Implementing empowerment-based Lay Health Worker programs: a preliminary study

Lay Health Worker (LHW) programs have been shown to be effective in engaging community members in health promotion. While successful LHW program implementation requires an understanding of factors influencing program effectiveness, evidence informing such understanding is lacking for empowerment and ecological theory-based LHW programs. This descriptive study explores how enablers and barriers, identified from LHW literature apply (from the LHWs' perspective) in the context of implementing an empowerment and ecological theory-based LHW model in Melbourne, Victoria. A qualitative case study was carried out. Data were collected from participating LHWs (n = 11) via anonymized online activity logs (n = 7) and semi-structured interviews (n = 7). Deductive-inductive thematic analysis was guided by five a priori themes identified from the literature: community relationships; intrinsic traits, values and motivations; capacity building; program design; and work conditions. Data supported the enablers and barriers to program effectiveness and implementation reported by previous research. Subthemes identified the importance of the LHW bridging role; the empowerment model; integrating the program; and program inclusiveness. This research contributes to the growing practice literature regarding how to effectively implement diverse LHW models in diverse settings. It also contributes to social ecological and complex systems-based health promotion practice evidence in suggesting LHWs to be potentially useful elements which may add to the effectiveness of ecologically based health promotion interventions.