Use of Implementation Mapping to Develop a Promotora Empowerment Training for a Faith-Based Physical Activity Program...

Physical activity (PA) interventions in faith-based organizations (FBOs) delivered by para-professionals (e.g., community health workers, promotoras) have been effective in increasing PA among participants. However, given their role within the FBO, promotoras often face implementation challenges such as limited organizational support and resources and lack of familiarity with how to change organizational procedures. Many existing promotora trainings lack professional skills development needed to address these barriers. This study developed a promotora empowerment training program to improve PA intervention implementation in FBOs and increase physical activity levels among Latina parishioners. The study used Implementation Mapping to develop a promotora empowerment training curriculum within the Faith in Action project, an evidence-based intervention designed to increase PA levels among Latina parishioners. Curriculum development included (1) conducting a needs assessment through post-intervention focus groups with Faith in Action promotoras; (2) identifying implementation outcomes and performance objectives, identifying determinants, and creating matrices of change objectives; (3) selecting theory-informed methods and implementation strategies; (4) developing implementation protocols and materials; and (5) planning for implementation evaluation. (1) Focus group findings suggest that promotoras needed additional training in advocating for resources and problem-solving barriers with FBO staff. (2) Key implementation outcomes (e.g., engaging FBO leaders), performance objectives (e.g., identifying resources), and the determinants (e.g., understanding program goals) influencing these objectives were identified. Change objectives were mapped to the corresponding performance objectives and determinants. (3) Empowerment Theory and Dialectical Behavior Therapy interpersonal skills were selected to guide the development of the training. (4) The study team focused training sessions on communication, conflict resolution, planning, problem-solving, and social media use. The training will be delivered by a promotora coordinator in Spanish. (5) Implementation outcomes will be evaluated by examining program fidelity and participant engagement. This study offers a roadmap for development of future promotora trainings and can inform the extent to which the additional promotora training leads to successful implementation outcomes and enhanced efficacy. This study also serves as an example of how Implementation Mapping can be utilized to improve implementation outcomes for a high-priority population in real-world settings.