Training to Act (Formar para Actuar): Peer-to-Peer Education to Promote Health Among Vulnerable Immigrant Women in Barcelona (Spain).

"Formar para actuar" (FxA; "Training to act") is an innovative peer-to-peer educational program that employs a training-action model with a gender and intercultural perspective. The program aims to enhance knowledge and empower immigrant women to advocate for health promotion within their communities. This study assesses FxA program's impact on knowledge acquisition and participant satisfaction. Conducted across four FxA editions (2018, 2020, 2021, 2022), this before-and-after intervention study evaluates a structured two-module approach implemented consecutively in each edition. In Module 1 (Training), migrant women with leadership and community ties attended 12 h of training led by healthcare professionals, covering sexual and reproductive health and communication strategies. Those identifying a peer group advanced to Module 2 (Action), acting as peer educators and leading workshops. Self-reported questionnaires covering sociodemographics, knowledge and satisfaction, were collected from both peer educators and participants. Knowledge impact comparisons before and after the intervention were performed using paired t-tests. Module 1 of the FxA program trained 29 migrant women as peer educators; 20 continued in Module 2, delivering workshops to 166 participants who faced higher vulnerability levels, including language barriers, fewer years in Europe, and lower educational levels. The study revealed significant knowledge improvements, particularly among women participants. Overall satisfaction was high. This study highlights the program's effectiveness in transmitting health promotion messages within vulnerable environments by training immigrant women as peer educators. The findings provide valuable insights to implement the program in other regions and further reinforce its application in public health programs.