Conmigo: A Mother-daughter Intervention to Promote Physical Activity
Condition: Exercise; Women; Hispanic Americans; Child
Study type: Interventional

Summary: 
      Regular physical activity (PA) contributes to reduced risk of obesity, chronic disease,
      cardiovascular disease, and cancer, and can improve emotional and mental health, learning,
      productivity, and social skills. Latina girls are less likely to meet guidelines for
      moderate-to-vigorous physical activity (MVPA) than non-Hispanic white girls; factors that
      contribute to low PA rates among Latina girls include sex role expectations, low PA
      competency, few active role models, lack of parental support for PA, and lack of access to
      resources.

      The goal of this study, informed by social cognitive theory and family systems theory, is to
      design, implement, and evaluate an intervention promoting physical activity among Latina
      pre-adolescent girls (aged 8-11) and their mothers. The intervention is based on evidence
      suggesting that parent-child interventions and single-sex interventions are more effective at
      improving PA. Mothers and daughters will participate in a 12-week virtual intervention where
      they will engage in weekly 1.5-hour sessions that incorporate didactic teaching,
      skill-building, interactive discussions, and PA. Each session will include at least 30
      minutes of PA. The intervention will be compared with a control condition that will receive
      an abbreviated version of the intervention following completion of all measurement points.

      Ninety mother-daughter dyads will be randomly assigned to the intervention or the wait-list
      control condition. The primary aim is to determine whether the intervention will increase
      MVPA among Latina girls in the intervention condition relative to those in the control
      condition. The investigators hypothesize that daughters participating in Conmigo will have
      higher minutes of MVPA at M2 and M3 compared to girls in the delayed treatment control
      condition.
    

Detailed description: 
      This two-group randomized controlled trial integrates evidence-based strategies for promoting
      moderate-to-vigorous physical activity (MVPA) among Latina women and girls to design and
      deliver a mother-daughter intervention to increase girls' MVPA.

      Mothers are instrumental in promoting healthy behaviors to their daughters. Specifically,
      mothers' PA and PA parenting practices influence their daughters' PA. Mothers can create and
      support PA opportunities, reduce access to sedentary activities, model PA, and reinforce
      daughters to be physically active. Other family level factors like parent-child communication
      positively predicts PA for girls. Family influences are generally hierarchical, in that
      influence often flows from mothers to daughters. However, parents are not parenting in
      isolation, but in response to children's traits and behaviors, as well as other social
      factors. Thus, children play an important role in shaping PA parenting practices and mothers'
      PA through encouragement and support. Understanding daughters' and mothers' PA and other
      family factors from multiple perspectives will extend our understanding of the bidirectional
      nature of parent-child relationships that may hinder or facilitate behavioral trajectories of
      PA.

      The study will recruit 90 pairs of mothers and their preadolescent daughters through
      partnerships with schools and diverse community organizations that serve Latinos. Each pair
      will be randomly assigned to a 12-week Conmigo PA intervention (n=45 dyads) or to a 4-week
      abbreviated intervention following completion of M3 assessment (control) (n=45 dyads). The
      full and abbreviated (control) interventions will include PA and PA counseling, as well as
      parenting discussion. The study will examine the efficacy of the intervention in increasing
      daughters' and mothers' PA at 12 and 24 weeks after baseline measurements. Secondary outcomes
      include mother-daughter communication and PA parenting practices at 12 weeks (M2), and 24
      weeks (M3) using protocols and instruments developed in the formative phase. Participants in
      the control condition will participate in an abbreviated (4 week) version of the intervention
      after the M3 assessment. After the 12-week intervention, the investigators will conduct focus
      groups with intervention condition participants, stratified by daughters who met the PA
      guidelines and those who did not, to identify potential moderators (e.g., BMI, perceived
      barriers to PA) and mediators (e.g., mother-daughter communication, PA support, PA parenting
      practices) that may explain and influence program impact.

      The investigators hypothesize that daughters participating in Conmigo will have higher
      minutes of MVPA at M2 and M3 compared to girls in the delayed treatment control condition.
      They also hypothesize that mothers in the intervention will increase minutes of MVPA and
      demonstrate improved use of PA parenting practices and mother-daughter communication compared
      to the control condition.
    

Intervention name(s): Intervention
Intervention type(s): Behavioral
Intervention description(s): Twelve weekly sessions will be led by Ms. Schneider and Ms. Montañez supported by Drs. Arredondo and Ayala and student research assistants. Mothers and daughters will participate in weekly virtual 1.5-hour sessions that include didactic teaching, skill building (including PA parenting and communication skills training), interactive discussions, PA, and homework review (homework examples: 30-min walks, practicing communication strategies). Mothers and daughters will attend sessions together, with 10-12 mother-daughter dyads participating in each series. Sessions 2-12 will include at least 30 min PA. Sessions will discuss strategies to engage in PA outside the sessions (goal of 60-min MVPA daily).
Other intervention name(s): Conmigo
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Delayed abbreviated intervention
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Prevention