Progress 02/01/17 to 01/31/18

Outputs
Target Audience:During this reporting period, project teams worked with community residents and stakeholders who are of Mexican-heritage and low-income, many who reside in improverished areas along the Texas, New Mexico, and Arizona borders with Mexico. Texas A&M team worked community residents, community partners, promotoras, and community advisory boards that served 16 areas of colonias in Hidalgo County; Arizona team worked with community residents, stakeholders, and promotoras in Santa Cruz County; and the New Mexico team worked with community residents and promotoras in Chapparal and Columbus areas. We reached children (ages 7-11), mothers, and fathers for participation in project activities. More than 700 women participated in the Mothers' Elicitation Survey and 300 men in the Fathers' Elicitation Survey. In Texas, the team were actively involved in three project-related community advisory boards (Progreso Community Health Advisory Council [P-CHAC], Hand in Hand in San Carlos [HHSC], and Advisory Committee for Health and Community [CASCO]) in the development and deployment of project activities; the three community advisory boards (CABs) met monthly, consisted of a total of 69 community leaders and community residents, and responded to community concerns. In Arizona, the team discussed project activities with their community coalition in Nogales; and in New Mexico, the team helped form an advisory board in Chapparal with 2 members. Graduate students from Texas A&M, New Mexico State, and Baylor University were reached through classroom and field experiences. Texas A&M promotoras conducted 20 charlas (outreach education sessions) and reached 326 Mexican-origin community residents with lessons on "Understanding Fats and Their Effects to Live a Healthier Lifestyle" and "Shopping Practices, Nutrition Labels, and Safe Food handling." Ten Mexican-heritage fathers and 30 mothers particpated in a pilot test of a Grocery Store board game; and 300 Mexican-heritage fathers participated in Elicitation Surveys. Arizona reached women in the Nogales community with a charla on nutrition. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?During this project year, training and professional development was provided undergraduate and graduate students, promotoras, academic researchers, and staff. Student training and professional development: 1) Susie Barr and Crystal Perez, along with Dr. Sharkey participating in a short-course on advanced qualitative data analysis techniques in Chapel Hill, NC. Susie (current MPH student) and Crystal (now a PhD student at Johns Hopkins) have been actively engaged in the core analysis team for children's pláticas, with both students as lead authors on manuscripts that are in preparation, conducting field observations, and both presenting project research and education at national conferences. Students from TX and Baylor participated in several of the project workgroups. Dr. Sharkey provided project-based training to graduate students participating in the Maternal and Child Health Program at Texas A&M School of Public Health. Fathers' Elicitation Survey Training: Mr. Gomez (TAMU) developed the training into two parts: 1) WebEx portion and 2) face-to-face portion. The 2-hour WebEx portion covered the purpose of the Fathers' Elicitation surveys and the step-by-step process for: recruitment and registration of participants, consent form, information sheet, survey, protocol, weekly reporting, and question and answer time. The 8-hour face-to-face training reviewed all project materials, participant checklist, weekly goals, and overall plan sheet. The training also included recruitment techniques, role-play, and question and answer time. The Program Coordinator observed field researchers complete surveys with father participants to assure protocol fidelity, provide feedback, and address further questions. Charla #2 and #3 Training: The charla content was developed and compiled by Texas promotoras, with assistance of Dr. Sharkey and Mr. Gomez. Promotora Martinez coordinated a training in order to have two promotoras practice giving the lesson. During the practice, feedback was shared among all three in order to find ways to improve the lesson. Grocery Board game: The training was developed by Mr. Gomez with the assistance of student Ms Barr (developer of the game). The training covered game protocol, game rules, preparing the board game for play, responsibilities for moderator and researcher assistants during game time, discussion with the participants, pre- and post-survey, researcher's guide, and a practice round with team members. "Remind" App Training: Members of the three Texas CABs requested a cell phone based reminder for meetings and project activities. This App was preferred by team members, who were trained on how to train CAB members. The training was developed by promotora Martinez and included step-by-step process on how to download and navigate the application. Trainees practiced using the app on their own. Following this training, members of the three CABs were trained by team promotoras. Physical activity policy and research: Dr. Umstattd Meyer (Baylor) participated in monthly meetings of PAPRN+ which is focused on environmental and policy challenges and strategies around active living; led monthly workgroup calls focused on rural active living issues, challenges and solutions. Postdoctoral training: Dr. Robert Garcia joined the Texas team as a Postdoctoral Research Associate and has been provided the opportunity to mentor several students are working in the project. He is acquiring additional training in working with promotoras in the field; and participated in the following professional development: 1) RWJF New Connections: Grant Writing Clinic; 2) Society for the Advancement of Chicanos and Native Americans in the Sciences Annual Conference; 3) TAMHSC Postdoctoral Orientation; and 4) TAMHSC Office of Postdoctoral Affairs on writing and Publishing Journal Articles: An intensive workshop. Promotora Professional Development: Promotora Beltran attended the following professional development trainings: Time Management, Self-Awareness, Million Hearts Training, Grassroot Promotora without Borders, Zika Update, CPR Training, Zika Awareness on the Border, Mental Health, Substance Abuse, & HIV Prevention, and Get it D.O.N.E. Conferences on Diabetes and opioid substance abuse. Promotora Garza attended the following professional development workshops: Time Management, Self-Awareness, Grassroot Promotora without Borders, Zika Update, and CPR Training. Data Management Training: TX database team underwent the following training, which were developed by TX team members: introduction to data entry process, database creation training, database modification training, and database splitting training (split to allow multiple users to work simultaneously in the same database). Student mentorship and training: Dr. Robert Garcia, under direction from Dr. Joseph Sharkey, mentors the team (7 students and 2 staff) in identifying new avenues for research projects, manuscript development, education, and career planning. The mentorship is one-on-one and scheduled on a weekly basis (or more frequently), depending on current assignments and project needs. Student workers and staff members are able to ask questions and clarifications on assignments and tasks. In addition, Dr. Garcia challenges the student workers and staff members to learn new skills as it relates to literature review, manuscript writing, and data analysis. How have the results been disseminated to communities of interest?During this project year, dissemination included manuscript preparation and submission, and presentations by Promotoras, students, and academic researchers, education and outreach materials. Manuscript preparation and submission: 1) Descriptive Case Study of Child's Food and Physical Activity Experiences with Family Relationships (Susie Barr, Christina Bridges, Dr. Umstattd Meyer, and Dr. Sharkey; in preparation); 2) Development of Paseo Por El Super (A Trip through the Supermarket): A Hands-on, Fun Activity to Improve Supermarket Literacy for Limited-Resource Mexican-heritage Women in Texas Border Colonias (Susie Barr, Luis Gomez and Dr. Sharkey; to be submitted); 3) ¡Nosotros corremos, nosotros jugamos! [We run, we play!]: Children's Perceptions of Physical Activity in Mexican-origin border Communities (Selina Stasi, Megan McClendon, Dr. Umstattd Meyer, Luis Gómez, and Dr. Sharkey, submitted and under review); 4) Physical activity of Mexican-heritage youth during the summer and school-year: The role of parenting strategies (McClendon, Umstattd Meyer, Yitalo, and Sharkey) published in the Journal of Community Health; 5) Variations in access: how neighborhood characteristics in Texas border colonias relate to the proximity and availability of different retail food venues (Perez, Barr, Baishya, Garcia, and Sharkey), revised manuscript under review; 6) Manuscript on Child's Perceptions of Physical Activity (Marin and Gurola), in preparation; 7) Manuscript on Child's Perceptions and Relationships Regarding Food (Barr, Garcia, Umstattd Meyer, Sharkey), in preparation; 8) Manuscript on Maternal Co-Participation and Physical Activity (McClendon, Umstattd Meyer, and Sharkey), in preparation. Presentations: 1) McClendon ME, Umstattd Meyer MR, Ylitalo KR, Sharkey JR, and Bridges C. Physical activity of Mexican-heritage children during the summer and school-year: The role of parenting strategies, presented at the Annual Active Living Research Conference: Active Living across the Life Span, February 2017, Clearwater Beach, FL. 2) Barr S and Sharkey JR. Food Resource distribution in functionally-rural colonias participating in a family-centered intervention to improve nutrition, presented at 2017 Student Research Poster Contest, March 2017, Texas A&M School of Public Health, College Station, TX; 3) Barr S, Gómez L, and Sharkey JR. Moderating the cultural knowledge gap: the development of a board game to address the underlying cultural assumptions of grocery shopping in the U.S., presented at Nutrition Research Symposium, April 2017, Texas A&M University, College Station, TX. 4) Dr. Sharkey gave an invited talk to The Nutrition, Physical Activity and energy balance Affinity group (NPAAG), The Fred Hutchinson Cancer Research Center in Seattle, WA; title: Todos en la Familia [All in the Family]: Developing a Family-Centered Program to Improve Nutrition and Increase Physical Activity among Mexican-Heritage Children in Texas Border Colonias. 5) TX promotoras (Garza, Beltran, and Martinez) conducted 12 charlas (community education sessions on "Understanding Fats and their Effects to Live a Healthier Lifestyle" attended by 178 community members; 6) TX promotoras (Garza, Beltran, and Martinez) conducted 15 charlas on "Saving Money and Eating Healthy", attended by 148 community members; 7) Promotora Beltran presented to the three CABs on Charla #1 experiences and charla #2 development, charla #2 experiences and charla #3 development, experiences with fathers' elicitation surveys in Progreso; 8) Promotora Garza presented to the three CABs on fathers' dyadic interview development, charla #2 promotion, grocery game experiences, charla #3 experiences; 9) Promotora Martinez presented to the three CABs on grocery game board development, fathers' elicitation survey development, charla #3 experiences, and development of charla #4. 10) AZ conducted 6 charlas on nutrition and engaged 64 community residents. What do you plan to do during the next reporting period to accomplish the goals?Our Research plans for the next annual reporting period include the following: 1) Children's platicas: Complete data analysis, manuscript preparation, member-check sessions, transcription and translation of member-checks, and digital stories; 2) Mothers' platicas: Complete data analysis, manuscript preparation, member-check sessions, transcription and translation of member-checks, and digital stories; 3) Fathers' dyadic interviews: Complete data analysis and manuscript preparation; 4) Community assessment: Complete manuscript preparation on physical activity; 5) Elicitation Interviews: Complete data analysis and manuscript preparation; and integrate results into intervention development; 6) Intervention: Development, protocol development, training, pre-test, pilot test, refine materials, deployment in TX, data entry, data analysis, and preparation of manuscripts.; 7) Community Advisory Boards: Dissemination and discussion of materials, evaluation, and digital stories. 8) Manuscripts: 15 manuscripts are in preparation and will be submitted for publication in peer-reviewed journals (11 from TX and 4 from NM). Education Plans include: 1) Academic courses: New undergraduate and graduate courses based on the project will continue to be developed, deployed, and evaluated. Manuscripts will be prepared for submission; 2) Existing courses: Project-related modules will be developed and deployed for use in existing undergraduate and graduate in-person and on-line courses; 3) Service learning: Service learning program will continue development, deployment, and evaluation for engaged high school, undergraduate, and graduate students.; 4) Practicum: New practicum opportunities will be developed to provide students with opportunities in a variety of settings in TX, NM, and AZ; 5) Research internships: New research opportunities for undergraduate and graduate students will be developed to provide students with opportunities in TX and NM. 5) Student Participation in Manuscripts: Students will take the lead (1st author) on 7 manuscripts that will be submitted for publication. Extension Plans include: 1) Grocery store education game: Manuscript prepared; 2) Charlas: Develop materials, training, deployment, evaluation, and manuscript preparation for colonia/neighborhood chats/discussions based on project learnings; 3) Community workshops: Develop materials, training, deployment, evaluation, for workshops to be held at community events, such as health fairs and community centers; 4) Project website: Work with TAMU Office of Communications to develop, implement, and oversee a project-related website; 5) Rural outreach: provide intervention insights and approaches for use in rural Hispanic, non-Hispanic, and Tribal areas of WA.

Impacts
What was accomplished under these goals? During this project year, the following major RESEARCH activities were completed: 1) Environmental Needs and Assets - completed mapping of all Texas areas, constructed two scales for describing neighborhood characteristics and quality, and submitted a manuscript that links neighborhood quality and characteristics with access to food venues; in NM, the team is preparing for analysis. 2) Children's pláticas: teams in TX and NM are separately working on coding, analysis, and manuscript preparation; in Texas, there are three manuscripts in preparation and in NM, there are two manuscripts in preparation. 3) Mothers' pláticas (panel series of three group discussions with MH mothers): In TX, transcription and translation are nearing completion (4 TX panels of 12 sessions completed, and one panel of 3 sessions nearing completion), a qualitative expert from Baylor University was added to lead the analysis and manuscript preparation for mothers' sessions, with support from two additional faculty; analysis is underway. 4) Fathers' dyadic interviews (facilitated discussion with two fathers): The Texas team (TX only site for the interviews) completed 15 dyadic interviews and one individual interview (all in Spanish); a total of 31 fathers participated. The Linguistics Core transcribed and translated all interviews. The length of the interviews ranged from 1:24 hours to 2:52 hours. 5) Mothers' Elicitation interviews: The Spanish-language elicitation surveys were completed in TX, NM, and AZ. In TX, 335 completed the survey; in NM, 205 completed the survey; and in AZ, 210 completed the survey. The TX team entered all data from the three sites into site-specific databases. The TX team began data analysis (TX and AZ data) and has one manuscript in preparation for submission to a peer-reviewed journal. 6) Fathers' Elicitation Surveys: The TX team was the only team to conduct Fathers' Elicitation Surveys, which examined the role of fathers on their children's nutrition and physical activity and to provide insight on what to include and consider for the intervention. This provided fathers with the same opportunity as mothers in the previous elicitation surveys; 300 fathers completed the survey. 7) Intervention development: During this project year, Dr. Sharkey worked with graduate students and team leadership from TX and Baylor on collecting data on candidate interventions and intervention components. Lessons and activities focus on characteristics, perceptions, expectations, outcome expectancies, behaviors, and choices of children, parents, other family members, and home environment; and strategies to both reduce unhealthy behaviors and promote positive behaviors. Pretesting of objective measure of physical activity with wrist-worn accelerometer is underway with fathers, promotoras, and team members. Weekly web-based meetings are being conducted along with monthly in-person meetings in College Station. Our goal is have intervention materials developed by the end of December, and begin pre-testing in January 2018. 8) CAB activities: The three TX CABs (Progreso Community Health Advisory Council [P-CHAC], Hand in Hand in San Carlos, and Advisory Committee for Health and Community [CASCO]) met monthly, increased their memberships, and provided feedback from community leaders and residents about our project and insights through brainstorming to help us better adapt our project approaches. TX Data Management Team: The TX Data Management team completed the following data management activities for the entire project: 1) creation of database and double data entry for NM Social Media Survey, NM Mothers' Elicitation Recruitment and Survey; 2) TX Grocery Board Game pretest and posttest; 3) TX Charlas evaluations; 4) TX CABs evaluations; 5) TX Fathers' Elicitation Participant Checklist and Surveys; 6) AZ Charla 1; and 7) Overall error tracking. During this project year, the following major EDUCATION activities were completed: 1) Completed a teaching module on Cultural Competence. 2) Completed a draft of a new Promotora 101 (Working with Promotoras to Improve Community Health: Basics) Module; and a module on Border Health is under development. 2) Ten undergraduate and graduate students were recruited as project research interns in TX, seven in NM, and two at Baylor. Students held key roles during the current project year; in TX, Tomas Johanson (supervise all transcription and translation; and data entry verification), Luz Martinez (facilitator of fathers' dyadic interviews), Susie Barr (GIS analysis and lead author on two manuscripts for journal submission), Alex Perez (undergraduate nutrition student and lead on identification of diet-related intervention components); 3) Baylor and TAMU students completed a public health internships and practicum; 4) TX Linguistics Core (handles all transcription and translation) provides Spanish-language opportunities to five undergraduate and graduate students from a variety of disciplines; and 5) undergraduate and graduate students were provided opportunities for field observations in TX and NM. During this project year, the following major EXTENSION activities were completed: TX: 1) Charla 2 (Understanding Fats and their Effects to Live a Healthier Lifestyle) was developed and presented by team promotoras. These free nutritional lessons were offered to community members at community centers, churches, homes, and other venues. These informal education sessions were delivered in 12 locations and attended by 178 community members. 2) Charla 3 (Saving Money and Eating Healthy) was developed and presented by team promotoras. Informal lessons were conducted in 15 locations, with 148 community members participating. As more community members benefitted from the charlas, South Texas Promotora Association (STPA) and the local citizenship class (Progreso) requested they be provided during their meetings. 3) Paseo por el Super Grocery Store Board Game was developed by a student researcher and the TX project team to prepare low-income Mexican-heritage mothers/fathers living in functionally rural colonias in South Texas to effectively navigate grocery stores in the U.S. Team promotoras completed observations of local grocery stores to create a board game with a similar layout to the layout found in local stores. Discussions were conducted with the three CABs in order to provide more insight and assist with the development of the activity. Ten fathers and 30 mothers participated in a pilot test of the board game, which provided insight on how participants prepare to go grocery shopping and how they think of what/when they will be purchasing items. 4) Community outreach: team promotoras provided informal education to community residents during Children's Day Book Fair in Progreso, San Juan Spring Festival, Progreso Trick or Treat Book Fair, Back-to-School Health Fair (San Juan, TX), Hidalgo County Sheriff's National Night Out (Monte alto, TX), and San Juan Fall Fun Run. These events provided an opportunity for team promotoras to directly interact with community members, provide education, and develop relationships with community members and city/county officials. 5) Maternal and Child Health (MCH) Certificate Program: Dr. Sharkey is working with Dr. Taylor, director of the School of Public Health's MCH Program in linking activities with our project to service learning and experiential learning for students.

Publications

• Type: Journal Articles Status: Published Year Published: 2017 Citation: McClendon M, Umstattd Meyer MR, Yitalo K, and Sharkey JR. Physical activity of Mexican-heritage youth during the summer and school-year: The role of parenting strategies. Journal of Community Health 2017;42(6):1102-1110
• Type: Journal Articles Status: Under Review Year Published: 2017 Citation: Perez C, Barr S, Baishya M, Garcia R, and Sharkey JR. Variations in access: how neighborhood characteristics in Texas border colonias relate to the proximity and availability of different retail food venues
• Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: McClendon ME, Umstattd Meyer MR, Ylitalo KR, Sharkey JR, and Bridges C. Physical activity of Mexican-heritage children during the summer and school-year: The role of parenting strategies, presented at the Annual Active Living Research Conference: Active Living across the Life Span, February 2017, Clearwater Beach, FL.
• Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Barr S and Sharkey JR. Food Resource distribution in functionally-rural colonias participating in a family-centered intervention to improve nutrition, presented at 2017 Student Research Poster Contest, March 2017, Texas A&M School of Public Health, College Station, TX
• Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Barr S, G�mez L, and Sharkey JR. Moderating the cultural knowledge gap: the development of a board game to address the underlying cultural assumptions of grocery shopping in the U.S., presented at Nutrition Research Symposium, April 2017, Texas A&M University, College Station, TX.
• Type: Journal Articles Status: Under Review Year Published: 2017 Citation: Stasi, Bridges,McLendon, Umstattd Meyer, Gomez, and Sharkey. �Nosotros corremos, nosotros jugamos! [We run, we play!]: Children's Perceptions of Physical Activity in Mexican-origin border Communities
• Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: McClendon M. E., Umstattd Meyer M. R., & Bridges C. A systematic review of the paternal influence on child physical activity.
• Type: Conference Papers and Presentations Status: Published Year Published: 2017 Citation: Bridges C., Umstattd Meyer M. R., Cunningham E., & McClendon M. E. Physical activity interventions for pregnant and postpartum minority women: A systematic literature review
• Type: Other Status: Other Year Published: 2017 Citation: Sharkey JR. Todos en la Familia [All in the Family]: Developing a Family-Centered Program to Improve Nutrition and Increase Physical Activity among Mexican-Heritage Children in Texas Border Colonias. The Nutrition, Physical Activity, and energy balance Affinity Group (NPAAG), The Fred Hutchinson Cancer Research Center, Seattle, WA.

Progress 02/01/16 to 01/31/17

Outputs
Target Audience:During this reporting period, project teams worked with community residents and stakeholders who are of Mexican-heritage and low-income, many who reside in improverished areas along the Texas, New Mexico, and Arizona borders with Mexico. Texas A&M team worked community residentsw, community partners, promotoras, and community advisory boards that served 16 areas of colonias in Hidalgo County; Arizona team worked with community residents, stakeholders, and promotoras in Santa Cruz County; and the New Mexico team worked with community residents, stakeholders, and promotoras in Chapparal and Columbus areas. We reached children (ages 7-11), mothers, and fathers for participation in project activities. In Texas, the team engaged three community advisory boards in the development and deployment of project activities; in Arizona, the team discussed project activities with their community coalition in Nogales; and in New Mexico, the team helped form an advisory board in Chapparal. Graduate students from Texas A&M, New Mexico State, and Baylor University were reached through classroom and field experiences. Two panels of promotoras presented project activities at two national conferences. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?Training: During this project year, training and professional development was provided undergraduate and graduate students, promotoras, academic researchers, and staff. Student training and professional development included: 1) Susie Barr and Christina Bridges being selected as Student Ambassadors to a week-long qualitative research intensive in Chapel Hill, NC. Both students have been actively engaged in the core analysis team for children's pláticas, with both students as lead authors on two manuscripts that are in preparation, conducting field observations, and both presenting project research and education at national conferences. 2) Students from TX and Baylor participated in several of the project workgroups. 3) Training conducted by FSCC: a) Children Pláticas Booster Training for TX Team: Training to assist program coordinator, researchers, researcher assistants, and teams in carrying out the children pláticas (Session 3). Training covered purpose, details of logistics, materials needed, facilitation techniques, and particular items for the session. b) Mother Pláticas Training for TX Team: Training to assist program coordinator, researchers, researcher assistants, and teams in carrying out the mother pláticas (Session 1-3). Training covered purpose, details of logistics, materials needed, facilitation techniques, and particular items for each of the sessions. The 1-hour training was completed with WebEx and was usually scheduled 2-3 days before each of the sessions. c) Translation Training for NM: Training to assist the NM team in translating completed transcriptions of children pláticas. The training was recorded and completed using WebEx. The 2-hour training covered all aspects of the translation stage: formatting, protocol, translation techniques, etc. Trainees received the training from Luz, Tomas, and Luis. d) Transcription & Translation Booster Trainings for AZ & NM Team: Multiple interactive booster trainings were held with AZ & NM team at separate times. The trainings for NM varied from entire group trainings to one on one trainings. For AZ, given only one transcriber, all trainings were one on one. The trainings were developed and carried out by Luz, Susana, and Tomas, under Luis' supervision. The trainings lasted anywhere from 30 minutes to 1 hour and were composed of feedback from the TX team to the NM team, questions from NM team were answered, and additional issues were discussed. e) TX Transcription & Translation Refresher Training: The interactive and Saturday training was developed by Luz and Tomas, under Luis' supervision. The 5-hour training was held on-site at SPH and everyone was present. It assisted all transcribers and translators in refreshing up on the protocol and clarified many confusions. Both, the transcription and translation stage were discussed during the training. For record-keeping, the training was recorded using WebEx. f) TX Data Entry Training: The training was developed by Diana G. and Susannah in order to prepare Diana B. for data entry; training was held in South Texas. Luis attended the training to get a better understanding of data entry work. The 3-hour training covered each of the databases and it described the process of reviewing the data being collected. g) TX Elicitation Survey Training: The 5-hour training was developed by Dr. Sharkey and Luis and it was held in South Texas. The training covered all aspects of the elicitation survey: recruitment, consent forms, information sheet, word-use, confusions on questions, different scenarios, data entry, etc. In addition to the training, Dr. Sharkey and Luis observed the completion of the surveys to further assist in the completion of the surveys by providing feedback based on observations. h) AZ Elicitation Survey Training: The training was developed by Dr. Sharkey and Luis and it was completed and recorded using WebEx. The interactive training was divided into 4 WebEx calls and completed within 3 days. The training covered all aspects of the elicitation survey: recruitment, consent forms, information sheet, word-use, confusions on questions, different scenarios, data entry, etc. i) NM Elicitation Survey Training: The training was developed by Dr. Sharkey and Luis and it was completed and recorded using WebEx. The interactive training was divided into 4 WebEx calls and completed within 3 days. The training covered all aspects of the elicitation survey: recruitment, recruitment survey, consent forms, information sheet, word-use, confusions on questions, different scenarios, data entry, etc. j) TX, AZ, NM Social Media Survey Training: The training was developed by Dr. Sharkey and Luis and was completed using WebEx (TX, NM & AZ) and in person (TX only). The trainings were done at separate times, for each of the teams, to clarify confusions or questions once the promotoras were out in the field completing the social media survey. A separate training was needed for this survey because it was an additional survey added after the elicitation survey. The booster trainings lasted anywhere from 30 minutes to 1 hour. k) TX, AZ, & NM Elicitation Booster Trainings: The interactive trainings were developed by Dr. Sharkey and Luis and were completed using WebEx (TX, NM & AZ) and were also done in person (TX only). The trainings were done at separate times, and when necessary/requested by each of the teams. The purpose of the trainings was to clarify confusions or questions once the promotoras were out in the field completing elicitation and social media surveys. Specific scenarios and resolutions were discussed during each of the booster trainings. The booster trainings lasted anywhere from 30 minutes to 1 hour. l) Reviewing Elicitation Surveys Training: The interactive training was developed by Luis and was completed/recorded using WebEx. During the training, Luis discussed, step by step, the process of reviewing all submitted paperwork for the elicitation surveys: recruitment survey, consent form, surveys, participant checklist, recruitment methods, weekly reporting, etc. Notes were made of the most common errors and of the different techniques to follow to check data integrity. m) Technical assistance to field sites on data collection and accuracy of data provided on weekly basis. How have the results been disseminated to communities of interest?Dissemination: During this project year, dissemination included manuscript preparation and submission, and presentations by Promotoras, students, and academic researchers (student names are underlined), and research, education and outreach materials. Manuscript preparation and submission (all from TX and Baylor): 1) Descriptive Case Study of Child's Food and Physical Activity Experiences with Family Relationships (Susie Barr, Christina Bridges, Dr. Umstattd Meyer, and Dr. Sharkey; in preparation); 2) Development of Paseo Por El Super (A Trip through the Supermarket): A Hands-on, Fun Activity to Improve Supermarket Literacy for Limited-Resource Mexican-heritage Women in Texas Border Colonias (Susie Barr and Dr. Sharkey; to be submitted by 11/15); 3) ¡Nosotros corremos, nosotros jugamos! [We run, we play!]: Children's Perceptions of Physical Activity in Mexican-origin border Communities (Selina Stasi, Megan McClendon, Dr. Umstattd Meyer, Luis Gómez, and Dr. Sharkey; submitted to Maternal and Child Health Journal). Presentations: TX: 1) 16th Annual Meeting of the American Academy of Health Behavior. Stasi S. S., Sharkey J. R., Umstattd M. R., Gómez Montelongo L, McClendon M., & Bridges C. ¡Nosotros corremos, nosotros jugamos! [We run, we play!]: Children's perceptions of physical activity in Mexican-heritage border communities. Promotora partnerships in active living environmental assessments for low-income communities: Primary care implications: Where can they run and play? 2) Sharkey JR. Thinking about the Complexity of Meeting the Dietary Needs of Mexican-Heritage Seniors in Texas Border Colonias, presented at Experimental Biology 2016, April 2016, San Diego, CA; 3) Sharkey JR. Promotora-academic partnership to reduce nutritional health disparities among Mexican-heritage families in Texas border colonias, presented at Experimental Biology 2016, April 2016, San Diego, CA; 4) Barr S and Sharkey JR. Paseo por el Super: A Tool for Teaching Low-Income Mexican-Heritage Mothers to Navigate the American Supermarket, presented at the Society for Nutrition Education and Behavior's 49th Annual Conference, July 2016, San Diego, CA; and Journal of Nutrition Education and Behavior (2016);48(7):S9; 5) Dr. Sharkey. Challenges to Nutritional Health Faced by Mexican-American and Mexican Immigrant Families in Texas Border Colonias, presented at IOM WIC Meeting; and 6) St. John JA and Sharkey JR. Training CHWs/Promotores to conduct pláticas in a multi-border state obesity prevention study, presented at the National Rural Health Association, May 2016, Minneapolis, MN. Baylor: 1) Umstattd Meyer MR, Sumrall J, Walsh SM, McClendon M, and Sharkey JR. Where will they play? A description of the neighborhood physical activity resources available to Mexican-origin children residing in colonias along the U.S.-Mexico border, presented at 2016 Active Living Research Conference, February 2016, Clearwater Beach, FL; 2) Umstattd Meyer MR and Sharkey JR. Where can they run and play? Promotora partnerships in rural active living environmental assessments. To be presented as part of the symposium entitled Don't preach to the choir: Reaching the underserved by integrating physical activity promotion into primary care as part of the 37th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, March-April 2016, Washington DC; 3) Umstattd Meyer M. R. & Sharkey J. Symposium Title: "Don't Preach to the Choir: Reaching the Underserved by Integrating Physical Activity Promotion into Primary Care", Presentation Title: Where can they run and play? Promotora partnerships in rural active living environmental assessments, presented at Society of Behavioral Medicine. NMSU: 1) Elizabeth Olivares, Dr. Gurrola, and Dr. McDonald. Building Research Capacity Among Community Health Workers in Southern New Mexico; 2) Maria Garza and Aracely Pedraza. Salud Para usted y Su Familia: Community-Based Research with Promotoras as Drivers, presented at SWIHDR Conference; 3) Elizabeth Olivares, Dr. Gurrola, and Dr. McDonald. Building Research Capacity Among Community Health Workers in Southern New Mexico, presented at National Institute Conference on Social Work & Human Services in Rural Areas. Cross-site: 1) Sharkey JR, Umstattd Meyer MR, McDonald J, Molina P, and St. John JA. Salud Para Usted y Su Familia [Health For You and Your Family]: Constructive Evaluation of the Program-Planning Stage, presented at the Society for Nutrition Education and Behavior's 49th Annual Conference, July 2016, San Diego, CA; and Journal of Nutrition Education and Behavior (2016);48(7): S130-S131; 2) Dr. McDonald, Maria Garza, Irma Casta?eda, Roxanna Flores, Elva Beltrán. Nuestra Experiencia como Promotoras de Investigación en las Comunidades Fronterizas de México-EE.UU. [Our Experience as Promotora Researchers in U.S.-Mexico Border Communities, presented at the New Mexico Public Health Association; 3) Elva Beltrán, Maria Garza, and Alicia Sanders. Promotoras de Salud as Community Researchers for Obesity Prevention Along the US-Mexico Border, presented at the 2016 Unity Conference. What do you plan to do during the next reporting period to accomplish the goals?Our Research plans for the next annual reporting period include the following: 1) Children's platicas: Complete data analysis, manuscript preparation, member-check sessions, transcription and translation of member-checks, and digital stories; 2) Mothers' platicas: Complete data analysis, manuscript preparation, member-check sessions, transcription and translation of member-checks, and digital stories; 3) Fathers' dyadic interviews: Complete transcription and translation, data analysis, and manuscript preparation; 4) Community assessment: Complete data analysis and manuscript preparation, and discuss results with CABs and community members through charlas (discussions); 5) Elicitation Interviews: Complete data analysis and manuscript preparation; and integrate results into intervention development; 6) Fathers' Feeding and Activity Practices survey:Survey development, training, pre-test, recruitment, data collection and entry, data analysis, and manuscript preparation; 7)Teen Health Leaders Program:Development, recruitment, deployment, and evaluation; 8)Intervention:Development, protocol development, training, pre-test, pilot test, refine materials, and prepare for deployment to all sites.; 9)Community Advisory Boards:Dissemination and discussion of materials, evaluation, and digital stories. Education Plans include: 1) Academic courses: New undergraduate and graduate courses based on the project will continue to be developed, deployed, and evaluated. Manuscripts will be prepared for submission; 2)Existing courses: Project-related modules will be developed and deployed for use in existing undergraduate and graduate in-person and on-line courses; 3) Service learning: Service learning program will continue development, deployment, and evaluation for engaged high school, undergraduate, and graduate students.; 4) Practicum: New practicum opportunities will be developed to provide students with opportunities in a variety of settings in TX, NM, and AZ; 5) Research internships: New research opportunities for undergraduate and graduate students will be developed to provide students with opportunities in TX and NM. Extension Plansinclude: 1) Grocery store education game: Finalize materials, pilot test, modify materials, deploy for larger evaluation, data analyzed, and manuscript prepared; 2) CHW CEU:Develop, deploy, and evaluate courses for CEU for CHW; 3)Charlas:Develop materials, training, deployment, evaluation, and manuscript preparation for colonia/neighborhood chats/discussions based on project learnings; 4) Community workshops: Develop materials, training, deployment, evaluation, for workshops to be held at community events, such as health fairs and community centers; 5) Project newsletter: Work with TAMU Office of Communications to develop and implement strategy for communicating the project activities and results; 6) Project website: Work with TAMU Office of Communications to develop, implement, and oversee a project-related website.

Impacts
What was accomplished under these goals? Year 2 accomplishments Research Objective 1: Engage MH children and families from underserved areas along the AZ, NM, and TX border with Mexico and conduct formative research. During this project year, the following major activities were completed: 1) Environmental Needs and Assets - completed enumeration of colonias, food venues, parks, and policies; 2) Children's pláticas; there were 24 panels (groups) of children who completed a total of 72 sessions; 12 groups/36 sessions (10 groups in Spanish only and 2 groups in Spanish/English; each session 1.75-2 hours in length) in TX, 8 groups/24 sessions (4 groups in Spanish and 4 groups in English; each session 1.5 hours in length) in NM, and 4 groups/12 sessions (all English; each session 1 hour) in AZ. Open coding is ongoing.3) Mothers' pláticas (panel series of three group discussions with MH mothers): we added a fathers' component to the discussion guide and Mr. Gómez conducted a WebEx training session with all sites. There were 17 panels of MH mothers of children 7-11 y who completed a total of 51 sessions; 7 groups/21 sessions (all Spanish only; each session 1.75-2 hours in length) in TX, 6 groups/18 sessions (5 groups in Spanish and 1 in English; each session 1.5 hours) in NM, and 4 groups/12 sessions (all Spanish only; each session 1 hour) in AZ. 4) Fathers' dyadic interviews (facilitated discussion with two fathers): we formed a workgroup (Dr. Sharkey, Dr. Umstattd Meyer, Dr. Marin, and Dr. Ojeda); after reviewing the literature and identifying barriers to pláticas for fathers, such as work schedules, decided on dyadic interviews, which pair two fathers with a facilitator. Twenty-four fathers were recruited for 12 dyadic interviews in TX. 5) Elicitation interviews: The Spanish-language elicitation surveys included the following sections: child's healthy eating behaviors, child's physical activity and active play, parental roles, parental rules, husband's dietary behaviors, husband's physical activity behaviors, and demographics (background, employment, nutrition assistance program participation, insurance). The TX team used the door-to-door recruitment protocol and planned on completing 20 elicitation surveys in each of the 16 areas for a total of 320 completions. As of 10/21, TX promotoras approached 524 individuals, with 523 completing the recruitment survey; 242 were determined to be eligible, with 236 completing the survey, and 235 agreeing to future contact. The TX team is on schedule to complete elicitation surveys by 11/19. The goal for AZ and NM was set at 240 completed surveys in each state. AZ, as of 10/21, approached 677 individuals, with 648 completing the recruitment survey; 240 were eligible, with 240 completing the elicitation survey and 240 agreeing to future contact. NM, as of 10/23, approached 810 individuals, with 809 who completed the recruitment survey; 204 were eligible, with 152 completing the survey, and 148 agreeing to future contact. 6) Intervention development: During this project year, Dr. Sharkey worked with graduate students on collecting data on candidate interventions and intervention components. Lessons and activities focus on characteristics, perceptions, expectations, outcome expectancies, behaviors, and choices of children, parents, other family members, and home environment; and strategies to both reduce unhealthy behaviors and promote positive behaviors. Program development has started to integrate team members from research, education, and extension, along with input from CABs. Education Objective 1: Use experiential learning and innovative teaching methods to increase the competency of faculty and undergraduate and graduate students. During this project year, the following major activities were completed: 1) Education workgroup under the leadership of Dr. Marin (NM) met via WebEx to develop and deliver new courses and modules for existing courses that provide opportunities for undergraduate and graduate students to be exposed to improving health among children and families along the U.S. border with Mexico. Dr. St. John (Texas Tech) completed a draft of a new Promotora 101 (Working with Promotoras to Improve Community Health: Basics). In addition to Dr. St. John, workgroup members that developed Promotora 101 included Dr. Gurrola (NM), Christina Bridges (Baylor graduate student), Luz Martinez and Elva Beltrán (TX), and Rosie Piper and Alicia Sander (AZ). Module content included definitions, characteristics of Promotores/CHWs, qualities of Promotores/CHWs, core and emerging competencies, roles and responsibilities, training, workforce development, literature findings, models of care, reasons employers utilize Promotores, barriers/challenges, national movements, certification/credentialing, national strategies, best practices, and resources. Dr. Marin (NM) started work on a course/module on Culture; and Dr. McDonald (NM) started work on course on Border Health. Dr. Umstattd Meyer (Baylor) and Dr. Sharkey (TAMU) developed and deployed modules in their public health courses for graduate students. 2) Ten undergraduate and graduate students were recruited as project research interns in TX, seven in NM, and two at Baylor. Students held key roles during the current project year; in TX, Tomas Johanson (supervise all transcription and translation), Luz Martinez (moderator of children's and mothers' pláticas and fathers' dyadic interviews), Susie Barr (coordinator of all data entry and verification, GIS analysis, and lead author on two manuscripts for journal submission; 3) Baylor and TAMU students completed a public health internships and practicum; 4) completed an inventory of undergraduate and graduate courses that context information and experience could be provided by this project; 5) as part of an for mothers during the children's pláticas, Susie Barr (TAMU) developed Paseo Por El Super (A Trip through the Supermarket): A Hands-on, Fun Activity to Improve Supermarket Literacy for Limited-Resource Mexican-heritage Women in Texas Border Colonias. The purpose was to familiarize participants with the supermarket environment through a board game; 6) Diana Beltrán (MSW) was responsible for an innovative teaching approach; she worked with TX promotoras and community residents to create their own digital stories; and 7) undergraduate and graduate students were provided opportunities for field observations in TX and NM. Extension Objective 1: Develop, deliver, and evaluate science-based knowledge and skills through informal education, certificate programs, in-service training, and group discussions. During this project year, the following major activities were completed: 1) each of the three sites (TX, AZ, and NM) developed and delivered three education sessions for mothers while their children were participating the children's pláticas. TX provided Spanish-language knowledge and skills that focused on cancer education (session 1; bingo game, handouts, and jewelry making), nutrition education (session 2; grocery game and cooking), and stress management (session 3; bingo and jenga). NM focused on diabetes (session 1; developed loteria to enhance diabetes awareness), breast cancer (session 2; hands-on activity and painted mugs), and stress and hypertension (session 3; education and stress reduction activity). 2) TX promotoras (Beltrán and Garza) provided education and skill building during community health and book fairs in Progreso, San Juan, Donna, and San Carlos areas. 3) A charlas workgroup (Dr. Sharkey and Dr. St. John as leads) was formed to prepare for year 3 charlas (community discussions). 4) Dr. St. John continued to work on professional development training for promotoras that would provide Continuing Education credit. 5) During this project year, we refocused extension to be delivered by promotoras.

Publications

• Type: Journal Articles Status: Under Review Year Published: 2016 Citation: Stasi S, McClendon M,Umstattd Meyer MR, Gomez L, and Sharkey JR. �Nosotros corremos, nosotros jugamos! [We run, we play!]: Childrens Perceptions of Physical Activity in Mexican-origin border Communities
• Type: Journal Articles Status: Submitted Year Published: 2016 Citation: Barr S and Sharkey JR. Development of Paseo Por El Super (A Trip through the Supermarket): A Hands-on, Fun Activity to Improve Supermarket Literacy for Limited-Resource Mexican-heritage Women in Texas Border Colonias
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Stasi S. S., Sharkey J. R., Umstattd M. R., G�mez Montelongo L, McClendon M., & Bridges C. �Nosotros corremos, nosotros jugamos! [We run, we play!]: Childrens perceptions of physical activity in Mexican-heritage border communities. Promotora partnerships in active living environmental assessments for low-income communities: Primary care implications: Where can they run and play?, presented at the 16th Annual Meeting of the American Academy of Health Behavior
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Sharkey JR. Thinking about the Complexity of Meeting the Dietary Needs of Mexican-Heritage Seniors in Texas Border Colonias, presented at Experimental Biology 2016
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Sharkey JR. Promotora-academic partnership to reduce nutritional health disparities among Mexican-heritage families in Texas border colonias, presented at Experimental Biology 2016
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Barr S and Sharkey JR. Paseo por el Super: A Tool for Teaching Low-Income Mexican-Heritage Mothers to Navigate the American Supermarket, presented at the Society for Nutrition Education and Behaviors 49th Annual Conference, July 2016, San Diego, CA and Journal of Nutrition Education and Behavior (2016);48(7):S9
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Sharkey JR. Challenges to Nutritional Health Faced by Mexican-American and Mexican Immigrant Families in Texas Border Colonias, presented at IOM WIC Meeting
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: St. John JA and Sharkey JR. Training CHWs/Promotores to conduct pl�ticas in a multi-border state obesity prevention study, presented at the National Rural Health Association, May 2016, Minneapolis, MN.
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Umstattd Meyer MR, Sumrall J, Walsh SM, McClendon M, and Sharkey JR. Where will they play? A description of the neighborhood physical activity resources available to Mexican-origin children residing in colonias along the U.S.-Mexico border, presented at 2016 Active Living Research Conference, February 2016, Clearwater Beach, FL
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Umstattd Meyer MR and Sharkey JR. Where can they run and play? Promotora partnerships in rural active living environmental assessments. To be presented as part of the symposium entitled Dont preach to the choir: Reaching the underserved by integrating physical activity promotion into primary care as part of the 37th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, March-April 2016, Washington DC
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Umstattd Meyer M. R. & Sharkey J. Symposium Title: "Don't Preach to the Choir: Reaching the Underserved by Integrating Physical Activity Promotion into Primary Care", Presentation Title: Where can they run and play? Promotora partnerships in rural active living environmental assessments, presented at Society of Behavioral Medicine
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Elizabeth Olivares, Dr. Gurrola, and Dr. McDonald. Building Research Capacity Among Community Health Workers in Southern New Mexico; 2) Maria Garza and Aracely Pedraza. Salud Para usted y Su Familia: Community-Based Research with Promotoras as Drivers, presented at SWIHDR Conference
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Elizabeth Olivares, Dr. Gurrola, and Dr. McDonald. Building Research Capacity Among Community Health Workers in Southern New Mexico, presented at National Institute Conference on Social Work & Human Services in Rural Areas
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Sharkey JR, Umstattd Meyer MR, McDonald J, Molina P, and St. John JA. Salud Para Usted y Su Familia [Health For You and Your Family]: Constructive Evaluation of the Program-Planning Stage, presented at the Society for Nutrition Education and Behaviors 49th Annual Conference, July 2016, San Diego, CA; and Journal of Nutrition Education and Behavior (2016);48(7): S130-S131
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Dr. McDonald, Maria Garza, Irma Casta?eda, Roxanna Flores, Elva Beltr�n. Nuestra Experiencia como Promotoras de Investigaci�n en las Comunidades Fronterizas de M�xico-EE.UU. [Our Experience as Promotora Researchers in U.S.-Mexico Border Communities, presented at the New Mexico Public Health Association
• Type: Conference Papers and Presentations Status: Published Year Published: 2016 Citation: Elva Beltr�n, Maria Garza, and Alicia Sanders. Promotoras de Salud as Community Researchers for Obesity Prevention Along the US-Mexico Border, presented at the 2016 Unity Conference.

Progress 02/01/15 to 01/31/16

Outputs
Target Audience:During this reporting period, project teams worked with community residents who are of Mexican heritage and low-income, many who reside in impoverished settlements along the U.S. border with Mexico. Texas A&M team worked with community residents, community partners, and promotoras that served 16 areas of colonias in Hidalgo County; Arizona team worked with community residents and partners in 16 areas within Santa Cruz County; and the New Mexico team worked with community residents and partmers in 16 areas in Luna and Otero counties. We reached children (ages 7-11 years) and mothers of children for participation in project activities. In Texas, the team presented project information and gained feedback with the Progreso Community Health Advisory Council and the Arizona team introduced the project tothe Nogales Community Group. Graduate students were reached in Texas through classroom instruction (Social and Behavioral Research Methods and Program Evaluation) andat Baylor (PUblic Health Research Course). Practicum experiences were provided graduate public health students in Texas and Arizona. The Education workgroup is developing curriculum to be used cross-site. Internships were provided students in Texas, Baylor, and New Mexico. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided?The project provided several training and professional development opportunities to promotoras de salud, students, academic partners, and project staff. Community assessment training, which included didactic and experiential approaches to neighborhood observations, assessments of physical activity and food environment opportunities, and documenting existing policies and infrastructure, were conducted on-site by Dr. Sharkey (PI) and Dr. Umstattd Meyer (Baylor PI) at the Texas, New Mexico, and Arizona field sites with all local team members. This was followed by training in ensuring reliability of collected data and a booster session. Dr. Hye-Chung Kum (Familia Saludable Coordinating Center [FSCC]) conducted training for Data Management Team, which included the development of protocol for cross-site transfer of encrypted data, database development and deployment to sites, and providing technical assistance to remote sites. Database use and data entry was conducted by FSCC staff (Garcia and Barr) through telephone, skype, and cloud methods. Two-day training for the children's platicas was conducted on-site by Sharkey and St. John (Texas Tech and Mariposa member) in Texas, Arizona, and New Mexico using didactic and role-playing approaches. Those involved at each site included all promotoras, students, and faculty. After Texas conducted a pre-test of the children's platicas, modifications were made to the protocol and booster training was conducted through WebEx. Training to assist all program coordinators, researchers, researcher assistants, and teams in carrying out the children platicas. Training covered purpose, participant requirements, recruitment, details of logistics, materials needed, facilitation techniques, and particular items for each session. One-day training for the mothers' platicas was conducted on-site by Sharkey and Luis Gómez (FSCC). Similar to training for the children's platicas, training was designed to assist all program coordinators, researchers, researcher assistants, and teams in carrying out the mother platicas. Training covered purpose, participant requirements, recruitment, details of logistics, materials needed, facilitation techniques, and particular items for each session. Transcription training was conducted on-site and by telephone by Gómez (FSCC) with field team members identified for transcription of audio files from the platicas. Training was designed to assist all program coordinators and transcribers in carrying out the transcription process for mother and children platicas. The training covered the purpose, written protocol (step by step), and offered a transcription practice. Throughout this first year of the project, team promotoras received professional development in knowledge and skills. As leader of the project Evaluation Team, Dr. Sharkey attended Advanced Evaluation Training through American Evaluation Association. The project has also provided training to students in working in interdisciplinary teams, understanding the challenges and opportunities in working with hard-to-reach and vulnerable populations, and engaging community partners in research, education, and extension. How have the results been disseminated to communities of interest?Year 1 activities have been disseminated to communities of interest in a variety of ways. The Texas team present activities and results to the Progreso Health Advisory Council (P-CHAC) on a monthly basis. We've noticed, many times, through this project community members feel empowered to express their concerns and struggles. For many of them, this is the first time they are heard and/or for others this is the first time they talk about what they find is important. During P-CHAC meetings, members get very emotional when talking about ways they can improve their community. Since city officials are part of PCHAC, members know they're being heard by people who can make a difference and change their current situation. Texas team promotoras started to notice a change in attitude among community members. They are becoming aware of what is missing in their colonia. For the most part, they are starting to understand that working together (as in children platicas and mother platicas) they can learn from each other and improve their lifestyle. We're seeing a lot more movement by city officials to make changes to their communities and to improve places for physical activity and eating habits. The Arizona team (Mariposa) made an oral presentation about the project for a Mariposa Health and Wellness Department staff retreat and informed all of their activities and goals. New Mexico team members (McDonald and Marin) were interviewed on Fronteras by Edmundo Resendez; the interview was aired on August 27 and September 10. Texas team members (Sharkey, Beltran, and Gómez) presented talks in English and Spanish to a large audience attending the Poverty and Hunger Summit. The presentations focused on Promotora-Academic Partnership to Address Challenges to Health among Mexican-American and Mexican Immigrant Children and Adults. In Texas and in collaboration with P-CHAC, the Texas team conducted outreach during several community events: Fall Book Fair and Health Fair. Community members were given the opportunity to see us in one of their events and became a bit more familiar with our program. This assisted our team in developing trust among community members, especially when doing community evaluations. New Mexico's Dr. McDonald made an oral presentation about the project at the US-Mexico Border Health Commission's Border Obesity Prevention Workshop in Laredo, TX. Dissemination also occurred in Texas during the children's and mothers' platicas. Some of the children who participated in the platicas had a lot to say. They wanted to be heard and wanted to talk about the pictures they had taken about physical activity and food. We were able to tell the children knew their perspective was of great importance to us and they started to share their views with us. Several kids mentioned, "I would change for all my family to be involved". Mothers continuously express how happy and content they are to be part of the mother platicas. For many of them, this time to chat is the only time they get for themselves. In many occasions, as facilitators or observers, we were able to take note of how mother platicas became more of a support group for each of the mothers involved in the discussion. The mothers would advise each other on how they could improve together. A lot of the mothers would discuss they would share all of the information with family members and friends; what we call the ripple effect. Mothers wanted more time to talk and said 1.5 hours was not enough, they wanted more. Mothers started to become a lot more interested in participating and becoming aware of their eating habits and physical activity. What do you plan to do during the next reporting period to accomplish the goals?Our plans for the next annual reporting period include the following: 1) Community assessments - complete all assessments in the 48 study clusters in Arizona, New Mexico, and Texas; complete all data entry and data cleaning; combine data at the Familia Saludable Coordinating Center (FSCC); analyze the combined and site-specific data; report assessment results to community partners; and prepare manuscripts for submission to peer-reviewed journals. 2) Children's platicas - conduct four additional series of groups in Texas in January; complete transcription and translation of all data; assemble a da data analysis team; develop coding methods; analyze the data; conduct member-checks for verification of interpretation; report to community partners; and prepare manuscripts. 3) Mothers' platicas - conduct two additional series of groups in Texas in January; complete mothers' platicas in NM and AZ; complete transcription and translation of all data; assemble a da data analysis team; develop coding methods; analyze the data; conduct member-checks for verification of interpretation; report to community partners; and prepare manuscripts. 4) Fathers' platicas - develop materials, translate into Spanish, and pilot test; conduct series of two fathers' platicas in Arizona, New Mexico, and Texas complete transcription and translation of all data; assemble a da data analysis team; develop coding methods; analyze the data; conduct member-checks for verification of interpretation; report to community partners; and prepare manuscripts. 5) Develop short elicitation interview based on the integrated behavioral model for follow-up with platicas participants on healthy eating and physical activity. 6) Dr. St. John will facilitate the development and implementation of a support network for promotoras from the three field sites, using a variety of channels of communication (website/blog, email, group discussion). 7) Community advisory boards - continue active engagement of Progreso Community Health Advisory Council (TX) and Vivir Mejor! Consortium (AZ); form a community advisory board in the San Carlos (TX), Chaparral (NM), and Deming (NM) areas. 8) Education - recruit MPH students for practicum opportunities at Baylor University, Texas A&M, New Mexico State, and Mariposa; recruit students for directed studies and research internships; mini-retreat in January for year 2 planning; integration of project activities and strategies in undergraduate and graduate courses; continue to discuss plans for a cross-institution certificate program; continue to work with the Central Texas Maternal and Child Health (CTXMCH) at Texas A&M School of Public Health to provide research and extension opportunities for CTXMCH trainees. 9) Extension - continue to work on curriculum for community outreach and promotora training. 10) Develop a project website.

Impacts
What was accomplished under these goals? Border colonias/neighborhoods present an opportunity to provide much-needed primary obesity prevention to economically and geographically disadvantaged households. Demographic characteristics of the proposed study areas in AZ, NM, and TX indicate families are predominately of MH; almost half are foreign-born; Spanish is the language spoken; half of families have incomes below the poverty level; a large proportion of adults have less than 9 years of education; a large proportion of households receive nutrition assistance. MH residents of colonias have significant needs and face substantial barriers to being healthy and are considered hard-to-reach. The impact of this project included improved understanding of food and activity environments; strengthened capacity of community partners; improved knowledge and skills of undergraduate and graduate students related to health disparities; strengthened capacity of promotoras de salud (community health workers) working with limited resource and underserved families to improve health; and empowered MH community residents with increased knowledge and skills. Community members were given a voice. Community members felt empowered to express their concerns and struggles. For many of them, this was the first time they felt their voice was important. Children felt important. Children who participated in the children's platicas shared their views and wanted to talk about their individual and family meals and physical activity. As several children mentioned, "I would change for all my family to be involved". Mothers given an opportunity to talk. Mothers were excited to be part of the mothers' platicas, which provided a venue for group discussion and served as a support group. The mothers advised each other on how they could improve together; and how they shared all of the project information with family members and friends, creating a 'ripple effect'. Change in community attitude. During this year, team promotoras noticed a change in attitude among community members. They were becoming aware of what is missing in their colonia. They started to understand that by working together, they can learn from each other and improve their lifestyle. City officials in one of our areas started to make changes to improve places for physical activity. Research Objective 1: Engage MH children and families from underserved areas along the AZ, NM, and TX border with Mexico and conduct formative research. The following major activities were completed. Community assessment: 1) identification and mapping of 16 areas each in AZ, NM, and TX; 2) community/neighborhood assessment materials developed, modified, and translated into Spanish; 3) training materials developed and training and field practice sessions completed in Texas, NM, and AZ; 4) reliability checks in AZ, NM, and TX; 5) booster training in AZ, NM, and TX; 5) community assessments (street segments, food environment, physical activity opportunities, existing infrastructure and policies) completed in 75% of the 48 clusters. Children's platicas (panel series of group discussions with children): 1) workgroup formed for children's platicas; 2) developed protocol and interview guides for researchers and observers; 3) each platica met three times over four weeks - Session 1 focused on food-related activities and included Draw, Write and Tell and Circles of Closeness activities; Session 2: Physical activity, active play, and screen time with Map and Tell and Circles of Closeness activities; Session 3: Participant-Driven Photo Elicitation of food-related activities and physical activity; 4) Training manuals (agendas, facilitative questioning, laughter exercises, observations template, pre- and post-training evaluation) were developed and translated into Spanish; 5) developed recruitment criteria and strategies, tracking ineligibles, and documenting geographic distribution; 6) developed 2-day training agenda, tip sheets, Platica components and individual sessions; 7) developed curricula and activities for mothers' activities while their children participated in the platicas; 8) completed children's platicas: children were divided into separate groups based on gender and age (7/9 and 10/11); Texas completed a pre-test of four groups (9/19, 9/26, 10/10) in San Carlos (Spanish) and Progreso (Spanish and English); four groups (10/24, 10/31, 11/21) in San Carlos and Donna (all in Spanish); mothers' activities included: session 1 (cancer screening and jewelry making), session 2 (nutrition and healthy Mexican dishes), and session 3 (stress and anxiety and picture frame decorating); New Mexico completed four groups (11/14, 11/21, 12/5) in Deming (English) and Chaparral (Spanish); mothers' activities included: session 1 (Diabetes), session 2 (Breast Cancer Awareness), and session 3 (Hypertension); Arizona completed four groups (English) in Nogales; 9) Obtained inputs from children participants from all study areas to potentially create an effective and appropriate intervention for these communities; 10) Databases were developed and deployed, and data entry teams trained. Mothers' platicas (panel series of group discussions with mothers: 1) workgroup formed for mothers' platicas; 2) developed protocol and interview guides for researchers and observers; 3) each platica met three times over four weeks - Session 1 focused on food-related activities; Session 2: Physical activity, active play, and screen time; Session 3: Participant-Driven Photo Elicitation of food-related activities and physical activity; 4) Training manuals (agendas, facilitative questioning, laughter exercises, observations template, pre- and post-training evaluation) were developed and translated into Spanish; 5) developed recruitment criteria and strategies, tracking ineligibles, and documenting geographic distribution; 6) developed 1-day training agenda, Platica components and individual sessions; 7) completed platicas: Texas completed four groups (all Spanish) in San Carlos, Donna, and Progreso (10/29-30, 11/5-6, 11/19-20); 8) planned platicas: New Mexico recruited and scheduled for four groups (Spanish); and Arizona recruited and scheduled for four groups (Spanish). 9) Databases were developed and deployed, and data entry teams trained. Education Objective 1: Use experiential learning and innovative teaching methods to increase the competency of faculty and undergraduate and graduate students. We completed the following activities: 1) Education workgroup formed; 2) Students were recruited as project research interns in TX and NM; 3) Students completed a public health practicum in AZ and TX; 4) Started inventory of undergraduate and graduate courses that context information and experience could be provided by this project; 5) Learnings and strategies from the project incorporated in Dr. Sharkey's HPCH 605 (Social and Behavioral Research Methods) for second-year MPH students; 6) Linkage established with Central Texas Maternal and Child Health Program (CTXMCH), with one student involved in this project; 7) Filmed a promotora-focused guest lecture; and 8) five guest lectures presented. Extension Objective 1: Develop, deliver, and evaluate science-based knowledge and skills through informal education, certificate programs, in-service training, and group discussions. The major activities completed included: 1) Extension workgroup organized; 2) Practicum student conducted a comprehensive "Nutrition and Physical Education Resource Inventory" of all Extension programs relating to physical activity and nutrition; 3) Prepared a 228-page report; 4) Conducted a "Nutrition Education Literature Review" and compiled a 32-page document of references; 5) Developed a draft curriculum for community outreach; and 6) Developed curriculum in English and Spanish and provided training in Spanish that increased knowledge and skills for promotoras on conducting community assessments and platicas.

Publications

• Type: Journal Articles Status: Accepted Year Published: 2015 Citation: Allen SJ, Umstattd Meyer MR, and Sharkey JR. Physical activity of Mexican-origin children: Examining parental support. Journal of Health Care for the Poor and Underserved
• Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Walsh SM, Umstattd Meyer MR, and Sharkey JR. Oh, the Places They Can Play: A Descriptive Study of Four South Texas Colonias Communities, presented at the 15th Annual American Academy of Health Behavior Meeting, March 2015, San Antonio, TX.
• Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Sharkey JR, Frank G, and Manzo R. Latino Community Engagement and Obesity Prevention: The Promotores Model, presented at 8th Biennial Childhood Obesity Conference, June 2015, San Diego, CA.
• Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Sharkey JR, McDonald J, Kunz S, and Umstattd Meyer MR. Salud Para Usted y Su Familia [Health for You and Your Family]: Childhood Obesity Prevention in Arizona, New Mexico, and Texas Border Areas, presented at Society for Nutrition Education and Behaviors 48th Annual Conference, July 2015, Pittsburg, PA; and Journal of Nutrition Education and Behavior (2015);47(4S):S97-98.
• Type: Conference Papers and Presentations Status: Published Year Published: 2015 Citation: Sharkey JR, Beltran E, and Gomez L. Promotora-Academic Partnership to Address Challenges to Health among Mexican-American and Mexican Immigrant Children, Adults, and Seniors in Texas Border Colonias, panel presentation at Texas Hunger Initiative's Hunger and Poverty Summit
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2016 Citation: Umstattd Meyer MR, Sumrall J, Walsh SM, McClendon M, and Sharkey JR. Where will they play? A description of the neighborhood physical activity resources available to Mexican-origin children residing in colonias along the U.S.-Mexico border, to be presented at 2016 Active Living Research Conference, February 2016, Clearwater Beach, FL.
• Type: Conference Papers and Presentations Status: Accepted Year Published: 2016 Citation: Umstattd Meyer MR and Sharkey JR. Where can they run and play? Promotora partnerships in rural active living environmental assessments. To be presented as part of the symposium entitled Dont preach to the choir: Reaching the underserved by integrating physical activity promotion into primary care as part of the 37th Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine, March-April 2016, Washington DC.
• Type: Conference Papers and Presentations Status: Under Review Year Published: 2016 Citation: Stasi S, Sharkey J, Umstattd Meyer M R, G�mez Montelongo L, McClendon M, Bridges C. �Nosotros corremos, nosotros jugamos! [We run, we play!]: Childrens Perceptions of Physical Activity in Mexican-heritage border Communities
• Type: Conference Papers and Presentations Status: Under Review Year Published: 2016 Citation: Umstattd Meyer and Sharkey JR. "Don't Preach to the Choir: Reaching the Underserved by Integrating Physical Activity Promotion into Primary Care", Presentation Title: Where can they run and play? Promotora partnerships in rural active living environmental assessments. Society of Behavioral Medicine.