Unpacking the 'black box' of lay health worker processes in a US-based intervention.
Unpacking the 'black box' of lay health worker processes in a US-based intervention.
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DOI：
10.1093/yel/day094
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发表时间：
2018-12-01
影响因子：
2.7
通讯作者：
Tsoh, Janice Y
中科院分区：
文献类型：
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作者：
Burke, Nancy J;Phung, Kristine;Tsoh, Janice Y
以前的研究支持使用非专业卫生工作者（LHWs）作为管理慢性健康状况的干预模式的有效性，但很少有记录的机制，干预措施的有效性。这项研究提供了一个第一次看看如何LHWs提供了一个以家庭为基础的干预和遇到的挑战。我们利用LHW领导的教育会议的观察数据，作为随机对照试验（RCT）的一部分，旨在测试LHW外展家庭为基础的干预措施，以促进越南裔美国吸烟者戒烟。随机对照试验包括实验组（戒烟）和对照组（健康生活）。越南的LHWs接受培训，以越南语向家庭二人组（吸烟者和家庭成员）提供健康信息。双语，双文化的研究小组成员进行了不引人注目的观察，在一个子集的LHW教育会议，并描述了结构化的fieldnotes的设置，过程和活动。两名团队成员编码每个fieldnote以下扎根理论的方法。我们利用Atlas.ti定性软件组织编码并促进综合分析。调查结果提供了一个详细的看看“黑匣子”的LHWs如何与他们的参与者提供健康信息。LHWs利用多种关系策略，包括准备一个环境，使关系的建立，使用公认的教学方法，使学习者和合作学习者以及使用幽默和采用文化特定的战略，如层次形式的地址，以创建信任。未来的研究将评估LHW技术的有效性，从而提高LHW干预措施的潜力，以促进服务不足人群的健康。
Prior studies have supported the effectiveness of the use of Lay Health Workers (LHWs) as an intervention model for managing chronic health conditions, yet few have documented the mechanisms that underlie the effectiveness of the interventions. This study provides a first look into how LHWs delivered a family-based intervention and the challenges encountered. We utilize observation data from LHW-led educational sessions delivered as part of a randomized controlled trial (RCT) designed to test a LHW outreach family-based intervention to promote smoking cessation among Vietnamese American smokers. The RCT included experimental (smoking cessation) and control (healthy living) arms. Vietnamese LHWs were trained to provide health information in Vietnamese to groups of family dyads (smoker and family member). Bilingual, bicultural research team members conducted unobtrusive observations in a subset of LHW educational sessions and described the setting, process and activities in structured fieldnotes. Two team members coded each fieldnote following a grounded theory approach. We utilized Atlas.ti qualitative software to organize coding and facilitate combined analysis. Findings offer a detailed look at the 'black box' of how LHWs work with their participants to deliver health messages. LHWs utilized multiple relational strategies, including preparing an environment that enables relationship building, using recognized teaching methods to engage learners and co-learners as well as using humor and employing culturally specific strategies such as hierarchical forms of address to create trust. Future research will assess the effectiveness of LHW techniques, thus enhancing the potential of LHW interventions to promote health among underserved populations.