The Impact of Lay Health Advisors on Cardiovascular Health Promotion: Using a Community-based Participatory Approach

Abstract

Overweight and obesity, lack of exercise, and exposure to tobacco smoke are clearly identified behavioral risk factors for cardiovascular disease. These problems disproportionately affect some communities. To address these problems within one community of underserved Latinos, participatory research methods were used to design an outreach program through a collaborative partnership between UCLA School of Nursing, Los Angeles County Department of Health Services, and members of the target community. Latina lay health advisors (LHAs) (n = 12) from the community were recruited and trained to teach 3 classes on healthy nutrition, physical activity, and maintaining smoke-free environments. Classes were offered in Spanish to adult Latinos recruited through the LHAs' social networks. A questionnaire on lifestyle behaviors was completed at baseline and 1 month following the last class. Exploratory open-ended questions on successes and challenges of applying new knowledge were also asked at follow-up. Results of paired t-tests on 256 participants showed significant increases in scores from baseline to follow-up in overall lifestyle behaviors and all 3 behavioral subsets (nutrition, physical activity, smoke-free behavior). Qualitative findings are also presented. Findings support utilizing LHAs as a feasible and effective healthcare delivery strategy for cardiovascular community health promotion, especially among immigrant populations.