title: Advancing Understanding of the Characteristics and Capacity of African American Women Who Serve as Lay Health Advisors in Community-Based Settings.
abstract: Lay Health Advisor (LHA) programs hold tremendous promise for reducing health disparities and addressing social determinants of health in medically underserved communities, including African American populations. Very little is understood about the capacity of LHAs in these roles and the broader contributions they make to their communities. This article seeks to address this gap by describing the characteristics and capacity of a sample of 76 female African American LHAs from a nationally disseminated evidence-based LHA program for breast and cervical cancer screening (The National Witness Project), as well as potential differences between cancer survivors and nonsurvivors who serve as LHAs. A conceptual model for understanding LHA capacity and contributions in underserved communities at the individual, social, and organizational levels is presented. We describe LHA experiences and characteristics (e.g., experiences of mistrust and discrimination, racial pride, sociodemographics), capacity at the individual level (e.g., psychological and physical health, health behaviors), capacity at the social level (e.g., social networks, social support), and capacity at the organizational level (e.g., role-related competencies, self-efficacy, leadership, role benefits/challenges). Data were obtained through interview-administered telephone surveys between 2010 and 2011. Findings highlight the critical capacity that LHAs bring to their communities and the importance of supporting LHAs to sustain these programs and to address racial/ethnic health disparities.
authors.affiliation: 1 Columbia University, New York, NY, USA.
authors.forename: Rachel C
authors.initials: RC
authors.lastname: Shelton
authors.affiliation: 1 Columbia University, New York, NY, USA.
authors.forename: Sheba King
authors.initials: SK
authors.lastname: Dunston
authors.affiliation: 1 Columbia University, New York, NY, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Leoce
authors.affiliation: 2 Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Lina
authors.initials: L
authors.lastname: Jandorf
authors.affiliation: 3 Wayne State University, Detroit, MI, USA.
authors.forename: Hayley S
authors.initials: HS
authors.lastname: Thompson
authors.affiliation: 4 Roswell Park Cancer Institute, Buffalo, NY, USA.
authors.forename: Deborah O
authors.initials: DO
authors.lastname: Erwin
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000073116:Cancer Survivors / Q000523:psychology*; D003153:Community Health Services; D003150:Community Health Workers / Q000458:organization & administration / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008875:Middle Aged; D020377:Self Efficacy; D012944:Social Support
keywords: African Americans; cancer screening; community capacity; implementation; lay health advisors