Advancing Understanding of the Characteristics and Capacity of African American Women Who Serve as Lay Health Advisors in Community-Based Settings

Abstract

Lay Health Advisor (LHA) programs hold tremendous promise for reducing health disparities and addressing social determinants of health in medically underserved communities, including African American populations. Very little is understood about the capacity of LHAs in these roles and the broader contributions they make to their communities. This paper seeks to address this gap by describing the characteristics and capacity of a sample of 76 female African American LHAs from a nationally disseminated evidence-based LHA program for breast and cervical cancer screening (The National Witness Project), as well as potential differences between cancer survivors and non-survivors who serve as LHAs. A conceptual model for understanding LHA capacity and contributions in underserved communities at the individual, social, and organizational levels is presented. We describe LHA experiences and characteristics (e.g. experiences of mistrust and discrimination; racial pride; sociodemographics), capacity at the individual-level (e.g., psychological and physical health, health behaviors), capacity at the social-level (e.g., social networks, social support), and capacity at the organizational-level (e.g., role-related competencies, self-efficacy, leadership, role benefits/challenges). Data was obtained through interview-administered telephone surveys between 2010 and 2012. Findings highlight the critical capacity that LHAs bring to their communities and the importance of supporting LHAs to sustain these programs and to address racial/ethnic health disparities.

Advancing understanding of the sustainability of lay health advisor (LHA) programs for African-American women in community settings

“…These findings complement our prior quantitative research on the multi-level capacity that is built through LHA programs [50].…”

“…This research comes from a 2-year longitudinal, mixed-methods study among eight NWP sites to understand factors that influence the long-term implementation, sustainability, and impact of this community-engaged LHA program within African-American communities [36,50]. This paper focuses on findings from qualitative interviews among 76 LHAs from eight NWP sites at baseline and 12-18 month follow-up.…”

Community Empowerment Partners (CEPs): A Breast Health Education Program for African-American Women

“…(16, 17) Interventions using peer educators may thus offer an opportunity to provide culturally relevant community-based education, navigation, resources and social support to enhance healthcare experiences - particularly for communities where health disparities exist. (17, 19)…”

“…A growing body of literature has evaluated the potential of peer education to eliminate breast cancer disparities among African American women. (22, 25, 26) Research has focused on either the feasibility or sustainability of peer education programs (33–35) or the effect on recipients of the peer education intervention. (25, 27, 36) We are not, however, aware of any study with the African American community that has assessed changes in knowledge among the peer educators and their advisee audience simultaneously.…”

Mobile Mammography Unit Utilization: Perceptions and Interests Among African American Women

“…Various studies have shown the usefulness of training community health advisors to provide psychosocial support and act as a liaison between clinicians and individuals they seek to serve [25][26][27]. By sharing similar cultural, social and economic characteristics as the populations of interest, they are more inclined to connect and understand the subtle distinctions that influence health behaviors [26].…”