Elva M. Arredondo, PhD
Dr. Arredondo is professor of public health at San Diego State University and Core Investigator in the Institute for Behavioral and Community Health (IBACH). Dr. Arredondo earned her bachelor’s degree in psychology from the University of Washington, Seattle and her PhD in clinical psychology from Duke University. She completed her clinical internship in behavioral medicine from the University of California, San Diego. She is bilingual/bicultural native of Mexico with over 18 years of research experience in developing, implementing, and evaluating multi-level community-based programs that improve the health of ethnic minority and socially/economically disadvantaged communities. She has served as PI, Co-PI or subcontract PI of grants, from sources ranging from the American Cancer Society, the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the National Institutes of Health. Her research has resulted in over 130 manuscripts, book chapters, and scientific entries. As Principal Investigator, Dr. Arredondo and her team completed the evaluation of a clustered randomized controlled trial promoting physical activity among churchgoing Latinas (Faith in Action) living in the border community. Although most of Dr. Arredondo’s research has involved the testing the effectiveness of community based interventions, she’s expanding her research to translate and adapt evidence based interventions into practice.
Jessica Haughton, MPH, MA
Jessica Haughton is a Project Manager at San Diego State University’s Institute for Behavioral and Community Health. She completed her Masters in Public Health and Masters in Latin American Studies at San Diego State University.
Over the past 10 years, Ms. Haughton has led efforts to recruit, train, and empower promotoras (community health workers) to implement multilevel community-based interventions. Her research includes promoting physical activity, cancer screening, and environmental advocacy among underserved populations, particularly among Latinos living in the US-Mexico border region. Ms. Haughton’s contributions include evidence-based curricula development, a publication on the promotora-led intervention, scientific presentations, and collaborations with diverse community partners.
Questions & Answers
Faith in Action is a faith-based multi-level promotora-led Physical Activity (PA) intervention. Promotoras (i.e., community health workers) implemented the effectiveness trial under “real-world” conditions. The activities in Faith in Action were peer-led cardio dance classes, walking groups, strength training classes, and Motivational Interviewing calls. Also, participants were mailed health educational handouts addressing topics related to PA (e.g., benefits, guidelines, strategies for overcoming barriers, injury prevention). The peer leaders were Latinas from the participating churches.
There are key aspects of the program that can be adapted.
1. The group exercise classes like the cardio dance classes, strength training classes, and walking groups can be adapted to diverse groups. They were developed with women so it’s likely that these activities appeal more to women from diverse backgrounds than men.
2. We had a Motivational Interviewing component that aimed to increase motivation and decrease ambivalence to engage in physical activity which may be adapted to men and women.
3. Health education handouts were also distributed to church members and can be adapted to men and women from diverse backgrounds.
Although Faith in Action included scripture tailored to Catholic churchgoers, this aspect may be tailored to other denominations and contexts. We are delighted that Faith in Action was accepted into the RTIPS repository.
In terms of facilitators, churches include natural groups with a level of group cohesion. This natural connection between churchgoers is an aspect that likely facilitates the implementation of the intervention (e.g., people participate because trusted churchgoers are also participating). Another aspect that likely facilitates the implementation of the program is the involvement of trusted leaders (i.e., promotoras) connected to the church. Churchgoers are more likely to attend classes that are being led by trusted members of their church community with similar characteristics (e.g., Spanish speakers). In terms of barriers, churches that do not have facilities like rooms to hold the physical activity classes may need to identify community resources like nearby parks to hold the physical activity classes.
The effectiveness of the program was evaluated using objective measures and a rigorous study design (Randomized Controlled Trial), thereby demonstrating good internal validity. Future programs would benefit from evaluating Faith in Action by using the RE-AIM framework to assess reach, effectiveness, adoption, implementation, and maintenance to provide more evidence of the external validity of the program. Future programs may also consider tracking adaptations to Faith in Action.
We are exploring various implementation strategies for the uptake of Faith in Action. Along these lines, we are interested in testing the mechanisms of action between implementation strategies and implementation outcomes. Another area of interest is identifying strategies to promote program maintenance in churches and effective ways to engage Latino children and men.