The Feasibility of Recruiting and Training Lay Leaders During Real-World Program Delivery and Scale-up: The Case of Walk With Ease

Abstract

Introduction. To maximize limited resources, many health promotion programs are designed to be delivered by volunteer lay leaders. But this model poses challenges to implementation in real-world settings and barriers to successfully scaling-up programs. This study examines the current lay leader training model for Walk With Ease, a Centers for Disease Control and Prevention–funded evidence-based arthritis program delivered at-scale. Method. Recruited volunteers (n = 106) opted into free online or in-person training and agreed to deliver one Walk With Ease program within the following year—only 49%, however, did. Using logistic regression models and qualitative interviews, we explored predictors of volunteer delivery. Results. Volunteers had higher odds of delivering programs if they trained online (odds ratio [OR] = 9.04, 95% confidence interval [CI: 2.30, 48.36]), previously taught health programs (OR = 15.52, 95% CI [3.51, 103.55]) or trained in the second year of implementation (OR = 27.08, 95% CI [2.63, 415.78]). Qualitative findings underscored that successful volunteers were readied by their previous health education experience. Conclusions. While online training modes appear effective to prepare experienced volunteers, lay leaders required additional support. This calls into question whether lay-led delivery models are suitable for scaling-up programs with limited resources. Given the many lay-led health interventions for chronic disease self-management, investing in common training and infrastructures for lay leader development could advance the quality and sustainability of real-world program delivery.

An Integrative Review on the Feasibility and Acceptability of Delivering an Online Training and Mentoring Module to Volunteers Working in Community Organizations

“…Various ease of use (34,44), ease of understanding (34,44), acceptability of the workload or commitment (31,34), and perceptions of effectiveness in volunteer role (30).…”

“…Leadership/Mentorship Component. A mentorship or leadership component [e.g., a champion of the program or an experienced volunteer mentoring an incoming volunteer; (31,44)] promoted volunteers' participation in training.…”

“…A common barrier to feasibility was perceived lack of consideration for varying levels of technical literacy or computer skills (41,44,45). For instance, technical difficulties with the online platform meant that videos or other content loaded slowly and that the structure of the online program was overly complex (38,(43)(44)(45). The in-person design may not have been adapted sufficiently for online delivery (38).…”

“…Some volunteers felt clients had complex needs that they could not address sufficiently and that not all clients or recipients were amenable to volunteer support (31), indicating that some perception of insufficient training exists among volunteers trained online. Conte et al (44) also determined that those without a health education background typically sought out more resources than what was given to them. Given the six online training programs, all but one used video(s) as a means to convey educational content to the volunteers.…”

Extension Educators and Volunteer Leaders: Evaluation of Fitness Outcomes Among Participants in Community Strength Training Classes

“…The trend toward offering more web-based training may be suitable for some community-based programs, but effectiveness for exercise classes needs further evaluation. Program planners should carefully weigh costs and benefits of face-to-face vs. indirect training methods to determine the best strategy (63).…”