I Could Live other Places,but This is Where I Want to Be: Support for Natural Helper Initiatives

Abstract

Charlotte REACH 2010 is an example of a multi-level intervention with the goal of reducing cardiovascular disease (CVD) and diabetes. Structured within a socio-ecological framework, lay health advisors are the link between the multi-level programs. An exploratory assessment was conducted using focus group methodology. Nine focus groups were conducted with the Charlotte REACH LHAs, residents who had participated in REACH program activities, and residents who had not participated in REACH activities. Results reveal two prominent themes: improvements in health practices and community competence. Both LHAs and community participants improved their knowledge of health enhancement behaviors, developed health enhancement skills and behaviors, and noted personal, familial, and community wide health improvements. Community competence was also observed with regard to community commitment, communication of health issues, and expanded social support networks. The results of this qualitative evaluation suggest the effectiveness of incorporating natural helper models as part of larger multi-level initiatives.

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References

Ma'at

Owens

, and Hughes

. REACH 2010 Coalitions: Reaching for Ways to Prevent Cardiovascular Disease, Journal of Women's Health, 11, pp. 829–839, 2002.

DeBate

R. D.

Plescia

Joyner

, and Spann

. A Qualitative Assessment of Charlotte REACH: An Ecological Perspective for Decreasing CVD and Diabetes Among African Americans, Ethnicity and Disease, 14, pp. 77–82, 2004.

Eng

, and Parker

. Natural Helper Models to Enhance a Community's Health and Competence, Emerging Theories in Health Promotion Practice and Research: Strategies for Improving Public Health, DiClemente

R. J.

Crosby

R. A.

, and Kegler

M. C.

(eds.), San Francisco: Jossey-Bass, pp. 101–126, 2002.

Hawe

Degeling

, and Hall

. Evaluating Health Promotion, London: Maclennan & Petty, pp. 174–184, 1995.

Rutherford

L. R.

, Conducting Focus Groups, Community Health Education Methods, Bensley

R. J.

, and Brookins-Fisher

(eds.), MA: Jones and Bartlett, pp. 39–55, 2001.

Carey

M. A.

. The Group Effect in Focus Groups: Planning, Implementing and Interpreting Focus Group Research, Critical Issues in Qualitative Research Methods, Mores

J. M.

(ed.), London: Sage, pp. 225–241, 1994.

Spradley

J. P.

, The Ethnographic Interview, Fort Worth, TX: Holt, Rinehart and Winston, 1979.

Q. S. R. International. Nvivo 2.0, Melbourne, Australia, 2002.

Becker

M. H.

, and Maiman

L. A.

. Sociobehavioral Determinants of Compliance with Health and Medical Care Recommendations, Medical Care, 13, pp. 10–24, 1975.

10.

Brown

E. R.

. Community Action for Health Promotion: A Strategy to Empower Individuals and Communities, International Journal of Health Services, 21, pp. 441–456, 1991.

11.

Elder

J. P.

Ayala

G. X.

, and Harris

. Theories and Intervention Approaches to Health-Behavior Change in Primary Care, American Journal of Preventive Medicine, 17, pp. 275–284, 1999.

12.

Minkler

, and Cox

. Creating Critical Consciousness in Health: Applications of Freire's Philosophy and Methods to the Health Care Setting, International Journal of Health Services, 10, p. 311, 1980.

13.

Eng

Parker

, and Harlan

. Lay Health Advisor Intervention Strategies: A Continuum from Natural Helping to Paraprofessional Helping, Health Education & Behavior, 24, pp. 413–417, 1997.

14.

Jackson

E. J.

, and Parks

C. R.

. Recruitment and Training Issues from Selected Lay Health Advisor Programs Among African Americans: A 20-Year Perspective, Health Education & Behavior, 24, pp. 418–431, 1997.

15.

Jackson

E. J.

Salber

E. J.

, and Service

. Hiring and Training the Community Coordinators, Community Health Education: The Lay Advisor Approach, Service

, and Salber

E. J.

(eds.), Health Care Systems Inc., Dept. of Family and Community Medicine, Duke University, Durham, NC, 1979.

16.

Love

M. B.

Gardner

, and Legion

. Community Health Workers: Who They Are and What They Do, Health Education & Behavior, 24, pp. 510–522, 1997.

17.

Parker

E. A.

Schulz

A. J.

Israel

B. A.

, and Hollis

. Detroit's East Side Village Health Worker Partnership: Community-Based Lay Health Advisor Intervention in an Urban Area, Health Education & Behavior, 25, pp. 24–25, 1988.

18.

Booker

V. K.

Robinson

J. G.

Kay

B. J.

Najera

L. G.

, and Stewart

. Changes in Empowerment: Effects of Participation in a Lay Health Promotion Program, Health Education & Behavior, 24, pp. 452–564, 1997.

19.

U.S. Department of Health and Human Services (1994a): Community Health Advisors: Models, Research, and Practice, Selected Annotations—United States (Vol. 1). Atlanta, GA, U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Chronic Disease Control and Community.

20.

U.S. Department of Health and Human Services (1994b): Community Health Advisors: Programs in the United States, Health Promotion and Disease Prevention (Vol. 2). Atlanta, GA, U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Chronic Disease Control and Community Intervention.