There have been numerous calls in the literature for health educators to develop programs to improve access to and utilization of health and human services by traditionally underserved communities, including Latinos. While the literature suggests several principles that can guide the development of these programs, it is important to address the needs, and build on the strengths, of the specific community of interest. It is, therefore, important to use collaborative approaches in which community members take an active role in the initiation, design, implementation, and evaluation of program activities. Lay health advisor programs are particularly well suited to this approach as they are designed to build on the strength of already existing community relationships to improve community health. This article describes a collaborative, culturally appropriate, holistic, and ecological lay health advisor program--the Latino Health Advocacy Program. Lessons learned and implications for future program development are discussed.
The COVID-19 pandemic caused more than 30 million infections in the United States between March 2020 and April 2021. In response to systemic disparities in SARS-CoV2 testing and COVID-19 infections, health systems, city leaders and community stakeholders in Worcester, Massachusetts created a citywide Equity Task Force with a specific goal of making low-barrier testing available to individuals throughout our community. Within months, the state of Massachusetts announced the Stop the Spread campaign, a state-funded testing venture. With this funding, and through our community-based approach, our team tested more than 48,363 individuals between August 3, 2020 and February 28, 2021. Through multiple PDSA (Plan-Do-Study-Act) cycles, we optimized our process to test close to 300 individuals per hour. Our positivity rate ranged from 1.5% with our initial testing events to a high of 13.4% on January 6, 2021. During the challenges of providing traditional inpatient and ambulatory care during the pandemic, our health system, city leadership, and community advocacy groups united to broaden the scope of care to include widespread, population-based SARS-CoV2 testing. We anticipate that the lessons learned in conducting this testing campaign can be applied to further surges of SARS-CoV2, international environments, and future respiratory disease pandemics.
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