''It's a 24-hour thing ... a living-for-each-other concept'': Identity, networks, and community in an urban Village Health Worker Project

Social networks are webs of relationships between individuals, and they play an important role in the complex social processes through which individuals seek information, obtain social support, and mobilize for collective action to modify social, economic, and environmental conditions associated with health and illness. Studies have described and evaluated lay health advisor (LHA) programs that use social networks to improve individual and community health. The experience and perceptions of community members involved with LHA programs have been explored less often and offer essential information to health educators about the design, implementation, evaluation, and support of such programs. This article examines the perspective of LHAs in Detroit, Michigan. Their understanding and experience of their work, the relationships between their activities and a sense of self and community, and personal and programmatic rewards and challenges are examined. The authors discuss implications for health educators related to LHAs' roles, relationship to supporting organizations, recruitment, training, and ongoing support.