Lay health advisor activity levels: Definitions from the field

One type of lay health advisor model assumes that an effective mechanism fo r reaching the underserved is through informal advice-givers called natural helpers. Despite the growing use of this approach, few programs have defin ed what an active lay health advisor does within the natural helping proces s. To explore perceptions and definitions of lay health advisors' activity, we conducted semistructured, in-person interviews with four field staff wh o coordinate the advisors' activities in a breast cancer screening program. These staff viewed lay health advisor activity as fluctuating over the cou rse of a year, occurring along a continuum of participation (inactive, mode rately active, active, and superactive), and reflecting varying degrees of preactivity and participation in multiple activities. These results suggest an empirical process for refining the definition of an active lay health a dvisor, improving advisors' productivity in achieving outreach objectives, and managing and monitoring their ongoing activities.