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)：在一个新的增长社区中，一个男性非职业健康顾问网络拉丁裔，美国增长最快的人口，遇到了高质量的医疗保健障碍，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性面临更多抑郁、药物滥用和性传播疾病的风险。在拉美裔人口高度集中的社区中，宣传人员(非专业健康顾问)的有效性已得到记录。然而，今天美国20%的拉美裔美国人--1000万人--生活在新增长社区(NGC)中，这些社区的拉美裔人口密度较低，但仍在不断增长，拉美裔在人口中所占比例不到5%。居住在NGC的拉丁裔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，而且他们面临更多的社会孤立。在NGC中还没有发表过使用促进剂来促进健康的努力。推销员通常是女性；有必要研究男性推销员的有效性。Salud拉丁裔参与小组(LEGS)是由卫生和社会服务提供者、基层社区成员和大学研究人员组成的伙伴关系，在编写这项CBPR提案过程中发挥了不可或缺的作用。我们建议实现三个目标。1.评估CBPR领导的男性促进网络对增加与家人分开居住的男性获得医疗保健的机会和社会支持的影响，衡量标准是：a)在登记时为40%没有通常护理来源的客户获得护理来源；b)为去年没有健康状况访问的50%客户实现健康访问；以及c)将客户的社会支持从基线增加到参加促进方案后的3个月。2.定性探讨男性推广者网络对NGC客户的影响。3.考察网络在赋予男性提升者权力方面的作用。我们的项目将通过六个步骤进行CBPR组织。LEGS将与家人分开生活的男性确定为有关键医疗服务需求的人群。我们目前正在与重点小组、调查和主要线人面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推动者网络，其中将包括5名推动者和一名超级推动者或协调员。推广员将与客户(n=125)进行外联，并使用手机进行跟踪。我们将使用调查、来自临床合作伙伴的汇总数据以及对网络客户和推广者的深入采访来收集数据，以实现我们的特定目标。这项研究将回答CBPR中的关键问题：促销员网络在改善NGC的医疗保健机会和社会支持方面是否有效？客户和推销员在拥有男性推销员的网络中的经历是什么？CBPR流程能否赋予男性提升者权力？ 公共卫生相关性：相关性这项研究将提供信息，以填补健康促进信息方面的两个空白：如何接触到分散的新成长的拉丁裔社区，以及男性促进网络的动态是什么。1000万拉丁裔现在居住在新的增长社区；利用这些发现来指导类似地理环境下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.