Enlace: A Promotora-Led Physical Activity Study in Texas
To improve health, a new study by researchers at the IHPR at UT Health San Antonio will use promotoras—trained community health workers—to lead culturally appropriate group education and exercise sessions for people in community centers in South Texas’ Lower Rio Grande Valley. Participants also will get newsletters and telephone counseling. The effort, called Enlace (which means to “connect” or “join” in English) and funded by the National Institutes of Health, hopes to increase physical activity rates. “The idea behind Enlace is that, through this promotora intervention, women will gain an otherwise-unavailable layer of social support to overcome barriers to activity and make positive behavioral changes—namely that they engage in 30 minutes of moderate-to-vigorous physical activity on five or more days a week,” says study leader Dr. Deborah Parra-Medina. Dr. Parra-Medina and her colleagues had previously worked with community groups to identify and understand factors that influence physical activity behaviors in South Texas. They identified several barriers: the dominance of work and family responsibilities, time, social isolation, lack of social support and personal motivation, access issues (e.g., program costs, lack of childcare and transportation), neighborhood safety and other factors. The team then developed an Enlace intervention using promotoras to remove those very barriers and enable increased physical activity. They tested Enlace on a small scale last year in South Texas and also in South Carolina. In that test, the women in the Enlace intervention actually increased their physical activity by 56.4%, compared to 48.8% among control group women. For the new Enlace study, the research team will recruit 704 Latinas ages 18-64 who do not meet federal physical activity guidelines from eight community resource centers in colonias—impoverished, underserved Latino settlements in the Lower Rio Grande Valley. Half the women will be randomly assigned to the Enlace intervention, and the other half will serve as a control group. The team will compare the two groups based on minutes per week of moderate-to-vigorous physical activity (and the various factors that contributed to this equation, such as environmental barriers, social support and self-efficacy), physical fitness and weight maintenance. They hypothesize that Latinas in the intervention group will significantly increase their levels of moderate-to-vigorous physical activity, compared to those in the control group.