title: A lay health advisor program to promote community capacity and change among change agents.
abstract: The Charlotte REACH 2010 project focuses on cardiovascular disease and diabetes among African Americans in a geographically defined community. The goal of the project is to create changes in individual behaviors, community capacity, change agents, and systemic policies and actions that will result in the reduction of health disparities related to cardiovascular disease and diabetes. The project consists of three main components: lay health advisors as change agents, targeted interventions (exercise, nutrition, smoking cessation, primary care), and environmental and systemic interventions. The purpose of this article is to describe the lay health advisor intervention using qualitative methodologies that were developed to document changes in community capacity and change among change agents. Lay health advisors report that they have internalized their role as a community advocate and have made positive changes in their own personal health behavior. Their understanding of the underlying causes of poor health has expanded to include social and institutional factors and they have begun to shift their emphasis toward advocacy for social and institutional change.
authors.affiliation: Chronic Disease and Injury Section, North Carolina Division of Public Health, University of North Carolina School of Medicine, USA.
authors.forename: Marcus
authors.initials: M
authors.lastname: Plescia
authors.forename: Martha
authors.initials: M
authors.lastname: Groblewski
authors.forename: LaTonya
authors.initials: L
authors.lastname: Chavis
mesh_terms: D001741:Black or African American / Q000193:education / Q000523:psychology*; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000517:prevention & control*; D018672:Community Health Planning / Q000379:methods*; D003150:Community Health Workers; D055812:Community-Based Participatory Research; D003159:Community-Institutional Relations; D003920:Diabetes Mellitus / Q000208:ethnology / Q000517:prevention & control*; D015438:Health Behavior; D006265:Health Care Coalitions; D040441:Health Educators; D006293:Health Promotion / Q000379:methods*; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D017145:Models, Educational; D009657:North Carolina; D036301:Qualitative Research; D012380:Role