The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64599

Lara M. E. Vaz, SM¹, Kristen Stoimenoff, BA¹, and Guadalupe X. Ayala, PhD, MPH². (1) School of Public Health, University of North Carolina at Chapel Hill, CB #7440, Rosenau Hall, Department of Health Behavior & Health Education, Chapel Hill, NC 27599, 919-843-8043, laravaz@email.unc.edu, (2) Department of Health Behavior and Health Education, University of North Carolina School of Public Health, CB #7440, Rosenau Hall 315, Chapel Hill, NC 27599-7440

The Lay Health Advisor (LHA) model is touted as key to improving access to existing health services and health outcomes of hard-to-reach populations. In practice, LHA programs have been varied both in approaches and results. To better understand the experiences, we conducted a systematic literature review of peer-reviewed articles on the LHA model within U.S. Latino populations. Four literature databases were searched using a list of key terms commonly used to describe LHAs. Two evaluators independently reviewed 576 abstracts. Based on a set of inclusion and exclusion criteria, 86 articles were selected for the full review process. We also conducted backward searches of articles meeting the inclusion criteria and reviews of published bibliographies to identify additional articles for inclusion. Each article was independently reviewed twice and coded for study design content. Coded information was analyzed using SPSS and NVIVO.

The literature included a range of study designs, from program descriptions to quasi-experimental studies and randomized trials. Studies were conducted across the U.S., with nearly half of those reviewed in the Southwest, addressing a range of health issues including HIV, nutrition, prenatal care, breast and cervical cancer screening, and health care access. LHAs received varying levels of training (range 8-160 hours), and of articles with data reported, 50% were paid for their involvement. Limited information was available on the demographic and sociocultural profiles of the LHAs and the targets of their services. This review reveals areas where further study is needed to identify the best models of LHA-delivered interventions for Latinos.

Learning Objectives:

By the end of the session, participants will be able to:
• Identify the many roles LHAs adopt to improve health outcomes in the Latino community;
• Evaluate the existing knowledge base and identify areas for further study of LHAs serving Latinos; and
• Apply lessons learned from existing studies to improve the health of Latinos in the US

Keywords: Latino Health, Lay Health Workers

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.