De la Mano con la Salud (Lend A Hand for Helath): A Male Lay Health Advisor Netwo

描述（由申请人提供）：De la Mano con la Salud（Lend a Hand for Health）：一个新增长社区的男性非专业健康顾问网络，拉丁美洲人是美国增长最快的人口，他们在获得优质医疗保健方面遇到障碍，健康状况比白人更差。缺乏社会支持使与家人分开生活的男子更容易患抑郁症、滥用药物和性传播疾病。在拉丁美洲人高度集中的社区，有文件证明了促进者（非专业健康顾问）的有效性。然而，今天美国所有拉丁美洲人的20%-1000万人-生活在“新增长社区”（NGC），拉丁美洲人集中度低，但不断增长的地区，拉丁美洲人占人口的比例不到5%。居住在NGC的拉美裔人面临更多的医疗保健障碍，因为很少有服务满足他们的文化和语言需求，因为他们面临更多的社会孤立。在国家地理理事会中，没有使用促进剂的已公布的健康促进工作。促销员通常是女性;有必要研究男性促销员的有效性。拉丁裔健康参与小组（LEGS）是卫生和社会服务提供者，基层社区成员和大学研究人员的合作伙伴关系，在准备这项CBPR提案时不可或缺。我们建议实现三个目标。1.评估以社区重建方案为主导的男性促进者网络在增加与家人分开的男性获得保健服务和社会支持方面的效果，衡量标准是：a）使40%在登记时没有通常保健来源的客户获得保健来源; B）使50%在过去一年中没有接受过健康检查的客户获得健康检查;以及c）从基线到参加promotores计划后3个月，增加客户的社会支持。2.探索定性的影响，男性promotores网络对客户在NGC。3.检查网络在赋予男性促销员权力方面的效果。我们的项目将使用六个步骤进行CBPR。专家组已将与家人分开居住的男子确定为急需保健服务的人群。我们目前正在通过焦点小组、调查和主要线人访谈进行进一步的需求评估。在这项研究中，我们将实施一个男性促进者网络，其中包括5个促进者和一个超级促进者或协调者。促销员将对客户（n=125）进行外联，并使用手机进行跟踪。我们将使用调查、临床合作伙伴的汇总数据以及与网络客户和推广人的深入访谈来收集数据，以实现我们的特定目标。这项研究将回答CBPR中的关键问题：促进者网络是否能有效改善NGC中的医疗服务和社会支持？客户和促销员在与男性促销员的网络中有什么经验？CBPR过程能赋予男性发起人权力吗？ 公共卫生相关性：相关性-这项研究将提供信息，以填补两个空白的健康促进信息：如何达到一个分散的新增长的拉丁裔社区，和什么样的动态的男性promotores网络。现在有1000万拉丁美洲人居住在新的增长社区;利用这些发现来指导类似地理环境中的新项目的潜力是巨大的。

DESCRIPTION (provided by applicant): De la Mano con la Salud (Lend a Hand for Health): a male lay health advisor network in a new growth community Latinos, the fastest growing population in the United States, experience barriers to quality health care and have worse health outcomes than Whites. Lack of social support puts men living apart from their families at additional risk for depression, substance abuse and STDs. The effectiveness of promotores (lay health advisors) has been documented in communities with high concentrations of Latinos. However, today 20% of all Latinos in the U.S. -10 million people- live in "new growth communities" (NGC), areas with low, yet growing, concentrations of Latinos, where Latinos represent fewer than 5% of the population. Latinos residing in NGC face more health care access barriers because there are few services that address their cultural and language needs and because they face more social isolation. There are no published health promotion efforts using promotores in NGC. Promotores are usually female; there is need for studying the effectiveness of male promotores. The Latino Engagement Group for Salud (LEGS) is a partnership of health and social service providers, grassroots community members and university researchers that has been integral in the preparation of this CBPR proposal. We propose to accomplish three aims. 1. Assess the effect of the CBPR-led male promotores network on increasing health care access and social support for men living apart from their families, as measured by a) obtaining a source of care for 40% of clients without a usual source of care at enrollment; b) achieving a well-health visit for 50% of clients who have not had a well-health visit in the last year; and c) increasing clients' social support from baseline to 3 months after enrollment in the promotores program. 2. Explore qualitatively the impact of the male promotores network on clients in an NGC. 3. Examine the effect of the network in empowering male promotores. Our project will be organized using six steps to conduct CBPR. The LEGS has identified men living apart from their families as a population with critical health service needs. We are currently conducting further needs assessment with focus groups, surveys and key-informant interviews. For this study, we will implement a male promotores network that will include 5 promotores and a super-promotor or coordinator. Promotores will conduct outreach to clients (n=125) and follow up using cell phones. We will use surveys, summary data from our clinical partners, and in-depth interviews with network clients and promotores to gather data for our specific aims. This research will answer critical questions in CBPR: Will a promotores network be effective in improving health care access and social support in an NGC? What are the experiences of clients and promotores in networks with male promotores? Can the CBPR process empower male promotores? PUBLIC HEALTH RELEVANCE: Relevance This study will provide information to fill two gaps in health promotion information: how to reach a dispersed new growth Latino community, and what the dynamics of a male promotores network are. Ten million Latinos now reside in new growth communities; the potential to use these findings to guide new programs in a similar geographical setting is vast.