The lay health minister approach to developing a health ministry
Adopted and Adapted for UCC
By Barbara T. Baylor, MPH, CHES
Minister for Health and Wellness Programs
The Lay Health Advisor (LHA) Concept
I think we can all agree that the church can make a difference in reducing disability and death. The church today still represents a natural point of reference for many communities. Because of this, focusing health promotion and disease prevention activities should be given careful thought. It is not a new idea for churches to develop health programs whose purpose is to have an impact upon the most significant health risks and health conditions in our congregations. However, targeting our churches for health promotion programs becomes increasingly important as health care funding and services gradually shrink. Increasing technical knowledge and skills of church members to be more effective health advisors among those in their networks will ultimately improve the health of the community as well as the health of the congregation.
The use of Lay Health Advisors (LHAs) to address health issues is well documented and considered an appropriate model of community health promotion. The practice of Public Health is replete with literature regarding this approach dating back to the early 60's. The roles of the professionally trained Public Health Educator and Public Health Nurse have been very involved in facilitating this model in churches, in under-served communities, and in third-world countries.
The LHA Concept in the U.S. was born out of the belief that in every community and every church there are people to whom others turn naturally for advice, help, and support. One research study revealed that people seek health advice from those who most look like them and not from a health professional. Therefore, one of the prime objectives of the Lay Advisor approach is to demystify the provider/profesional-consumer relationship by bringing professionals and lay persons together in a setting which promotes interaction and mutual respect for the unique resources that each has—technical knowledge and community expertise—for effective health promotion outreach.
The Healthy Connections Lay Minister of Health Training Program hinges on this basic objective: to assist the lay health advisor in knowing what, where and when to refer. What things can be done by a lay health advisor within their own support system and networks? And, when and where should they make referrals to the system? The LHA program respects the knowledge and training of health professionals, but at the same time seeks respect for the natural helping skills of lay persons. The program assists them in addressing the needs and concersn they have and can address themselves, thus, increasing the level of competency through capacity building.
The purpose of the "Healthy Connections" training is not to make lay health advisors "mini health professionals", but rather it is designed to enhance their role of helping and advising others. Eva J. Salber, a noted medical doctor and public health professional, believes that the lay advisor system should be used to strengthen professional ties with the community, channel knowledge to and from the community, educate community members on the role and function of the health care system, acquaint the community with available resources, lessen dependency and passivity of community members, and help community members cope better with their problems.
The screening and assessment role of the lay advisors is basically an understanding of these concepts and their role. Lay Health Advisors can and will receive training on how to take blood pressures and administer insulin. However, this training is in the realm of increasing their knowledge and technical skills as screeners only. For example, they will refer elevated blood pressures to the nurse or inform the individual to seek care with his or her primary care provider.
There is minimal liability for operating a Lay Health Advisor program in the church or community, especially if the training clearly makes known the limits—when not to cross the line. As long as lay advisors are providing education, information, and knowing when and where to make referrals, they are not likely to cross that line. Further, in the training we do stress and adivse lay advisors to work with health professionals that are already members of their own churches or to establish partnerships with health professionals in their community.
As a program of the national setting of the United Church of Christ, the Health and Wellness Program, Justice and Witness Ministries is able to provide certification. This certification process is based on certain parameters for participation in and completion of the program. The certificate is a reminder to the graduates that they are the links and partners in this health ministry. It is also a reminder that the mission of health and welfare belongs "to all who have been called by God in Christ."
The Healthy Connection Program is not designed to replace or detract from a congregation's Parish Nurse program, if one already exists. It is designed to enhance and support the existing program. The basic thrust of the program is to create informed health advocates and liaison persons who with their increased health knowledge and awareness can enable congregatios to increase their knowledge of health risks and lifestyle behaviors associated with most chronic diseases. Without encroaching upon any health profession or discipline, we hope to assist in creating a more sophisticated consumer of health services and resources.
What is the lay advisor approach
The Lay Advisor approach in developing a health ministry is one that is designed to strengthen the social support function that the church already provides. The goal is to improve and maintain better health for all its members.
How does the approach work
1. Pick Associations for this project and sites for training classes. Several associations in close proximity within a conference may collaborate with each other to implement this project, OR several churches in a given district, region, community may also collaborate with each other. The training can be ecumenical if there are not enough UCC churches to form a group. NOTE: it is also possible for an individual church to implement this approach on its own.
2. A planning committee may be formed with individuals from each association or church being represented or churches may send a health committee member, if a health committee currently exists. The purpose of this planning committee are to:
determine the training that is needed
determine the sites for training classes
discuss other logistics.
3. Each participating church will pick at least 4-5 persons who:
are leaders, who are respected in their church and community
others turn to for advice and help
are planning to remain in their church and community
are willing to attend all health training sessions
4. Specific topics for training will be determined by the planning committee. Generally, participants will be trained to (1) recognize risk factors associated with certain chronic diseases; (2) recommend ways to detect, manage and prevent these health problems; (3) refer persons to community health resources; (4) conduct health information and referral sessions for their congregations; (5) teach simple self-help techniques; and (6) operate audio-visual aids. In addition, participants will receive training in leadership development.
5. Participants meet at one church centrally located to the participating churches. Each training cycle goes for 12 consecutive weeks (one 2-hour training session per week) and each session is conducted by local health professionals or state health agency personnel. The planning committee or local health committee help locate and coordinate trainers for each topic and each session.
What happens after the training?
After participants complete training, they graduate and are certified as Health and Human Service Coordinators (or some other appropriate title) within their respective churches. Participants return to their respective churches to:
formulate the health committee (if one does not exist)
continue to work with local health and human service agencies to conduct health-related activities in their churches and communities
assist in training other church members
give advice through their natural networks
Parish nurse role in the lay advisor model
1. If your church already has an actively-working Parish Nurse, the Parish Nurse may coordinate and/or facilitate-train the Lay Advisor training for health ministry committee within the church. The Health Ministry Committee within your church may want to engage the members in training to increase knowledge on health issues and to build skills.
2. The Parish Nurse may also facilitate the design of the training and assist in the recruitment of other resource persons.
3. The Parish Nurse may coordinate the lay advisor training with Parish Nurses from other churches to form a training group of interested and committeed health ministry committee members.
Benefits of this model
2. Promotes ownership of church members to carry out health activities
3. Work is divided among members and does not rely on one person to carry out activities
4. Social networks increase (aids with isolation, mistrust, etc.)
5. Increased nurturing and mentoring
6. Provides ongoing collaborative relationships with local health agencies
7. Helps members to focus on what it is they want to do
8. Identifies what talents and gifts exist among members
9. Provides an effective segue and opportunity for members to focus on their health and human service issues
10. Institutionalization of the health ministry as an ongoing progam in the life of the church
Drawbacks of this model
1. Trained Members may move away from the church or community
2. Some cost in time for training that members may not always be willing to take
Institutionization of the health ministry
Having a TRAINED health ministry committee can be very effective in:
1. Developing and promoting programs that deal with the many issues relating to health, welfare and human service
2. Building relationships with state and local human service agencies and community organizations
3. Identifying public policy issues
4. Mobilizing congregation for action
5. Advocating on critical issues