We found little evidence of effectiveness of HRLAs for promotion of exercise/improved diets .
Conclusions Overall , there is limited evidence suggesting that HRLAs are cost-effective in terms of changing health-related knowledge , behaviours or health outcomes .
The evidence that does exist indicates that HRLAs are only cost-effective when they target behaviours likely to have a large impact on overall health-related quality of life .
Background Development of new peer or lay health-related lifestyle advisor ( HRLA ) roles is one response to the need to enhance public engagement in , and improve cost-effectiveness of , health improvement interventions .
This article synthesis es evidence on the cost-effectiveness of HRLA interventions aim ed at adults in developed countries , derived from the first systematic review of the effectiveness , cost-effectiveness , equity and acceptability of different types of HRLA role .
Efficacy of home-based peer counselling to promote exclusive breastfeeding: a randomised controlled trial
BACKGROUND Exclusive breastfeeding is recommended worldwide but not commonly practised . We undertook a r and omised controlled study of the efficacy of home-based peer counselling to increase the proportion of exclusive breastfeeding among mothers and infants residing in periurban Mexico City . METHODS Two intervention groups with different counselling frequencies , six visits ( 44 ) and three visits ( 52 ) , were compared with a control group ( 34 ) that had no intervention .  From March , 1995 , to September , 1996 , 170 pregnant women were identified by census and invited to participate in the study . Home visits were made during pregnancy and early post partum by peer counsellors recruited from the same community and trained by La Leche League . Data were collected by independent interview . Exclusive breastfeeding was defined by WHO criteria . FINDINGS 130 women participated in the study . Only 12 women refused participation . Study groups did not differ in baseline factors . At 3 months post partum , exclusive breastfeeding was practised by 67 % of six-visit , 50 % of three-visit , and 12 % of control mothers ( intervention groups vs controls , p<0.001 ; six-visit vs three-visit , p=0.02 ) . Duration of breastfeeding was significantly ( p=0.02 ) longer in intervention groups than in controls , and fewer intervention than control infants had an episode of diarrhoea ( 12 % vs 26 % , p=0.03 ) . INTERPRETATION This is the first reported community-based r and omised trial of breastfeeding promotion . Early and repeated contact with peer counsellors was associated with a significant increase in breastfeeding exclusivity and duration . The two-fold decrease in diarrhoea demonstrates the importance of breastfeeding promotion to infant health
We found little evidence of effectiveness of HRLAs for promotion of exercise/improved diets .
Conclusions Overall , there is limited evidence suggesting that HRLAs are cost-effective in terms of changing health-related knowledge , behaviours or health outcomes .
The evidence that does exist indicates that HRLAs are only cost-effective when they target behaviours likely to have a large impact on overall health-related quality of life .
Background Development of new peer or lay health-related lifestyle advisor ( HRLA ) roles is one response to the need to enhance public engagement in , and improve cost-effectiveness of , health improvement interventions .
This article synthesis es evidence on the cost-effectiveness of HRLA interventions aim ed at adults in developed countries , derived from the first systematic review of the effectiveness , cost-effectiveness , equity and acceptability of different types of HRLA role .