Investigating the effect of an mHealth coaching intervention on health beliefs, adherence and blood pressure of patients with hypertension: A longitudinal single group pilot study

Abstract

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.