Systematic Review of Lay Health Worker-Led Self-Management Interventions for Long-Term Conditions

The increasing prevalence of long-term conditions (LTC) necessitates effective self-management strategies. Lay health workers (LHW) play a pivotal role in supporting individuals with LTCs. This section outlines the significance of self-management in chronic disease management and the unique position of LHWs in facilitating this process. The self-management of LTCs is characterized as a flexible, ongoing process where individuals engage in goal-driven activities. These activities include managing symptoms, adhering to treatment regimens, and coping with emotional challenges. The concept of self-efficacy is crucial, as it reflects individuals' beliefs in their ability to manage their health. The review emphasizes that LHWs, often sharing similar backgrounds with the patients, can enhance the effectiveness of self-management interventions by fostering trust and understanding.

A systematic review was conducted to evaluate the implementation and outcomes of LHW-led self-management interventions. The review focused on studies published between January 2010 and December 2015, utilizing databases such as Cochrane, MEDLINE, CINAHL, PsycINFO, and Web of Science. A total of forty original studies were identified, meeting the inclusion criteria. These studies primarily addressed self-management in diabetes, cardiovascular diseases, and individuals at risk of cardiovascular diseases. The methodology section highlights the rigorous search strategy and inclusion criteria, ensuring a comprehensive synthesis of the available evidence. The findings indicate a wide variability in the training of LHWs and the implementation of interventions, underscoring the need for standardized approaches to enhance the effectiveness of LHW-led programs.

The review revealed that LHW-led interventions significantly impacted physical activity and nutrition behaviors. Eight interventions demonstrated positive effects on physical activity, while another eight influenced nutrition behaviors. The analysis identified key behavior change techniques (BCT), such as self-monitoring and group meetings, as effective components of these interventions. Notably, the same techniques were observed in both effective and non-effective interventions, suggesting that the context and delivery of these techniques may play a critical role in their success. The findings emphasize the potential of LHW-led interventions in promoting self-management among individuals with LTCs, highlighting the importance of tailoring interventions to meet the specific needs of diverse populations.

The implications of the findings are significant for public health and healthcare systems. LHW-led interventions can bridge gaps in healthcare access, particularly for underserved populations. The review advocates for the development of a qualified and evidence-based structure for LHW-led interventions to enhance their effectiveness and sustainability. Future research should focus on standardizing training for LHWs and evaluating the long-term impacts of these interventions on health outcomes. The integration of LHWs into healthcare teams can facilitate a more holistic approach to managing LTCs, ultimately leading to improved patient outcomes and reduced healthcare costs. The review underscores the necessity of continued investment in LHW programs as a viable strategy for chronic disease management.