A scoping review of the evidence available for the training lay advocates on CVD prevention in ethnically diverse women in hairdresser and beauty salons
Problem
Deprivation and ethnicity are associated with adverse cardiovascular disease outcomes, and inequities in access to health care. Community-based training of lay health advocates or “health navigators” can facilitate equitable access to preventative care, as salons are a trusted community service and more accessible than a formal service. We aimed to map and summarise the evidence about training lay health advocates on CVD prevention and management which have predominantly targeted women from ethnically diverse communities, including formative phases, theoretical approaches, and evaluation.
Approach
The methodological framework was based on the guidance of Arksey and O’Malley, with incorporation of other relevant materials. PubMed, Web of Science, Embase, PyscInfo, Medline and Global Health were systematically searched from inception until 28/2/24, and reference lists of relevant articles were screened. The Reach, Effectiveness, Adoption, Implementation, and Maintenance framework was used to explore the potential training impact.
Findings
Our previous search of 419 titles and abstracts screened for relevance in 2022 (will be updated to 2024), with eight meeting the inclusion criteria, all based in the USA. Two used formative phases to inform training development, five studies referred to theoretical or conceptual frameworks and three described evidence of co-development with key stakeholders or experts within the community. Incentivisation was provided to lay health advocates in five of the studies.
Consequences
Our literature review suggested that training salon-based interventions could increase access to preventative care and that formative research helped to refine the training content and mode of delivery. However, the reporting of formative research was inadequate, community participation varied considerably, conceptual frameworks about how change could be achieved were inconsistently applied, and there was inadequate process evaluation to understand the potential impact of salon-based training.