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首页> 美国卫生研究院文献>Journal of Healthcare Leadership >Lay health advisers: scoping the role and intervention landscape
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Lay health advisers: scoping the role and intervention landscape

机译：外行健康顾问：确定角色和干预前景

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The use of lay health advisers has become an established approach within public health, in particular for impact on health inequalities and engaging socially excluded groups. Evidence on how differences in terms of the multiple role dimensions impact the outcomes of programs is limited. This creates ambiguity for decision makers on which roles should be implemented in different contexts for different needs. This paper applies realist logic to an inquiry to explore the mechanisms that may operate in lay-led intervention models and understand how, why, and in what respect these lead to particular outcomes. It draws on a project focusing on health-related lifestyle advisers and further insights gained from a subsequent related project about outreach with traveler communities. Analysis highlights multiple and potentially interacting aspects of lay health-adviser roles that may influence their success, including characteristics of lay health advisers, characteristics of target populations, purpose or intent of interventions, and how advice is given. A model is proposed from which to examine the contexts and mechanisms of lay health advisers that may impact outcomes, and is subsequently applied to two examples of reported lay health-adviser interventions. The combination of skills and characteristics of lay health advisers must be considered when planning which interventions might be appropriate when targeting specific needs or target populations. Focus only on the peer/layperson distinction may overlook other potentially important skills and mechanisms of action integral to lay health-adviser roles.
机译：使用外行健康顾问已成为公共卫生领域的既定方法，尤其是对健康不平等的影响和社会排斥群体的参与。关于多重角色方面的差异如何影响计划成果的证据有限。这给决策者带来了歧义，他们应该在不同的环境中为不同的需求实施角色。本文将现实主义逻辑应用于研究中，以探索可在外行干预模型中发挥作用的机制，并了解这些机制如何，为什么以及在什么方面导致特定结果。它借鉴了一个以健康相关生活方式顾问为重点的项目，并从随后的有关与旅行者社区的外展相关项目中获得了进一步的见解。分析突出显示了非专业健康顾问角色的多个且可能相互作用的方面，它们可能影响他们的成功，包括非专业健康顾问的特征，目标人群的特征，干预目的或意图以及如何提供建议。提出了一个模型，用于检查可能影响结果的非专业卫生顾问的背景和机制，随后将其应用于已报告的非专业卫生顾问干预措施的两个示例。在计划针对特定需求或目标人群的干预措施时，必须考虑外行健康顾问的技能和特征的结合。只关注同龄人/外行人的区别可能会忽略其他可能构成卫生顾问角色的重要技能和行动机制。

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