Adapting a natural (lay) helpers model of change for worksite health promotion for women.

Social network interventions that utilize informal systems of helping can be an important strategy for health promotion change. This article describes the development, implementation and evaluation of a natural (lay) helping intervention for health promotion change, specifically designed for women in small rural blue-collar worksites. One hundred and four women in four intervention worksites were recruited as natural helpers, and received health and skill-building education over an 18-month period. Qualitative evaluation showed: (1) two patterns of natural helping for women, i.e. participation due to a specific health concern with either themselves or others in their personal networks, and participation due to a larger sense of the importance of health and prevention; (2) over time natural helpers expanded the diffusion of health promotion information from close network members to co-workers and were more likely to be approached by their co-workers for information; (3) group activities at the worksite, particularly around physical activity, increased over time; and (4) because of time constraints at the workplace, written materials were a major way of spreading information to co-workers. This study shows that women can be recruited and trained to diffuse health promotion information and provide support to co-workers for health behavior change.