Impact of a Binational Healthy Lifestyle Program in Underserved Communities in Mexicali, Baja California: The Athletes for Life Program (AFL-Mexicali)

The literature indicates that interventions addressing childhood overweight and obesity commonly integrate physical activity, nutrition, and behavioral change strategies; however, most evaluate their impact primarily through changes in body weight, yielding modest and poorly sustainable results. In contrast, improvements in cardiorespiratory fitness are associated with benefits in cardiometabolic health, prevention of premature cardiovascular disease, academic performance, and mental health in children and adolescents, even independently of weight loss. Furthermore, evidence highlights the role of parents and children as active agents in the adoption of healthy lifestyles and recognizes community centers as promising settings for implementing family-based programs. Athletes for Life (AFL), a multilevel, family-based behavioral healthy lifestyle program, emerges as a more viable alternative to weight-centered approaches, having demonstrated favorable outcomes in cardiovascular health, body fat reduction, and the home food environment across several pilot studies. To evaluate the feasibility of the Athletes for Life program on cardiorespiratory fitness, physical activity level, diet quality, and metabolic risk indicators among participating families from a community center in Mexicali, as well as its viability for long-term implementation. The study employed a two-group quasi-experimental design that incorporated both quantitative and qualitative methodologies. It was implemented and evaluated over a 12-month period divided into four phases: beginner, intermediate, advanced, and a final sustainability phase, in which nutrition and physical activity content and skills progressively increased. Two government-operated community centers participated in the study. One center received the intervention program, while the control center received monthly healthy lifestyle promotion sessions. A total of 14 parent-child dyads participated, and convenience non-probabilistic sampling was used. The project was structured into three major stages: 1) assessment of the contextual needs of the community centers and their members (administrators, staff, instructors, and users); 2) program implementation and impact evaluation through the assessment of physical fitness (YMCA 3-Minute Step Test and 1-mile run), physical activity level (accelerometry), anthropometry, cardiometabolic indicators, and diet quality; and 3) exploration of acceptability and the multilevel and organizational factors associated with effective program implementation. Outcome measurements were collected at baseline and at 4.5, 9, and 12 months. Data were analyzed using qualitative or quantitative methodologies according to data type, with Excel, QSR NVivo 14, SPSS v.24, and Prism software.