In recent years, there have been few reports in the literature of interventions using a lay health advisor approach in an urban area. Consequently, little is known about how implementation of this type of community health worker model, which has been used extensively in rural areas, may differ in an urban area.
This research sought to modify an instrument and to use it to collect information on smoking knowledge, attitudes, beliefs, and behaviors among Hispanics/Latinos, and to adapt survey methods to obtain high participation levels. Promotoras (outreach workers) conducted face-to-face interviews. Strategic, targeted, carefully designed methods and surveys can achieve high reach and response rates in hard-to-reach populations. Similar procedures could be used to obtain cooperation of groups who may not be accessible with traditional methods.
Research evaluating community health worker (CHW) programs inherently involves these natural community leaders in the research process, and often represents community-based participatory research (CBPR). Interpreting the results of CHW intervention studies and replicating their findings requires knowledge of how CHWs are selected and trained. There was inconsistent reporting of selection and training processes for CHWs in the existing literature. Common selection criteria included personal qualities desired of CHWs. Training processes for CHWs were more frequently reported.
BACCIS targeted ∼25,000 multiethnic, underserved women in eight neighborhoods and the public health clinics that served them. An outreach intervention using lay health worker peers and clinic provider inreach intervention to improve breast and cervical cancer screening were evaluated in a quasi-experimental, controlled trial with pretest and posttest household surveys. Analyses of community survey results showed no significant improvement in reported screening behaviors.
To address cardiovascular disease risk factors among Hispanics, a community model of prevention requires a comprehensive approach to community engagement. The objectives of our intervention were to reduce cardiovascular disease risk factors in Hispanics living in 2 low-income areas of El Paso, Texas, and to engage the community in a physical activity and nutrition intervention. Drawing on lessons learned in phase 1 (years 2005-2008) of the HEART Project, this new phase of the study used an iterative, community-based process to develop an intervention based on an ecological framework.
The development of health homes creates a unique opportunity to develop and implement care management models that meet the complex needs of high-need and high-cost patients. Incorporating CHWs into care management teams is an
This paper, together with the Framework for Partners’ Harmonized Support, proposes complementary operational frameworks through which national and international partners may align their actions with the collective goal to normalize a cadre of community workers and collaborate toward integrated, harmonized program designs rather than competitive, siloed, and parallel interventions.
The USAID-sponsored Community Health Worker (CHW) Regional Meeting was held in Addis Ababa, Ethiopia from June 19 to 21, 2012. Over 60 government and nongovernmental (NGO) representatives from Ethiopia, Kenya, Rwanda, Uganda, Zambia and Mali, as well as participants from NGOs and international organizations attended the meeting. The meeting, designed by Initiatives Inc.
This paper reviews several initiatives in sub-Saharan Africa to implement community-based distribution (CBD) of family planning services. Although research suggests that community-based service delivery can contribute to contraceptive use, the magnitude of impact is often in doubt. This report reviews reasons for the limited impact of CBD in Africa, compared with similar projects in Asia in previous decades, and discusses the efficacy and mechanisms of CBD.
This short commentary discusses the Lady Health Worker (LHW) program in Pakistan. LHWs serve as an important link between community and health facilities, providing both preventative and curative care. However, additional improvements are suggested that could further facilitate a thriving program. These include: incentives for LHWs (improving salaries, timely contract renewals and providing transport), periodic reevaluation of program goals, integrating the LHW program into the main government system and improving supervision.