Cambodian boys' transitions into young adulthood: exploring the influence of societal and masculinity norms on young men's health.

A growing body of evidence focuses on the experiences of young men in low-income countries, including their health vulnerabilities. Much of this research has been conducted in sub-Saharan Africa, Asia and Latin America. Limited evidence exists on the norms influencing boys' transitions into young adulthood in Southeast Asia, and in Cambodia in particular. To help fill this gap, we conducted a comparative case study using participatory methods with 16-19-year-old young men in rural and urban Cambodia, and with the adults who intersect in their lives. Findings suggest that in line with their counterparts growing up elsewhere, Cambodian boys welcome becoming young men as a time of newly acquired adult roles and responsibilities, while some may experience growing up as a time of bodily change, burgeoning sexual feelings and limited sources of support and guidance. As a result, some may strive more intensely to conform to the alcohol use and violence modelled by the older men in their environments. Additional research is needed to better understand the vulnerabilities of boys' transition into young adulthood in Cambodia today, and how to prevent or reduce engagement with these more negative practices.

Advancing understanding of the sustainability of lay health advisor (LHA) programs for African-American women in community settings.

Lay health advisor (LHA) programs have made strong contributions towards the elimination of health disparities and are increasingly being implemented to promote health and prevent disease. Developed in collaboration with African-American survivors, the National Witness Project (NWP) is an evidence-based, community-led LHA program that improves cancer screening among African-American women. NWP has been successfully disseminated, replicated, and implemented nationally in over 40 sites in 22 states in diverse community settings, reaching over 15,000 women annually. We sought to advance understanding of barriers and facilitators to the long-term implementation and sustainability of LHA programs in community settings from the viewpoint of the LHAs, as well as the broader impact of the program on African-American communities and LHAs. In the context of a mixed-methods study, in-depth telephone interviews were conducted among 76 African-American LHAs at eight NWP sites at baseline and 12-18 months later, between 2010 and 2013. Qualitative data provides insight into inner and outer contextual factors (e.g., community partnerships, site leadership, funding), implementation processes (e.g., training), as well as characteristics of the intervention (e.g., perceived need and fit in African-American community) and LHAs (e.g., motivations, burnout) that are perceived to impact the continued implementation and sustainability of NWP. Factors at the contextual levels and related to motivations of LHAs are critical to the sustainability of LHA programs. We discuss how findings are used to inform (1) the development of the LHA Sustainability Framework and (2) strategies to support the continued implementation and sustainability of evidence-based LHA interventions in community settings.