Community as Medicine: A Qualitative Study of How Group Health Coaching and Social Connection Improve Mental Well-Being in Older Adults

Abstract

BACKGROUND/OBJECTIVES: (CAM) program is an evidence-based, community-delivered, clinically integrated program that combines trauma-informed, culturally-relevant, experiential group health coaching with social connection to improve mental and physical well-being. This qualitative study, conducted in early 2025, examined how participation in CAM supports mental well-being among older adults (age 65+) in under-resourced communities who are managing chronic physical and mental health challenges. METHODS: Semi-structured interviews were conducted with participants who completed CAM. Transcripts were analyzed using reflexive thematic analysis to explore relational and experiential processes associated with improved well-being. FINDINGS: Participants entered CAM with internalized ageist beliefs and low expectations for personal change. As they engaged in new behaviors, experienced successes, and observed similar progress among peers, they gained motivation, confidence, and a sense of control. Four interconnected themes appear to explain the mechanisms through which CAM supports mental well-being: (1) belonging and inclusion through trust and safety; (2) personal accountability through relational accountability; (3) self-efficacy through social learning and reciprocal support; and (4) agency through positive actions. CONCLUSIONS: Findings suggest that CAM supports mental well-being by creating conditions that help older adults overcome internalized ageism and feel connected, capable, and in control of their lives. These results identify actionable strategies that community organizations and health systems can adapt to support mental well-being for older adults in under-resourced communities.

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