Related Experiment Video
Updated: Apr 5, 2026

Virtual Agent for Real-Time Motivational Interviewing by Integrating Adaptive Nonverbal Behavior and Language Models
Published on: December 23, 2025
Are Low-Income Peer Health Coaches Able to Master and Utilize Evidence-Based Health Coaching?
Matthew L Goldman1, Amireh Ghorob1, Danielle Hessler1
1Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California.
Purpose:
A randomized controlled trial found that patients with diabetes had lower HbA1c levels after 6 months of peer health coaching than patients who did not receive coaching. This paper explores whether the peer coaches in that trial, all low-income patients with diabetes, mastered and utilized an evidence-based health coaching training curriculum. The curriculum included 5 core features: ask-tell-ask, closing the loop, know your numbers, behavior-change action plans, and medication adherence counseling.
Methods:
This paper includes the results of exams administered to trainees, exit surveys performed with peer coaches who completed the study and those who dropped out, observations of peer coaches meeting with patients, and analysis of in-depth interviews with peer coaches who completed the study.
Results:
Of the 32 peer coach trainees who completed the training, 71.9% lacked a college degree; 25.0% did not graduate from high school. The 26 trainees who passed the exams attended 92.7% of training sessions compared with 80.6% for the 6 trainees who did not pass. Peer coaches who completed the study wanted to continue peer coaching work and had confidence in their abilities despite their not consistently employing the coaching techniques with their patients. Quotations describe coaches' perceptions of the training.
Conclusions:
Of low-income patients with diabetes who completed the evidenced-based health coaching training, 81% passed written and oral exams and became effective peer health coaches, although they did not consistently use the techniques taught.
Related Concept Videos
Models of Health Promotion and Illness Prevention II
The agent-host-environment model states that disease results...
Levels of Health Promotion and Illness Prevention
In primary prevention, actions taken before disease onset prevent the disease from...
Models of Health Promotion and Illness Prevention I
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
Health Literacy
Self-Help Support Groups
Accessibility and Cost-Effectiveness
One of the primary strengths of self-help...
Community Based Intervention
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...

