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 .
The effect of peer support on breast-feeding duration among primiparous women: a randomized controlled trial.
BACKGROUND Most mothers stop breast-feeding before the recommended 6 months post partum . A systematic review showed that breast-feeding support programs by health care professionals did not substantially improve breast-feeding outcomes beyond 2 months post partum . We conducted a r and omized controlled trial to evaluate the effect of peer ( mother-to-mother ) support on breast-feeding duration among first-time breast-feeding mothers . METHODS We recruited 256 breast-feeding mothers from 2 semi-urban community hospitals near Toronto and r and omly assigned them to a control group ( conventional care ) or a peer support group ( conventional care plus telephone-based support , initiated within 48 hours after hospital discharge , from a woman experienced with breast-feeding who attended a 2.5-hour orientation session ) . Follow-up of breast-feeding duration , maternal satisfaction with infant feeding method and perceptions of peer support received was conducted at 4 , 8 and 12 weeks post partum . RESULTS Significantly more mothers in the peer support group than in the control group continued to breast-feed at 3 months post partum ( 81.1 % v. 66.9 % , p = 0.01 ) and did so exclusively ( 56.8 % v. 40.3 % , p = 0.01 ) . Breast-feeding rates at 4 , 8 and 12 weeks post partum were 92.4 % , 84.8 % and 81.1 % respectively among the mothers in the peer support group , as compared with 83.9 % , 75.0 % and 66.9 % among those in the control group ( p < or = 0.05 for all time periods ) . The corresponding relative risks were 1.10 ( 95 % confidence interval [ CI ] 1.01 - 2.72 ) at 4 weeks , 1.13 ( 95 % CI 1.00 - 1.28 ) at 8 weeks and 1.21 ( 95 % CI 1.04 - 1.41 ) at 12 weeks post partum . In addition , when asked for an overall rating of their feeding experience , significantly fewer mothers in the peer support group than in the control group were dissatisfied ( 1.5 % v. 10.5 % ) ( p = 0.02 ) . Of the 130 mothers who evaluated the peer support intervention , 81.6 % were satisfied with their peer volunteer experience and 100 % felt that all new breast-feeding mothers should be offered this peer support intervention . INTERPRETATION The telephone-based peer support intervention was effective in maintaining breast-feeding to 3 months post partum and improving satisfaction with the infant feeding experience . The high satisfaction with and acceptance of the intervention indicates that breast-feeding peer support programs , in conjunction with professional health services , are effective
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 .