TY - JOUR
T1 - Investigating the effect of an mHealth coaching intervention on health beliefs, adherence and blood pressure of patients with hypertension
T2 - A longitudinal single group pilot study
AU - Zahed, Karim
AU - Markert, Carl
AU - Dunn, Patrick
AU - Sasangohar, Farzan
N1 - Funding Information:
The study was developed in conjunction with the American Heart Association Center for Health Technology & Innovation and utilizing coaching material developed as part of the American Heart Association's 12-week hypertension CarePlan. The authors would also like to thank Jacob M. Kolman, MA, ISMPP CMPP, of Houston Methodist and Texas A&M University, for his critical review, editing and formatting assistance. This work was sponsored by the National Science Foundation Engineering Research Center: Precise Advanced Technologies and Health Systems focused on Underserved Communities (PATHS-UP).
Funding Information:
This work was sponsored by the National Science Foundation Engineering Research Center: Precise Advanced Technologies and Health Systems focused on Underserved Communities (PATHS-UP).
Publisher Copyright:
© The Author(s) 2023.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - BACKGROUND: Mobile health technologies have shown promise as delivery platforms for digital health coaching for chronic conditions. However, the impacts of such strategies on users' health beliefs, intentions and ultimately clinical outcomes are understudied.OBJECTIVE: This study sought (1) to evaluate the effects of a digital health coaching intervention on participants' belief constructs; and (2) to assess relationships between these belief constructs and intentions to utilize the technological intervention, actual adherence metrics and clinical outcomes related to hypertension.METHODS: Thirty-four participants with hypertension were recruited from a university community from January to May 2021. They self-measured weight and blood pressure (BP) for 30 days followed by digital coaching delivered via a mobile application for 30 days. Surveys assessed constructs from the Health Belief Model and Technology Acceptance Model, compared to intention, health belief, BP self-monitoring adherence and BP outcomes. A path analysis model was used to assess the relationships between constructs and intention, adherence metrics and clinical outcomes. A Kruskal-Wallis test was used to identify changes in beliefs.RESULTS: Participant health beliefs significantly improved after coaching, including
self-efficacy (
H(1) = 15.12,
p < 0.001),
cues to action (
H(1) = 5.33,
p =
0.02),
attitude (
H(1) = 10.35,
p = 0.002),
perceived usefulness (
H(1) = 15.02,
p < 0.001) and decreased
resistance to change (
H(1) = 4.05,
p = 0.04). Adherence to BP measurements positively correlated with
perceived health threat (
β = .033,
p = 0.007) and
perceived ease of use (
β = .0277,
p < 0.001).
Self-efficacy (
β = -2.92,
p = 0.02) and
perceived usefulness (
β = -3.75,
p = 0.01) were linked with a decrease in diastolic BP.
CONCLUSIONS: A mobile health coaching intervention may help participants improve beliefs regarding hypertension self-management.
AB - BACKGROUND: Mobile health technologies have shown promise as delivery platforms for digital health coaching for chronic conditions. However, the impacts of such strategies on users' health beliefs, intentions and ultimately clinical outcomes are understudied.OBJECTIVE: This study sought (1) to evaluate the effects of a digital health coaching intervention on participants' belief constructs; and (2) to assess relationships between these belief constructs and intentions to utilize the technological intervention, actual adherence metrics and clinical outcomes related to hypertension.METHODS: Thirty-four participants with hypertension were recruited from a university community from January to May 2021. They self-measured weight and blood pressure (BP) for 30 days followed by digital coaching delivered via a mobile application for 30 days. Surveys assessed constructs from the Health Belief Model and Technology Acceptance Model, compared to intention, health belief, BP self-monitoring adherence and BP outcomes. A path analysis model was used to assess the relationships between constructs and intention, adherence metrics and clinical outcomes. A Kruskal-Wallis test was used to identify changes in beliefs.RESULTS: Participant health beliefs significantly improved after coaching, including
self-efficacy (
H(1) = 15.12,
p < 0.001),
cues to action (
H(1) = 5.33,
p =
0.02),
attitude (
H(1) = 10.35,
p = 0.002),
perceived usefulness (
H(1) = 15.02,
p < 0.001) and decreased
resistance to change (
H(1) = 4.05,
p = 0.04). Adherence to BP measurements positively correlated with
perceived health threat (
β = .033,
p = 0.007) and
perceived ease of use (
β = .0277,
p < 0.001).
Self-efficacy (
β = -2.92,
p = 0.02) and
perceived usefulness (
β = -3.75,
p = 0.01) were linked with a decrease in diastolic BP.
CONCLUSIONS: A mobile health coaching intervention may help participants improve beliefs regarding hypertension self-management.
KW - digital coaching
KW - health belief model
KW - hypertension
KW - self-management
KW - technology acceptance model
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U2 - 10.1177/20552076231215904
DO - 10.1177/20552076231215904
M3 - Article
C2 - 38025096
AN - SCOPUS:85177458522
SN - 2055-2076
VL - 9
SP - 20552076231215904
JO - Digital Health
JF - Digital Health
ER -