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 .
Opening pathways to cancer screening for Vietnamese-American women: lay health workers hold a key.
PURPOSE We describe a controlled trial of a community outreach intervention to promote recognition , receipt , and screening-interval maintenance of clinical breast examinations ( CBE ) , mammograms , and Pap smears among Vietnamese-American women . METHODS Over a 3-year period ,  indigenous lay health workers conducted small-group sessions of Vietnamese women in a low-income district of San Francisco , California . Women in Sacramento , California , served as controls . Lay workers conducted 56 sessions on general prevention , 86 on cervical cancer , and 90 on breast cancer . Surveys of 306 to 373 women were conducted in the study communities in 1992 and 1996 . RESULTS In the intervention community , recognition of screening tests increased significantly between pre- and postintervention surveys : CBE , 50 to 85 % ; mammography , 59 to 79 % ; and Pap smear , 22 to 78 % ( P = 0.001 for all ) . Receipt of screening tests also increased significantly : CBE , 44 to 70 % ( P = 0.001 ) ; mammography , 54 to 69 % ( P = 0.006 ) ; and Pap smear , 46 to 66 % ( P = 0.001 ) . Best-fitting logistic regression models , adjusting for preintervention rates and significant covariates , also showed statistically significant odds ratios for the intervention effect ( P < 0.0001 ) . CONCLUSIONS Trained Vietnamese lay health workers significantly increased Vietnamese women 's recognition , receipt , and maintenance of breast and cervical cancer screening tests
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 .