title: Outcome effectiveness of the lay health advisor model among Latinos in the United States: an examination by role.
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.
authors.affiliation: Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA 92123, USA. ayala@mail.sdsu.edu
authors.forename: Guadalupe X
authors.initials: GX
authors.lastname: Ayala
authors.forename: Lara
authors.initials: L
authors.lastname: Vaz
authors.forename: Jo Anne
authors.initials: JA
authors.lastname: Earp
authors.forename: John P
authors.initials: JP
authors.lastname: Elder
authors.forename: Andrea
authors.initials: A
authors.lastname: Cherrington
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003376:Counseling; D005260:Female; D006282:Health Personnel; D006293:Health Promotion; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D017063:Outcome Assessment, Health Care; D012380:Role; D014481:United States; D055815:Young Adult