Reviewing Models of Patient Advocacy: Current Successes and Future Directions for Applying Community Health Workers and Patient Advocates to Advance Health Equity

Introduction: Health equity interventions aim to mitigate health inequities with evidence-based approaches. Patient advocacy is one such approach, and its goal is to empower patients to make informed decisions about how they engage their health care with support from a liaison between the health care team and the patient. While nurses have predominantly held this role, community health workers (CHWs) and patient peer advocates (PPAs) are also now being used as patient advocates to help lead patient-centered interventions. Studies have demonstrated that both CHWs and PPAs can benefit patient outcomes. Methods: In this article, we compare these two types of patient advocacy models and suggest that the differences between them may make them particularly useful for addressing different barriers to care among patients. We briefly review studies looking at the strengths of these two types of advocacy models and describe the only article we identified comparing the use of CHWs with PPAs, although even this was among differing intervention designs. Implications for Future Research: It is important for research to begin comparing the efficacy of these two models among congruent interventions to unveil which type of patient advocate has the strongest impact in alleviating particular barriers to care and enhancing patient health outcomes. By identifying the most efficacious type of patient advocate across different roles and settings, interventions will hopefully be better informed and more effective in achieving health equity.