Nav: Home

How can lay health advisor programs be designed for maximum impact?

April 14, 2016

April 14, 2016 -- Lay health advisors who share similar social, economic, cultural and linguistic backgrounds and values with the medically underserved groups they interact with have been shown to reduce health disparities. Looking to identify elements that can help make these advisors and the programs they support as effective as possible, researchers from Roswell Park Cancer Institute (RPCI) and Columbia University's Mailman School of Public Health found that support from the sponsoring organization and clear role expectations are critical for the success of these lay advisors. The study is one of the largest to date involving African-American lay health advisors. The findings have been published in the journal Implementation Science.

Lay health advisors are trained peers or community members who deliver health education and support in a range of community and clinical settings to enhance access to care and improve health outcomes. The research team gathered data from 76 lay health advisors participating at eight National Witness Project sites in the Northeast, South and Midwest regions of the U.S. over an interval of 18 to 24 months. The Witness Project is an evidence-based program that has been shown to increase breast and cervical screening among African-American women.

"We investigated individual, social and organizational factors that predict activity level and retention among a community-based sample of African-American lay health advisors," says Deborah Erwin, PhD, senior author of the study and director of the Office of Cancer Health Disparities Research at Roswell Park. "Our findings will inform strategies to successfully recruit, train, support and sustain lay advisors in a community setting, toward the goal of improving both the sustainability and the effectiveness of these programs."

The team collected information through telephone questionnaires administered to lay advisors and from National Witness Project assessments of the lay advisors' level of engagement with their programs.

The researchers report that lay advisors were involved in the program for an average of 5.5 years; more than half were breast or cervical cancer survivors; and 92 percent were not paid for their work as advisors. Lay health advisors who reported a greater commitment and understanding of their role were more than five times as likely to stay with the program, and women who were in the program longer were less likely than newer recruits to stay with the program. Assignment at a National Witness Project site that had a partnership with an academic institution -- which was true for 71 percent of the program sites -- was the strongest and most consistent predictor of both retention and activity levels among lay health advisors.

"A notable finding from this study is that role-related and organizational factors were consistently associated with higher retention and greater activity levels among lay advisors," adds the first author of the study, Rachel Shelton, ScD, MPH, assistant professor of Sociomedical Sciences at Columbia University's Mailman School of Public Health. "Given that many of the lay health advisors were volunteers who were not paid for their participation, the rates of retention and activity levels are impressive and indicate a strong commitment to the program."

The researchers note that because lay advisors are increasingly being enlisted in efforts to improve health and address health disparities, further research on program implementation and sustainability is critical in order to maximize their reach and impact.

The study, "Predictors of activity level and retention among African American lay health advisors (LHAs) from The National Witness Project: Implications for the implementation and sustainability of community-based LHA programs from a longitudinal study," is available at implementationscience.biomedcentral.com
-end-
The research was supported by a grant from the National Cancer Institute, or NCI (project no. R03CA150543).

About Columbia University's Mailman School of Public Health


Founded in 1922, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 450 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,300 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including ICAP (formerly the International Center for AIDS Care and Treatment Programs) and the Center for Infection and Immunity. For more information, please visit http://www.mailman.columbia.edu.

About Roswell Park


The mission of Roswell Park Cancer Institute (RPCI) is to understand, prevent and cure cancer. Founded in 1898, RPCI is one of the first cancer centers in the country to be named a National Cancer Institute-designated comprehensive cancer center and remains the only facility with this designation in Upstate New York. The Institute is a member of the prestigious National Comprehensive Cancer Network, an alliance of the nation's leading cancer centers; maintains affiliate sites; and is a partner in national and international collaborative programs. For more information, visit http://www.roswellpark.org, call 1-877-ASK-RPCI (1-877-275-7724) or email askrpci@roswellpark.org. Follow Roswell Park on Facebook and Twitter.

Columbia University's Mailman School of Public Health

Related Public Health Articles:

Public health guidelines aim to lower health risks of cannabis use
Canada's Lower-Risk Cannabis Use Guidelines, released today with the endorsement of key medical and public health organizations, provide 10 science-based recommendations to enable cannabis users to reduce their health risks.
Study clusters health behavior groups to broaden public health interventions
A new study led by a University of Kansas researcher has used national health statistics and identified how to cluster seven health behavior groups based on smoking status, alcohol use, physical activity, physician visits and flu vaccination are associated with mortality.
Public health experts celebrate 30 years of CDC's prevention research solutions for communities with health disparities
It has been 30 years since CDC created the Prevention Research Centers (PRC) Program, currently a network of 26 academic institutions across the US dedicated to moving new discoveries into the communities that need them.
Public health experts support federally mandated smoke-free public housing
In response to a new federal rule mandating smoke-free policies in federally funded public housing authorities, three public health experts applaud the efforts of the US Department of Housing and Urban Development to protect nonsmoking residents from the harmful effects of tobacco exposure.
The Lancet Public Health: UK soft drinks industry levy estimated to have significant health benefits, especially among children
The UK soft drinks industry levy, due to be introduced in April 2018, is estimated to have significant health benefits, especially among children, according to the first study to estimate its health impact, published in The Lancet Public Health.
Social sciences & health innovations: Making health public
The international conference 'Social Sciences & Health Innovations: Making Health Public' is the third event organized as a collaborative endeavor between Maastricht University, the Netherlands, and Tomsk State University, the Russian Federation, with participation from Siberian State Medical University (the Russian Federation).
Columbia Mailman School Awards Public Health Prize to NYC Health Commissioner Dr. Mary T.
Dr. Mary T. Bassett, Commissioner of the New York City Department of Health and Mental Hygiene, was awarded the Frank A.
Poor health literacy a public health issue
America's poor record on health literacy is a public health issue, but one that can be fixed -- not by logging onto the internet but by increased interaction with your fellow human beings, a Michigan State University researcher argues.
Despite health law's bow to prevention, US public health funding is dropping: AJPH study
Although the language of the Affordable Care Act emphasizes disease prevention -- for example, mandating insurance coverage of clinical preventive services such as mammograms -- funding for public health programs to prevent disease have actually been declining in recent years.
'Chemsex' needs to become a public health priority
Chemsex -- sex under the influence of illegal drugs -- needs to become a public health priority, argue experts in The BMJ this week.

Related Public Health Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Anthropomorphic
Do animals grieve? Do they have language or consciousness? For a long time, scientists resisted the urge to look for human qualities in animals. This hour, TED speakers explore how that is changing. Guests include biological anthropologist Barbara King, dolphin researcher Denise Herzing, primatologist Frans de Waal, and ecologist Carl Safina.
Now Playing: Science for the People

#SB2 2019 Science Birthday Minisode: Mary Golda Ross
Our second annual Science Birthday is here, and this year we celebrate the wonderful Mary Golda Ross, born 9 August 1908. She died in 2008 at age 99, but left a lasting mark on the science of rocketry and space exploration as an early woman in engineering, and one of the first Native Americans in engineering. Join Rachelle and Bethany for this very special birthday minisode celebrating Mary and her achievements. Thanks to our Patreons who make this show possible! Read more about Mary G. Ross: Interview with Mary Ross on Lash Publications International, by Laurel Sheppard Meet Mary Golda...