecological framework and involved promotoras. We examined 12-month intervention effects, including accelerometer-based moderate-to-vigorous physical activity (MVPA; primary outcome) and secondary outcomes. We conducted the study from 2010 to 2016. RESULTS: Mixed effects analyses showed significant increases in accelerometer-based MVPA (effect size = 0.25) and self-report leisure-time MVPA (effect size = 0.38) among Latinas in the intervention versus comparison condition. Participants in the intervention condition had about 66% higher odds of meeting the 2008 Physical Activity Guidelines, had reduced body mass index (effect size = 0.23), and used more behavioral strategies for engaging in physical activity (effect size = 0.42). Program attendance was associated with increased self-reported leisure-time MVPA and the number of motivational interviewing calls was associated with meeting the 2008 Physical Activity Guidelines. CONCLUSIONS: A faith-based intervention was effective in increasing MVPA and decreasing body mass index among participants. Process analyses showed the value of program attendance and motivational interviewing calls.

Fe en Accion/Faith in Action: Design and implementation of a church-based randomized trial to promote physical activity and cancer screening among churchgoing Latinas.

OBJECTIVES: To describe both conditions of a two-group randomized trial, one that promotes physical activity and one that promotes cancer screening, among churchgoing Latinas. The trial involves promotoras (community health workers) targeting multiple levels of the Ecological Model. This trial builds on formative and pilot research findings. DESIGN: Sixteen churches were randomly assigned to either the physical activity intervention or cancer screening comparison condition (approximately 27 women per church). In both conditions, promotoras from each church intervened at the individual- (e.g., beliefs), interpersonal- (e.g., social support), and environmental- (e.g., park features and access to health care) levels to affect change on target behaviors. MEASUREMENTS: The study's primary outcome is min/wk of moderate-to-vigorous physical activity (MVPA) at baseline and 12 and 24 months following implementation of intervention activities. We enrolled 436 Latinas (aged 18-65 years) who engaged in less than 250 min/wk of MVPA at baseline as assessed by accelerometer, attended church at least four times per month, lived near their church, and did not have a health condition that could prevent them from participating in physical activity. Participants were asked to complete measures assessing physical activity and cancer screening as well as their correlates at 12- and 24-months. SUMMARY: Findings from the current study will address gaps in research by showing the long term effectiveness of multi-level faith-based interventions promoting physical activity and cancer screening among Latino communities.