A mixed methods implementation evaluation of a brief movement-based health promotion workshop for health professionals in the Ecuadorian highlands.

Background: Although Ecuador's Ministry of Public Health promotes regular physical activity, program design and implementation remains limited, especially in rural Indigenous communities. The purpose of this study was to examine Movimiento como Medicina (MCM) as a contextually grounded implementation strategy to enhance movement and physical activity counseling among health professionals serving Indigenous communities. Methods: An exploratory mixed methods design was used to assess core implementation outcomes: acceptability, appropriateness, and feasibility. Pre-post changes in provider confidence served as a proximal indicator of adoption. Differences in confidence were analyzed using a two-tailed Wilcoxon Signed-Rank Test for paired, non-parametric data. Qualitative data, collected via text responses to open-ended survey questions and analyzed via deductive thematic content analysis, helped further elucidate participants' assessment of the program. Results: Thirty-six health professionals completed the one- or two-day MCM workshop. The mean acceptability score was 4.8 (Standard Deviation [SD] = 0.69). Ninety percent or more of participants strongly agreed that the training objectives were clearly stated, the facilitators were knowledgeable about the topics and created an engaging learning environment, and the pace of the training was appropriate. The mean appropriateness score was = 4.8 (SD = 0.68). Ninety-three percent of participants strongly agreed that the content was relevant to their work and that the program increased their understanding of movement as medicine. Seventy-seven percent of participants strongly agreed that the training included culturally appropriate examples. The most useful aspects of the training included talking through and applying content to learning cases and practicing the various movement-based strategies. The mean feasibility score was 4.65 (SD = 0.61). 92% of participants were likely or very likely to integrate movement strategies into their practice as a result of the workshop. Participants' confidence in identifying the four components of movement, discussing the benefits of movement, and exploring community beliefs regarding movement increased significantly from pre- to post-training. Conclusion: MCM's high acceptability, appropriateness, and feasibility, combined with significant improvements in participant confidence, positions the program as a contextually aligned and scalable health promotion strategy.