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lay health worker

Stephanie M Topp, Chanda Mwamba, Anjali Sharma, Njekwa Mukamba, Laura K Beres, Elvin Geng, Charles B Holmes, Izukanji Sikazwe
BACKGROUND: Failure to keep people living with HIV engaged in life-long care and treatment has serious implications for individual and population-level health. Nested within a four-province study of HIV care and treatment outcomes, we explored the dynamic role of social and service-related factors influencing retention in HIV care in Zambia. METHODS: From a stratified random sample of 31 facilities, eight clinics were selected, one urban and one rural from each province...
2018: PloS One
Jane Goudge, Tobias Chirwa, Sandra Eldridge, Francesc Xavier F Gómez-Olivé, Chodziwadziwa Kabudula, Felix Limbani, Eustasius Musenge, Margaret Thorogood
Introduction: In low/middle-income countries with substantial HIV and tuberculosis epidemics, health services often neglect other highly prevalent chronic conditions, such as hypertension, which as a result are poorly managed. This paper reports on a study to assess the effect on hypertension management of lay health workers (LHW) working in South African rural primary healthcare clinics to support the provision of integrated chronic care. Methods: A pragmatic cluster randomised trial with a process evaluation in eight rural clinics assessed the effect of adding two LHWs supporting nurses in providing chronic disease care in each intervention clinic over 18 months...
2018: BMJ Global Health
Edith Van't Hof, Katie S Dawson, Alison Schafer, Anna Chiumento, Melissa Harper Shehadeh, Marit Sijbrandij, Richard A Bryant, Dorothy Anjuri, Phiona Koyiet, Lincoln Ndogoni, Jeannette Ulate, Mark van Ommeren
Background: Problem Management Plus (PM+) is a brief multicomponent intervention incorporating behavioral strategies delivered by lay health workers. The effectiveness of PM+ has been evaluated in randomized controlled trials in Kenya and Pakistan. When developing interventions for large-scale implementation it is considered essential to evaluate their feasibility and acceptability in addition to their efficacy. This paper discusses a qualitative evaluation of PM+ for women affected by adversity in Kenya...
2018: Global Mental Health
Jennifer E Swanberg, Helen M Nichols, Jessica M Clouser, Pietra Check, Lori Edwards, Ashley M Bush, Yancy Padilla, Gail Betz
We systematically reviewed the literature to describe how community health workers (CHWs) are involved in occupational health and safety research and to identify areas for future research and research practice strategies. We searched five electronic databases from July 2015 through July 2016. Inclusion criteria were as follows: (1) study took place in the United States, (2) published as a full peer-review manuscript in English, (3) conducted occupational health and safety research, and (4) CHWs were involved in the research...
March 3, 2018: Journal of Immigrant and Minority Health
Geoffrey Fatti, Debra Jackson, Ameena E Goga, Najma Shaikh, Brian Eley, Jean B Nachega, Ashraf Grimwood
INTRODUCTION: Adolescents and youth receiving antiretroviral treatment (ART) in sub-Saharan Africa have high attrition and inadequate ART outcomes, and evaluations of interventions improving ART outcomes amongst adolescents are very limited. Sustainable Development Goal (SDG) target 3c is to substantially increase the health workforce in developing countries. We measured the effectiveness and cost-effectiveness of community-based support (CBS) provided by lay health workers for adolescents and youth receiving ART in South Africa...
February 2018: Journal of the International AIDS Society
Roberto Cardarelli, Mary Horsley, Lisa Ray, Nancy Maggard, Jennifer Schilling, Sarah Weatherford, Fran Feltner, Kayla Gilliam
This exploratory study aimed to address the effectiveness of a lay-health worker (LHW) model in addressing social needs and readmissions of high-risk patients admitted in a rural community hospital. A quasi-experimental study design assessed implementation of a LHW model for assisting high-risk patients with their post-discharge social needs. Outcome measures included 30-day hospital readmissions rates during a 4-month baseline period compared with a 6-month post-implementation period. The LHW intervention involved assessment and development of a personalized social needs plan for enrolled patients (e...
February 21, 2018: Health Education Research
Sanghamitra Pati, Abhimanyu Singh Chauhan, Pranab Mahapatra, Devraj Hansdah, Krushna Chandra Sahoo, Sandipana Pati
BACKGROUND: Evidence-based research has documented the association between alcohol intake during pregnancy and increased risk of miscarriage, stillbirth and congenital birth defects. Alcohol consumption is a complex behavior whose origins lay in cultural norms and the social structure. In tribal communities in India, alcohol misuse among women is a public health problem. This study is intended to explore perceptions and beliefs among tribal women and the community towards alcohol consumption during pregnancy...
February 20, 2018: Substance Abuse Treatment, Prevention, and Policy
Grace Kathryn Ryan, Andreas Bauer, Judith K Bass, Julian Eaton
INTRODUCTION: There is a severe shortage of specialist mental healthcare providers in low-income and middle-income countries (LMICs) affected by humanitarian crises. In these settings, talking therapies may be delivered by non-specialists, including lay workers with no tertiary education or formal certification in mental health. This systematic review will synthesise the literature on the implementation and effectiveness of talking therapies delivered by lay workers in LMICs affected by humanitarian crises, in order to develop a Theory of Change (ToC)...
February 17, 2018: BMJ Open
Byamah B Mutamba, Jeremy C Kane, Joop T V M de Jong, James Okello, Seggane Musisi, Brandon A Kohrt
BACKGROUND: Despite increasing evidence for the benefits of psychological treatments (PTs) in low- and middle-income countries, few national health systems have adopted PTs as standard care. We aimed to evaluate the effectiveness of a group interpersonal psychotherapy (IPT-G) intervention, when delivered by lay community health workers (LCHWs) in a low-resource government health system in Uganda. The intended outcome was reduction of depression among caregivers of children with nodding syndrome, a neuropsychiatric condition with high morbidity, mortality and social stigma...
February 15, 2018: Psychological Medicine
Lorna McWilliams, Sarah Bellhouse, Janelle Yorke, Richard Cowan, Cathy Heaven, David P French
BACKGROUND: US-based evidence suggests that lay-health worker (LHW) interventions can increase awareness around cancer risk-related lifestyles, symptom recognition and screening programme uptake. The suitability of LHW interventions in the UK and the potential barriers and facilitators for implementation is currently unknown. This study explored the acceptability and feasibility of developing LHW interventions for cancer prevention, screening and early diagnosis. METHODS: Purposive sampling recruited five separate lay groups: a) completed cancer treatment; b) friends/family of cancer patients; c) cancer hospital volunteers; d) cancer charity volunteers; and e) members of the public...
February 13, 2018: Psycho-oncology
Epiphany Munetsi, Victoria Simms, Lloyd Dzapasi, Georgina Chapoterera, Nyaradzo Goba, Tichaona Gumunyu, Helen A Weiss, Ruth Verhey, Melanie Abas, Ricardo Araya, Dixon Chibanda
BACKGROUND: Suicidal ideation may lead to deliberate self-harm which increases the risk of death by suicide. Globally, the main cause of deliberate self-harm is depression. The aim of this study was to explore prevalence of, and risk factors for, suicidal ideation among men and women with common mental disorder (CMD) symptoms attending public clinics in Zimbabwe, and to determine whether problem solving therapy delivered by lay health workers can reduce common mental disorder symptoms among people with suicidal ideation, using secondary analysis of a randomised controlled trial...
February 8, 2018: BMC Public Health
Daniel L R Kuetting, Andreas Feisst, Alois M Sprinkart, Rami Homsi, Julian Luetkens, Daniel Thomas, Hans H Schild, Darius Dabir
Fatigue and sleep deprivation are common phenomena, especially among medical professionals and shift workers. Studies have proven that short episodes of sleep deprivation can lead to sympathetic hyperactivity with an elevation in blood pressure, heart rate, and an increased secretion of stress hormones (e.g. cortisol, noradrenaline, thyroid hormones). In this study investigating cardiac strain in 20 healthy subjects undergoing short-term sleep deprivation, it could be shown for the first time that 24-hr-shift-related short-term sleep deprivation leads to a significant increase in cardiac contractility, blood pressure, heart rate and stress hormone secretion...
February 7, 2018: Journal of Sleep Research
Nicola J Reavley, Allison J Milner, Angela Martin, Lay San Too, Alicia Papas, Katrina Witt, Tessa Keegel, Anthony D LaMontagne
OBJECTIVE: To assess depression literacy, help-seeking and help-offering to others in members of the police force in the state of Victoria, Australia. METHODS: All staff in police stations involved in a cluster randomised controlled trial of an integrated workplace mental health intervention were invited to participate. Survey questions covered sociodemographic and employment information, recognition of depression in a vignette, stigma, treatment beliefs, willingness to assist co-workers with mental health problems, help-giving and help-seeking behaviours, and intentions to seek help...
February 1, 2018: Australian and New Zealand Journal of Psychiatry
Miya L Barnett, Anna S Lau, Jeanne Miranda
Mobilizing lay health workers (LHWs) to deliver evidence-based treatments (EBTs) is a workforce strategy to address mental health disparities in underserved communities. LHWs can be leveraged to support access to EBTs in a variety of ways, from conducting outreach for EBTs delivered by professional providers to serving as the primary treatment providers. This critical review provides an overview of how LHW-supported or -delivered EBTs have been leveraged in low-, middle-, and high-income countries (HICs). We propose a conceptual model for LHWs to address drivers of service disparities, which relate to the overall supply of the EBTs provided and the demand for these treatments...
January 31, 2018: Annual Review of Clinical Psychology
Jeremiah Laktabai, Alyssa Platt, Diana Menya, Elizabeth L Turner, Daniel Aswa, Stephen Kinoti, Wendy Prudhomme O'Meara
BACKGROUND: Community health workers (CHWs) play an important role in improving access to services in areas with limited health infrastructure or workforce. Supervision of CHWs by qualified health professionals is the main link between this lay workforce and the formal health system. The quality of services provided by lay health workers is dependent on adequate supportive supervision. It is however one of the weakest links in CHW programs due to logistical and resource constraints, especially in large scale programs...
2018: PloS One
Daniel M Blonigen, Luisa Manfredi, Adrienne Heinz, Xiaoyu Bi, Paola Suarez, Andrea L Nevedal, Anita A Vashi, Christine Timko, Todd Wagner
OBJECTIVE: Use of psychiatric emergency services in emergency departments (EDs) and inpatient psychiatry units contributes substantially to the cost of mental health care. Among patients who utilize psychiatric emergency services, a small percentage ("high utilizers") contributes a disproportionate share of the total cost, yet little is known about the context of care for these patients. This study employed qualitative methods to identify barriers to and facilitators of reducing use of psychiatric emergency services among high utilizers...
February 1, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Alexander Jenson, Debra L Roter, Harran Mkocha, Beatriz Munoz, Sheila West
OBJECTIVE: Prevention of Trachoma, the leading cause of infectious blindness, requires community treatment assistants (CTAs) to perform mass drug administration (MDA) of azithromycin. Previous research has shown that female CTAs have higher MDA coverage, but no studies have focused on the content of conversation. We hypothesize that female CTAs had more patient-centered communication and higher MDA coverage. METHODS: In 2011, CTAs from 23 distribution sites undergoing MDA as part of the Partnership for Rapid Elimination of Trachoma were selected...
January 6, 2018: Patient Education and Counseling
Abby DiCarlo, Ruby Fayorsey, Masila Syengo, Duncan Chege, Martin Sirengo, William Reidy, Juliana Otieno, Jackton Omoto, Mark P Hawken, Elaine J Abrams
BACKGROUND: The recent scale-up of prevention of mother-to-child transmission of HIV (PMTCT) services has rapidly accelerated antiretroviral therapy (ART) uptake among pregnant and postpartum women in sub-Saharan Africa. The Mother and Infant Retention for Health (MIR4Health) study evaluates the impact of a combination intervention administered by trained lay health workers to decrease attrition among HIV-positive women initiating PMTCT services and their infants through 6 months postpartum...
January 10, 2018: BMC Health Services Research
Faisal S Malik, Joyce P Yi-Frazier, Craig E Taplin, Christian L Roth, Kathryn B Whitlock, Waylon Howard, Catherine Pihoker
Purpose The purpose of this study was to examine the feasibility and efficacy of the Diabetes Community Care Ambassador (DCCA) Program, a novel medical-legal community intervention designed to support high-risk youth with type 1 diabetes. Methods Study eligibility criteria: ages 3-19 years, A1C ≥8.5% (≥69 mmol/mol) and/or recent diabetic ketoacidosis hospitalization, type 1 diabetes duration ≥1 year, and English- or Spanish-speaking. Eighty-nine youth and their caregivers participated in the 9- to 12-month intervention, which included diabetes education and support through 3 home visits, 1 to 2 school visits, and phone support from a lay health worker, as well as legal support from a medical-legal partnership attorney...
January 1, 2018: Diabetes Educator
Reuben N Robbins, Hetta Gouse, Henry G Brown, Andries Ehlers, Travis M Scott, Cheng-Shiun Leu, Robert H Remien, Claude A Mellins, John A Joska
BACKGROUND: Neurocognitive impairment (NCI) is one of the most common complications of HIV infection, and has serious medical and functional consequences. South Africa has 7 million people living with HIV (PLHIV) with up to three-quarters of antiretroviral therapy (ART)-naïve individuals having NCI. South Africa's health system struggles to meet the care needs of its millions of PLHIV; screening for NCI is typically neglected due to limited clinical staff trained to administer, score, and interpret neuropsychological tests, as well as long test batteries and limited screening tools for South African populations...
January 5, 2018: JMIR MHealth and UHealth
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