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.