Promotora-led health program shows promise for rural Latina women

A culturally adapted health and lifestyle program, ¡Coma, Muévase y Viva! ("Eat, Move, and Live!"), showed promising results in helping low-income Latina and Indigenous Mexican women in rural Inland Southern California make healthier changes in their daily lives, according to a new pilot study conducted in 2022 by researchers at the University of California, Riverside.

The 10-week program, delivered by trusted community health workers called promotoras, focused on nutrition education, healthy cooking, physical activity, and goal setting. A total of 35 women - primarily Latina, foreign-born, and mothers - completed a pilot randomized controlled trial (RCT) with a waitlist control. The researchers found that participants in the intervention group were more likely to cook healthier foods, engage in physical activity, and make progress toward personal health goals compared to those in the control group.

"Overall, women in the intervention group were more than twice as likely as women in the waitlist control group to report healthier eating and physical activity behaviors," said Ann Cheney, a professor of social medicine, population, and public health at UCR, who led the study that appears in Public Health Nutrition. "Our findings highlight the effectiveness of culturally relevant, promotora-led programs in reaching rural farm-working communities that often face food insecurity, limited access to preventive care, and barriers to healthy lifestyle resources."

Coauthor Jacqueline Moreira, a premedical student working with Cheney, said the study demonstrates the power of culturally grounded, community-led health interventions.

"Participants not only gained knowledge about chronic disease prevention, but many also reported meaningful changes in their daily routines," she said.

The researchers adapted the existing Eat, Move, Live! curriculum specifically for Spanish-speaking Latina and Indigenous Mexican women living in rural farm-working communities in the Eastern Coachella Valley, an agricultural region in Inland Southern California.

"We named it ¡Coma, Muévase y Viva! and modified the curriculum to support lower health literacy levels, incorporate cultural norms and values, and improve accessibility for participants facing language, educational and structural barriers," Moreira said.

The intervention included weekly sessions on nutrition education, food preparation, physical activity, and behavior change strategies delivered by bilingual promotoras.

The researchers found rural Latino and Indigenous Mexican communities experience disproportionately high rates of chronic disease, diabetes-related mortality, food insecurity and limited healthcare access despite playing a central role in the nation's agricultural workforce. According to Cheney, existing nutrition and lifestyle programs often focus on urban populations and may not adequately address the realities of rural communities.

"Our findings suggest promotoras are essential partners in advancing health equity in underserved communities," she said. "By building trust and delivering culturally and linguistically appropriate education, these programs can overcome many of the barriers that have historically limited participation in preventive health programs and research."

Moreira credited the project's success to the team's community-based participatory research approach, which emphasized "shared leadership, collaboration, and engagement at every stage of the study."

"It highlights the promise of culturally tailored, community-driven interventions to improve health outcomes in historically underserved rural populations," Moreira said.

Cheney and Moreira were joined in the study by Shaokui Ge, Yameng Ge, Andrea Gonzalez, Ashley Moran, and Michael Guzman Hernandez.

The study was funded by the National Institutes of Health National Cancer Institute.

The title of the paper is "The Feasibility of a Dietary and Lifestyle Behavior Change Intervention among Low-income Latinas and Indigenous Mexicans in Rural Desert Communities: A Pilot Randomized Controlled Trial."

Header image shows Ann Cheney (second from left) with promotoras.