WED-101 - The Effectiveness of Community-based Mental Health Interventions Involving Lay Health Promoters: A Scoping Review

Brief Abstract Summary: This scoping review examined the effectiveness and limitations of lay-delivered mental health promotion interventions globally. Using PRISMA protocols, ten databases were searched, yielding 67 studies meeting inclusion criteria. Results showed that most studies demonstrated effectiveness of lay health promoter interventions, particularly for depression and anxiety. Other conditions addressed included schizophrenia, PTSD, and perinatal mental health. While interventions generally showed feasibility and engagement, obstacles included lack of sustained funding, limited cross-sector collaboration, and need for cultural applicability. Most studies were non-U.S. based, lacked randomization or control groups, and weren't culturally tailored. More U.S. studies are needed to test feasibility and sustainability of culturally responsive approaches. Findings underscore the promise of community-based interventions to strengthen mental health promotion and extend frontline support.

Detailed abstract description: Disparities relating to access to mental healthcare globally underscore the urgent need for innovative, community-based interventions to complement traditional healthcare models. Decades of research have demonstrated that community engaged approaches involving lay health promoters (e.g. CHWs, promotores, peer navigators) have significant positive impacts on health outcomes across a variety of conditions. However, less is known about their effectiveness relating to mental health promotion.

The purpose of this scoping review was to examine the effectiveness of lay-delivered mental health promotion interventions globally and defining characteristics and limitations. Standards for scoping reviews as well as updated PRISMA protocols were used. The authors searched ten scientific databases using Boolean terms relating to ‘mental health’ and ‘lay health” and “intervention.” A total of 461 articles were retrieved. Criteria for inclusion were: empirical studies testing lay mental health interventions, articles published in English, and publications available in full text. Upon initial screening and abstract review, 404 were excluded due to duplication across databases or failure to meet the inclusion requirements. Fifty-seven full articles met the inclusion criteria, and ten were added to the sample from sources outside of the databases or article references. The resulting final sample was 67.

Results showed the majority of studies demonstrated effectiveness of mental health programs and interventions involving lay health promoters. The most common areas of mental health addressed in the interventions were depression and anxiety, although the sample addressed a range of mental health conditions, including schizophrenia, PTSD, and perinatal mental health. While most interventions demonstrated feasibility, engagement, and effectiveness, there were still notable obstacles, such as: lack of sustained funding and collaboration across community, healthcare, and government sectors and the need for cultural applicability. Most studies in the sample were set outside of the U.S., did not involve randomization or control groups, and were not culturally tailored.
The results of this scoping review indicate that mental health interventions involving lay health promoters demonstrate effectiveness, particularly for addressing depression and anxiety. More U. S.-based intervention studies are needed to examine the feasibility, cost, and sustainability of community-based, culturally responsive approaches.