Leeds Metropolitan University, Leeds, LS2 8AF, UK.
Perspect Public Health. 2013 Mar;133(2):96-103. doi: 10.1177/1757913912453669. Epub 2012 Aug 13.
The contribution that lay people can make to the public health agenda is being increasingly recognised in research and policy literature. This paper examines the role of lay workers (referred to as 'community health champions') involved in community projects delivered by Altogether Better across Yorkshire and Humber. The aim of the paper is to describe key features of the community health champion approach and to examine the evidence that this type of intervention can have an impact on health.
A qualitative approach was taken to the evaluation, with two strands to gathering evidence: interviews conducted with different stakeholder groups including project leads, key partners from community and statutory sectors and community workers, plus two participatory workshops to gather the views of community health champions. Seven projects (from a possible 12) were identified to be involved in the evaluation. Those projects that allowed the evaluation team to explore fully the champion role (training, infrastructure, etc.) and how that works in practice as a mechanism for empowerment were selected. In total, 29 semi-structured interviews were conducted with project staff and partners, and 30 champions, varying in terms of age, gender, ethnicity and disability, took part in the workshops.
Becoming a community health champion has health benefits such as increased self-esteem and confidence and improved well-being. For some champions, this was the start of a journey to other opportunities such as education or paid employment. There were many examples of the influence of champions extending to the wider community of family, friends and neighbours, including helping to support people to take part in community life. Champions recognised the value of connecting people through social networks, group activities, and linking people into services and the impact that that had on health and well-being. Project staff and partners also recognised that champions were promoting social cohesiveness and helping to integrate people into their community.
The recent public health White Paper suggested that the Altogether Better programme is improving individual and community health as well as increasing social capital, voluntary activity and wider civic participation. This evaluation supports this statement and suggests that the community health champion role can be a catalyst for change for both individuals and communities.
在研究和政策文献中，越来越多的人认识到外行人可以为公共卫生议程做出贡献。本文考察了参与整个约克郡和亨伯地区项目的外展工作者（称为“社区健康大使”）的角色。本文的目的是描述社区健康大使方法的主要特点，并研究这种干预措施对健康产生影响的证据。
采用定性方法对评估进行评估，收集证据有两个方面：对不同利益相关者群体（包括项目负责人、社区和法定部门的主要合作伙伴以及社区工作者）进行访谈，以及举办两次参与式研讨会以收集社区健康大使的意见。确定了七个项目（共 12 个项目）参与评估。选择了那些允许评估小组充分探讨冠军角色（培训、基础设施等）以及该角色如何在实践中作为赋权机制运作的项目。总共对 29 名项目工作人员和合作伙伴进行了半结构化访谈，30 名年龄、性别、族裔和残疾各不相同的冠军参加了研讨会。
成为社区健康大使对健康有益，例如自尊心和自信心增强以及幸福感提高。对一些冠军来说，这是他们走向其他机会的起点，例如教育或带薪就业。冠军们的影响力延伸到家庭、朋友和邻居等更广泛的社区的例子很多，包括帮助支持人们参与社区生活。冠军们认识到通过社交网络、小组活动将人们联系起来，以及将人们与服务联系起来对健康和幸福感的影响。项目工作人员和合作伙伴也认识到，冠军们在促进社会凝聚力并帮助人们融入社区方面发挥了作用。
最近的公共卫生白皮书表明，整个约克郡和亨伯地区项目正在改善个人和社区健康，增加社会资本、志愿活动和更广泛的公民参与。这项评估支持这一说法，并表明社区健康大使的角色可以成为个人和社区变革的催化剂。
