194830 Experiences of a community-academic partnership in developing and implementing a lay health advisor perinatal tobacco cessation program

Wednesday, November 11, 2009: 8:30 AM

Kevin C. English, RPh, MPH , Mailman School of Public Health - Sociomedical Sciences, Columbia University, New York, NY
Cheryl Merzel, DrPH , Masters in Public Health Program - Lehman College, The City University of New York, Bronx, NY
Joyce Moon-Howard, DrPH , Mailman School of Public Health - Sociomedical Sciences, Columbia University, New York, NY
Pregnancy provides a brief yet robust window of opportunity for positive health behavior change, including tobacco cessation. Although there has been a steady reduction in perinatal tobacco use over the past several decades, women of lower socioeconomic status and certain minority groups have experienced slower rates of decline and there is evidence of a worsening disparity in perinatal tobacco use by social class. This presentation examines the experiences of a community-academic partnership in developing and implementing an evidence-based, lay health advisor-driven perinatal tobacco cessation program for low income, predominately African American and Hispanic women. This work highlights one of the first applications of the 5A's tobacco cessation model – a brief yet highly effective counseling approach – administered by lay health advisors within a community-based setting. A multi-method process evaluation, including client chart reviews, pre-post tests of lay health advisor training and qualitative key informant interviews was conducted to analyze three domains of program implementation: fit within the community context, fidelity to intervention protocols, and feasibility of implementation. Findings indicate that project partners succeeded in bringing state-of-the-art tobacco cessation programming to an underserved population. Success was largely attributable to two predominant factors: 1) the utilization of a scientifically-validated intervention model; and 2) the emphasis on continuous lay health advisor capacity development. The experiences of our program can provide useful lessons for similar efforts among lay health advisor programs and community-based organizations and help to expand the availability of evidence-based tobacco control resources for perinatal women in low income and minority communities.

Learning Objectives:
1.Describe key approaches in conducting a multi-method process evaluation and the value of assessing program fit, fidelity and feasibility as critical benchmarks towards the successful implementation of a community-based health promotion/disease prevention intervention. 2.Explain the benefits of sustained commitment to lay health advisor training and capacity development, including face-to-face workshops, tangible and interactive activities, and the development and implementation of evidence-based and user-friendly system tools to promote fidelity to intervention protocols. 3.Discuss the processes involved in translating scientific knowledge to bring state-of-the-art tobacco control programming into a real-world, community-based setting where lay health advisors serve as change agents in addressing health disparities among low income and minority women and their families.

Keywords: Lay Health Workers, Smoking Cessation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Kevin English is a DrPH candidate at Columbia University’s Mailman School of Public Health and has been working in the field of minority health/health disparities as both a public health practitioner and a clinical pharmacist for 13 years. He leads the perinatal tobacco cessation program at Downstate New York Healthy Start. His work centers on translational research aimed towards the amelioration of racial, ethnic and socioeconomic health disparities. He focuses on a mixed-method approach to explore individual, community and system level determinants that shape health disparities and integrates a community-based participatory approach into his work.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.