DESCRIPTION: This is a study of the effectiveness of a Lay Health Advisor (LHA) model of health promotion and intervention in a Native American (NA) community facing an environmental lead problem. Investigators from the University of Oklahoma (UOK) propose to work with the Quapaw Tribe and a newly established community advisory group (comprising 8 NA tribes and representatives from the Indian Health Service, State Departments of Health and Environmental Quality, and Ottawa County Health Departmentto do the following: (1) reduce the prevalence of Elevated Blood Levels (EBLs) in Native American kids, (2) induce behavior changes in caregivers to reduce lead exposure and absorption, (3) increase blood lead screening and follow-up for affected kids, and (4) build the capacity of the NA community to address this health problem. Forty NA LHAs will be trained bythe Health Department and Univ. of Oklahoma to engage in outreach and education activities in Ottawa county, an area of the state which was heavily mined for zinc and lead in the first half of this century. A non-equivalent comparison group design is used to study the effectiveness of the LHA model at the individual, network, organizational and community levels. NA and White kids will be studied; only the NA group, however, will receive the treatment. Blood lead level data will be collected on 300 randomly selected NA and 300 non-Hispanic white kids in year 1, and a second sample of 300 NA and 300 white kids in year 4. Four assessment teams, each consisting of a pediatric phlebotomist and a community health worker, will visit study homes, administer caregiver questionnaires, and collect blood samples in years 1 and 4. Additionally, an environmental assessment team will measure, in year 1, the amount of lead paint and collect environmental samples from a subset of study homes.