JMIR Publications

ABSTRACT

Background:

Population aging is a phenomenon worldwide, and a whole-of-society approach needs to be in place to support healthy aging. Recognizing the untapped potential in youth non-healthcare volunteers, HealthStart empowered this group of volunteers to perform health coaching through a structured training program built upon a strong conceptual framework to be equipped with skills to help participants who have gone through health screening to increase ownership of their health and knowledge of their own health conditions.

Objective:

Through HealthStart, we hope to enrich the field of knowledge by harnessing the ability of non-healthcare volunteers to promote health in the community. This article aims to share the theories underlying the conceptual framework, implementation of the program, and challenges faced in informing other health coaching programs involving non-healthcare volunteers.

Methods:

HealthStart is a self-determination theory-based intervention utilizing the SMART framework (Specific, Measurable, Achievable, Realistic, and Timely) for goal setting and an intergenerational service-learning approach. Each HealthStart group consists of one HCV and four nHCVs who commit for a period of three months. Participants are older adults 40 years and above participating in health screening programs. nHCVs support participants to (1) Learn about their chronic disease(s), (2) Learn at least one digital health application, (3) Enrollment with a Primary Care Provider, (4) Set a lifestyle goal and achieve it.

Results:

HealthStart had 192 participants. The mean age was 67 years and 100 (52.1%) were females. Most were of Chinese ethnicity, had completed primary or secondary school education, and resided in self-owned flats. Follow up rate with primary care increased from 42.7% (82/148) pre-program to 84.5% (125/148) post-program (χ2 = 43, p < 0.001). We recruited 58 HCVs, trained a total of 33 and deployed all of them. 149 nHCVs were recruited, 120 trained and 102 deployed. Eight nHCV (15%) were not deployed as they were deemed to be unsuitable during the summative assessment conducted during the training. The mean age of the HCVs was 37 years, 24 (72.7%) were female. Twenty-six were nurses, six were doctors, and the rest were allied health professionals. The mean age of the nHCVs who were deployed was 24 years, and 75 (73.5%) were female. Reflections included the importance of volunteer competency and selection criteria, tiering of participant intervention, tapping on community assets, adoption of a social prescription framework, importance of alignment with population health policies, and cultivating intergenerational relationships.

Conclusions:

HealthStart is possibly the first intergenerational layperson-led health coaching program described in the literature aimed at improving chronic disease management. We identified key lessons learned in the conceptualization and implementation of the program. We hope that these insights set a potential model for harnessing laypersons, an often underutilized asset, to promote health in the community. Clinical Trial: This project received approval from the SingHealth Centralised Institutional Review Board [CIRB Reference Numbers: 2022/2700 and 2023/2480]. All participants provided informed consent and were given a participant information sheet.