Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 20, 2025
Open Peer Review Period: Apr 21, 2025 - Jun 16, 2025
Date Accepted: Oct 31, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Full Title: The impact of lay volunteers on community health screening program outcomes for older adults: A mixed-methods evaluation Short Title: Impact of lay volunteers in community health
ABSTRACT
Objectives: Community health screening programs frequently report inconsistent follow-up rates and barriers to sustained lifestyle changes. This study evaluated the HealthStart program, a layperson-led intergenerational health coaching program that aims to improve health screening follow-up, chronic disease understanding and ownership, digital health application adoption and sustained lifestyle changes.
Methods:
HealthStart is a self-determination theory-based intervention that aims to increase the autonomy and competence of participants via volunteer engagement, health coaching, and post-health screening follow-up. Lay volunteers (LVs) were taught principles of motivational interviewing, health coaching and social determinants of health via a training model anchored on principles of intergenerational and service learning. LVs act as health advocates through the participants’ journeys under the guidance of healthcare volunteers. Convergent parallel mixed-methods analysis was employed. A total of 192 participants’ quantitative data were collected through pre- and post-program surveys. Qualitative data were obtained from 36 semi-structured interviews analyzed through thematic analysis.
Results:
The follow-up rate among primary care providers increased significantly from 42.7% to 84.5% (χ2=43, p<0.001). A total of 66.2% (92/139) of the participants achieved their health goals, and 81.3% (113/139) reported satisfaction with the program. There was a statistically significant correlation (Z=2.44, p=0.015) between participant health goal attainment and the number of follow-up visits and between post-cycle participant eHealth literacy scale (eHEALS) scores and the number of follow-up visits (F(2,130)=6.06, p=0.003). The qualitative findings highlighted LVs’ crucial role in facilitating health conversations, promoting lifestyle changes, and building meaningful connections in catalyzing lifestyle changes in the participants. While the training adequately prepared LVs for these tasks, some encountered challenges with participants resistant to change or with complex needs. Conclusion: HealthStart demonstrated the feasibility and impact of using laypersons in the community to increase follow-up rates and promote healthier lifestyles among older adults.
Citation
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Copyright
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