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Review
. 2010 Oct;25(5):815-40.
doi: 10.1093/her/cyq035. Epub 2010 Jul 5.

Outcome effectiveness of the lay health advisor model among Latinos in the United States: an examination by role

Guadalupe X Ayala  1 , Lara Vaz, Jo Anne Earp, John P Elder, Andrea Cherrington
Affiliations
Review

Outcome effectiveness of the lay health advisor model among Latinos in the United States: an examination by role

Guadalupe X Ayala et al. Health Educ Res. 2010 Oct.

Abstract

The objective of this study was to examine lay health advisor (LHA) programs designed to promote health among US Latinos and the extent to which educator-only versus educator-plus-bridge programs differed in designs and outcomes achieved. Two independent coders reviewed 128 published articles on LHAs yielding information at two levels: (i) study design and participant and LHA characteristics from 61 studies that broadly compared educator-only versus educator-plus-bridge programs and (ii) implementation features and outcomes from 17 randomized controlled trials or quasi-experimental studies with outcome data. LHA programs have been widely used with Latinos in certain US regions; our findings indicate that LHAs are effective intervention agents. We identified differences between educator-only and educator-plus-bridge LHA programs, although the small number of educator-plus-bridge programs with outcome data limited comparisons. Major gaps remain in research targeting Latino subgroups other than Mexican immigrants/Mexican Americans. Sufficient research has evaluated LHA programs among Latinos on their ability to achieve health behavior and/or health status changes. In the future, more of a focus on organizational and policy changes is warranted. Questions remain about diversity in LHAs' characteristics and roles, which influence not only outcomes but also program sustainability and dissemination.

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Figures

Fig. 1.
Fig. 1.
Literature included during the review process.
Fig. 2.
Fig. 2.
Latino LHA studies by health outcome and LHA role (N = 61).
Fig. 3.
Fig. 3.
Geographic distribution of 61 LHA studies, with darker map zones depicting greater concentrations of Latinos/Hispanics (E = educator only, B = educator plus bridge).
See this image and copyright information in PMC

References

    1. US Census Bureau. Hispanics in the United States. Washington, DC: US Department of Commerce; 2006.
    1. National Council of La Raza. The State of Hispanic America, 2004. Washington, DC: NCLR; 2004.
    1. Pew Hispanic Center and The Henry J. Kaiser Family Foundation. Survey Brief: Health Care Experiences. Washington, DC: Pew Hispanic Center and the Henry J. Kaiser Family Foundation; 2004.
    1. Liebman J, Heffernan D, Sarvela P. Establishing diabetes self-management in a community health center serving low-income Latinos. Diabetes Educ. 2007;33(Suppl. 6) 132S–8S. - PubMed
    1. Moore A, Earp JA. The long reach to basic healthcare services: partnering with lay health advisors to improve health equity. In: Earp JA, French EA, Gilkey MB, editors. Patient Advocacy for Healthcare Quality: Strategies for Achieving Patient-Centered Care. Sudbury, MA: Jones and Bartlett; 2007. pp. 121–50.

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