Primary author: _
Audrey Wilcox

Natural Helper Models
The natural helper model (NHM) is designed to enhance the ability of individuals “to help others through their own personal social networks” (Tessaro et al., 2000). The natural helper model “builds on the community’s infrastructure” (DeBate & Plescia, 2005) and functions on the basis of “key persons” within the community’s social network. These key persons are known as natural helpers and they have commonalities of the person in need (Bergstrom, 1982). Moreover, due to the fact that the NHM exercise a community-based approach, the community-based participatory research (CBPR) fits well with this model. The CBPR “increases the value of the community by creating bridges between scientists and the community through shared knowledge and valuable experiences” (Agency for Research Healthcare and Quality, 2004). CBPR is also useful because it “establishes mutual trust from the community that enhances both the quantity and quality of data collected for policymakers to help guide the community program development” (Agency for Research Healthcare and Quality, 2004). Furthermore, natural helpers gain from the collaborative process of research because of their involvement with the researcher. Being involved will allow the receiver to be informed from a peers view and would bring about change. Primarily, natural helpers can range from middle and high schools students, co-workers of the same setting, or neighborhood members who are sought out for help. The most common features among the natural helpers are their “reputation in their communities for being respected, trusted, good listeners, responsive to the needs of others, and in control of their own life circumstances” (Bishop, Earp, Eng, & Lynch, 2002).

Relatively, there is not a “definitive natural helper model” (Bishop, Earp, Eng, & Lynch, 2002). Bishop (2002) has identified the NHM as a natural lay model in which the two are indistinguishable. The natural lay model utilizes the same “social network intervention strategy” (Tessaro et al., 2000). Secondly, they are both “cultural models that build on the strengths within a community or cultural group” as they consider the “influences of naturally existing resources of social and community support” (Tessaro et al., 2000). Likewise, the NLM helps “increase social norms for health promotion and promotes systems change” (Tessaro et al., 2000). As it relates to public health, the natural helper model is utilized to address a variety of health issues that is evident in particular populations (Tessaro et al., 2000) and the natural helpers can “provide a viable approach to health programs at the grassroots level" (Bergstrom, 1982). “The actions can be either short-or long-term but they are in response to community health needs” (DeBate & Plescia, 2005).

Moreover, the natural helper model is very strategic as it exploits “having representation from each network to provide support and education to individuals that are of similar backgrounds” (Tessaro et al., 2000) and allows health information to be transposed through everyday discussion and interaction. These strategies are extremely relevant in the primary and secondary stages of prevention of public health and health promoters have “realized that a partnership with natural helpers can interweave formal services with the help provided by a community support system” (Eng & Parker, 2002, p. 140). For instance, a community-based, childhood obesity prevention program in two Houston low-income neighborhoods was designed on the basis of input from community members. Stemming from trust, the principals of community engagement and translational research helped health practitioners and researchers build a strong community partnerships and community ownership to ensure the significance of the intervention was a good fit in the context of the community (Correa, et al., 2010). This was achieved by engaging and listening to the communities while allowing the communities to prioritize the initiatives. Houston’s pilot initiative demonstrated progress in improving the health of the community by disseminating evidence-based practices through community engagement (Correa, et al., 2010). Likewise, research has found that a “community-based and participatory model may require a significant degree of flexibility from health educators” (Bishop, Earp, Eng, & Lynch, 2002) that is usually “culturally tailored” (Scott, 2009). For this reason, community building has to be inclusive of the psychosocial factors of the individuals needing help to be able to improve the perceived effectiveness of resources and the individual’s ability to cope and influence the outcome expectation. This can be attached to the construct of self-efficacy in the social cognitive theory. Accordingly, there is opportunity for many different models and theories to be used in conjunction with the NHM. It is contingent on the community and the community needs to utilize the appropriate models. Therefore, the NHM has to be “aware of behaviors and attitudes that reflect cultural norms when developing interventions” (Tessaro et al., 2000).

Lastly, the NHM has recognized another type of helper and that is the Lay Health Advisors (LHA). Although a slight difference exist between the two, each brings value for community development by ways of the social action model. For instance, the level of knowledge for LHA is greater with reference to health and resources (Bishop, Earp, Eng, & Lynch, 2002) and their realm of labor differs (Scott, 2009). With these abilities, the “LHA approaches are guided by the assumption that individuals behavior is influenced by social groups to which they belong and from which they derive their social identity”(Earp, et al., 1997). This can leave the individual with an imbalance of power and privilege . However, operating as a paid worker by an agency, the LHA “operates to distribute health promoting information and assistance to particular groups” (Scott, 2009) to influence change through empowerment. Nonetheless, the “LHA may or may not be part of a targeted community and is likely to be chosen according to criteria set by the governing agency, not community members” (Scott, 2009). Still coined as natural helpers, LHA are generally from the healthcare setting and they are paraprofessionals that are trained to carry out health care services normally performed by a professional among their existing social networks (Bishop, Earp, Eng, & Lynch, 2002). Examples are “health aids, community health advisors, peer educators, and outreach workers” (Eng, Parker, & Harlan, 1997). Additionally, in the collaboration efforts, they provide “linkage between the healthcare system and their own community” and serve to “strengthen these relations” (Bishop, Earp, Eng, & Lynch, 2002). Most importantly, they are influential resources that are activist in the promotion of health and prevention strategies.

References:

Agency for Research Healthcare and Quality. (2004, August). Retrieved November 27, 2010, from Community-Based Participatory Research: Summary: http://www.ahrq.gov/clinic/epcsums/cbprsum.pdf

Bergstrom, D. (1982). Collaborating with Natural Helpers for Delivery of Rural Mental Health Services. Journal of Rural Community Psychology , 3 (2), 5-26.

Bishop, C., Earp, J. A., Eng, E., & Lynch, K. S. (2002). Implementing a Natural Helper Lay Health Advisor Program: Lessons Learned from Unplanned Events. Health Promotion Practice , 3 (2), 233-244.

Correa, N., Murray, N., Mei, C., Baun, W., Gor, B., Hare, N., et al. (2010). CAN DO Houston: A Community-Based Approach to Preventing Childhood Obesity. Preventing Chronic Disease , 7 (4), 1-11.

DeBate, R., & Plescia, M. (2005). I Could Live Other Places, But This is Where I Want To Be: Support For Natural Helper Initiatives . International Quarterly of Community Health Education , 23 (4), 327-339.

Earp, J. A., Viadro, C. I., Vincus, A. A., Altpeter, M., Flax, V., Mayne, L., et al. (1997). Lay Health Advisors: A Strategy for Getting the Word Out About Breast Cancer. Health Education and Behavior , 24 (4), 432-451.

Eng, E., & Parker, E. (2002). Natural Helper Models to Enhance a Community's Health and Competence. In R. J. DiClemente, R. A. Crosby, & M. C. Kegler, Emerging Theories in Health Promotion Practice and Research (pp. 126-151). San Franciso, CA: Jossey-Bass.

Eng, E., Parker, E., & Christina, H. (1997). Lay Health Advisor Intervention Strategies a Continuum From Natural Helping to Paraprofessional Helping. Health Education & Behavior , 24 (4), 413-417.

Scott, T. N. (2009). Utilization of the Natural Helper Model in Health Promotion Targeting African American Men. Journal of Holistic Nursing , 27 (4), 282-292.

Tessaro, I., S.Taylor, Belton, L., M.K. Campbell, S. B., & DeVellis, B. (2000). Adapting a natural (lay) helpers model of change for worksite health promotion for women. Health Education Research , 15 (5), 603-614.