Enabling and Sustaining the Activities of Lay Health Influencers: Lessons From a Community-Based Tobacco Cessation Intervention Study

Abstract

The authors present findings from a community-based tobacco cessation project that trained lay health influencers to conduct brief interventions. They outline four major lessons regarding sustainability. First, participants were concerned about the impact that promoting cessation might have on social relationships. "Social risk" must be addressed during training to ensure long-term sustainability. Second, formal training provided participants with an increased sense of self-efficacy, allowed them to embrace a health influencer identity, and aided in further reducing social risk. Third, material resources functioned to mediate social tensions during health intervention conversations. A variety of resources should be made available to health influencers to accommodate type of relationship, timing, and location of the interaction. Finally, project design must be attentive to the creation of a "community of practice" among health influencers as an integral part of project sustainability. These lessons have broad implications for successful health promotion beyond tobacco cessation.

Research Priorities for Article 14--Demand Reduction Measures Concerning Tobacco Dependence and Cessation

“…In some Asian and African countries, up to 80% of the population utilize traditional medicine as their primary health care (World Health Organization, 2008a) and so replying only on practitioners trained in Western medicine to deliver TDT could potentially exclude many people. There are data to suggest that non-health care staff, such as social and community service workers (Johnston et al, 2005;O'Brien et al, 2012), outreach workers , and lay people (Castañeda, Nichter, Nichter, & Muramoto, 2010), can be trained to provide TDT. There, therefore, exists a need to research how to integrate screening and cessation advice into alternative health care and non-health care systems including agencies that deal with housing, financial aid, workplace wellness, and social support.…”

Tobacco

“…Others show aspects of "acculturation," such as English language use, modern lifestyles, and family formation, correlate with smoking behavior among Hispanic and Asian American adolescents in the United States (BaezcondeGarbanati 2001, Unger et al 2000). Yet others have clarified for tobacco-control scholars the value of qualitative case studies for understanding better the role of culture, relevant social, institutional, and behavioral contexts, and subjective experience (Nichter 2003) and, more practically, have helped to develop and promote culturally sensitive cessation programs (Castañeda et al 2008, Mohan et al 2006, Nichter et al 2009a, Nichter & Proj. Quit Tob.…”

How ethnic media producers constitute their communities of practice: An ecological approach

“…Communities of practice are collectives bound by common goals and shared identity, developed through participatory learning of core practices (Burkitt et al, 2001;Castañeda et al, 2008). Husband (2005) extended earlier work on communities of practice when he applied this conceptual framework to the experiences of ethnic media producers.…”