Conmigo: a multi-level mother-daughter physical activity intervention for pre-adolescent Latinas - ABSTRACT
Fewer US Latina girls meet current physical activity (PA) guidelines, with lower rates observed among those
from lower-income and less-acculturated backgrounds, contributing to widespread health disparities. PA
interventions in the pre-pubertal phase (ages 8-11) can help mitigate the sharp decline in PA during
adolescence. Multilevel interventions involving mothers and their preadolescent daughters hold great promise,
but prior studies lack objective outcomes and long-term follow-up. Our team recently completed R21 pilot
feasibility trial and additional formative research showing increases in moderate-to-vigorous physical activity
(MVPA) among Latina mother-daughter dyads following a 12-week multilevel intervention, Conmigo. Building
on these findings, we will conduct a two-arm cluster RCT in 18 schools serving Latina girls aged 8-11 to test
Conmigo compared to a similar attention control nutrition program, both delivered by YMCA staff. Using a
Hybrid-Type 1 effectiveness implementation design, we will use mixed methods to evaluate both effectiveness
and implementation outcomes. At the individual level, girls will attend PA classes and learn behavioral
strategies to support daily PA habits. At the family level, mothers will be engaged in the intervention to support
their daughters through PA parenting strategies and improved family communication around health behaviors.
Multilevel implementation strategies aim to increase community organizations' capacity to implement Conmigo
and strengthen partnerships between 9 YMCAs and 18 schools. PA will be measured by accelerometry in the
daughters and mothers (n=216 dyads) at baseline, 3, 9, and 15 months. Interviews will be conducted with
participants, program staff, and school and YMCA leaders to identify benefits, barriers, and facilitators to future
widespread adoption. Specific Aims are: To test the effectiveness of Conmigo on daughters' MVPA over time
(Aim 1); evaluate individual (e.g., mothers’ MVPA) and family level (e.g., mother-daughter communication)
mechanisms of change and their bidirectional effects (Aim 2); and use qualitative and quantitative methods to
evaluate implementation outcomes and barriers and facilitators of these outcomes (Aim 3). This study will
improve the rigor of research on Latina dyads where the influence of family and gender roles may be strong.
This study will advance implementation science by evaluating strategies to improve community coalitions by
partnering in program implementation.
