Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Special Issue: Current evidence and perspectives for hypertension management in Asia
  • Published:

The effect of health coaching on blood pressure control and disease self-management among patients in rural area in China: a randomized controlled trial

Hypertension Research volume 47, pages 1184–1195 (2024)Cite this article

A Comment to this article was published on 15 February 2024

Abstract

The self-management education for patients with hypertension has not been widely provided in rural areas of China. Our study aimed to examine the effect of health coaching intervention on controlling BP and improving self-management skills among rural resident of ≤6 month-history of hypertension. A total of 102 participants were enrolled in the RCT. The control group received usual health guidance and follow-up management; the experimental group received health coaching and follow up management. The primary outcomes were the difference in changes of BP and mean self-management scores. The secondary outcomes included waist circumference, body mass index (BMI), and medication literacy. Participants in the experimental group showed a significantly greater improvement with respect to systolic BP and diastolic BP respectively (133.85 ± 4.74 mmHg vs 127.96 ± 5.42 mmHg;80.94 ± 5.52 mmHg vs 77.37 ± 4.44 mmHg, P < 0.05) and BMI (24.66 ± 2.19 kg/m2 vs 23.44 ± 2.05 kg/m2, P < 0.05) compared with the control group. A significant difference was also observed between the experimental and control groups in terms of self-management and medication literacy at both 3 and 6 months (P < 0.05). However, there was no significant difference in changes of waist circumferences between the two groups (22.6% vs 38.8%). In conclusion, for patients with diagnosed with hypertension within the last 6 months, health coaching maybe is an effective approach to control blood pressure and improve medication literacy and self-management skills.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Cao ZX. Analysis of hypertension prevalence and related influencing factors in a community based on health management. Ji Lin University, China. 2018.

  2. Wang ZW, Chen Z, Zhang LF, Wang X, Hao G, Zhang ZG. Status of Hypertension in China: Results from the China Hypertension Survey, 2012-2015. Circulation. 2018;137:2344–56.

    Article  PubMed  Google Scholar 

  3. Zhang M, Wu J, Zhang X, Hu CH, Zhao ZP, Li C, et al. Prevalence and control of hypertension in adults in China, 2018. Zhonghua Liu Xing Bing Xue Za Zhi. 2021;42:1780–9.

    CAS  PubMed  Google Scholar 

  4. Hu GQ. Epidemiological investigation and analysis of hypertension in rural population of Shuocheng district correlation between RDW and mortality in CCU patients. Shanxi Medical University, China. 2021.

  5. Olsen JM. Health coaching: a concept analysis. Nurs Forum. 2014;49:18–29.

    Article  PubMed  Google Scholar 

  6. Park YH, Chang H. Effect of a health coaching self-management program for older adults with multimorbidity in nursing homes. Patient Prefer Adher. 2014;8:959–70.

    Google Scholar 

  7. Lozano P, Houtrow A. Supporting self-management in children and adolescents with complex chronic conditions. Pediatrics. 2018;141:S233–41.

    Article  PubMed  Google Scholar 

  8. Jin YL. Application of health coaching on patients with primary hypertension in community. Shanxi Medical University, China. 2020.

  9. Duan YL, Zhong ZQ, Ding SQ, Zheng F. Effect of health coaching on rehabilitation efficacy in patients with coronary heart disease. Mod Med J China. 2020;22:6–11.

    Google Scholar 

  10. Pamungkas RA, Chamroonsawasdi K, Charupoonphol P, Vatanasomboon P. A health-based coaching program for diabetes self-management (DSM) practice: A sequential exploratory mixed-method approach. Endocrinol Diabetes Nutr. 2021;68:489–500.

    Article  Google Scholar 

  11. Sua YS, Jiang Y, Thompson DR, Wang W. Effectiveness of mobile phone-based self-management interventions for medication adherence and change in blood pressure in patients with coronary heart disease: a systematic review and meta-analysis. Eur J Cardiovasc Nurs. 2020;19:192–200.

    Article  PubMed  Google Scholar 

  12. Sidhu MS, Daley A, Jordan R, Sidhu MS, Daley A, Jordan R, et al. Patient self-management in primary care patients with mild COPD—protocol of a randomised controlled trial of telephone health coaching. BMC Pulm Med. 2015;15:16.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Sharma AE, Willard-Grace R, Hessler D, Bodenheimer T, Thom DH. What happens after health coaching? Observational study 1 year following a randomized controlled trial. Ann Fam Med. 2016;14:200–7.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Margolius D, Bodenheimer T, Bennett H, Wong J, Ngo V, Padilla G, et al. Health coaching to improve hypertension treatment in a low-income, minority population. Annu Fam Med. 2012;10:199–205.

    Article  Google Scholar 

  15. Geest SD, Ruppar T, Berben L, Sandra S, Hill MN. Medication non-adherence as a critical factor in the management of presumed resistant hypertension: a narrative review. Eur Interv. 2014;9:1102–9.

    Google Scholar 

  16. Ma L, Wang FL, Li YC, Bi LL. Application of health coaching in self-management of hypertensive patients. Chin Gen Pract. 2020;23:2462–6.

    Google Scholar 

  17. Hou JW, Yang XF, Jiang JP, Li Y, Fan YY, Li LH. Research progress of health coaching and its enlightenment to China chronic disease nursing. J Mudanjiang Med Univ. 2020;41:151–3.

    Google Scholar 

  18. National Basic Public Health Service Hypertension Management Office, Grassroots Hypertension Management Expert Committee. National Guidelines for prevention and management of primary hypertension. Chin Circ J. 2017;32:1041–8.

  19. Liu N, Zhang JG, Yu XF. Development and testing of reliability and validity of self-management scale for patients with hypertension. Chin Nurs Res. 2015;29:1764–7.

    Google Scholar 

  20. Chinese Nutrition Society Obesity Prevention and Control Section. Expert consensus on obesity prevention and treatment in China. Chin J Epidemiol. 2022;43:619–31.

    Google Scholar 

  21. Sauceda JA, Loya AM, Sias JJ, Taylor T, Wiebe JS, Rivera JO. Medication literacy in Spanish and English: psychometric evaluation of a new assessment tool. J Am Pharm Assoc (2003). 2012;52:e231–40.

    Article  PubMed  Google Scholar 

  22. Shi SJ, Shen ZY, Duan YL, Ding SQ, Zhong ZQ. Association between medication literacy and medication adherence among patients with hypertension. Front Pharm. 2019;10:822.

    Article  Google Scholar 

  23. Li WW, Lew D, Quach L. Efficacy of a culturally and linguistically competent community health coach intervention for Chinese with hypertension. Asian Pac Isl Nurs J. 2020;5:111–9.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Ma L. Application of health coaching in self-management of hypertension patients. Xinxiang Medical University, China, 2019.

  25. Gu DF, Weng JP, Lu XF. Chinese guideline on healthy lifestyle to prevent cardiometabolic diseases. Chin Circ J. 2020;35:209–30.

    Google Scholar 

  26. Fletcher BR, Hartmann-Boyce J, Hinton L, Richard JM. The effect of self-monitoring of blood pressure on medication adherence and lifestyle factors: a systematic review and meta-analysis. Am J Hypertens. 2015;28:1209–21.

    Article  PubMed  Google Scholar 

  27. Wei HW, Tan J, Wang LQ, Yang KX, Wang Y. Research progress on treatment compliance of patients with hypertension. Chin J Urban Rural Enterp Hyg. 2021;36:55–7.

    Google Scholar 

  28. Thom DH, Willard-Grace R, Danielle H, Denise D, Prado C, Ellen C, et al. The impact of health coaching on medication adherence in patients with poorly controlled diabetes, hypertension, and/or hyperlipidemia: a randomized controlled trial. J Am Board Fam Med. 2015;28:38–45.

    Article  PubMed  Google Scholar 

  29. Yin R, Yin L, Li L, Silva-Nash J, Tan J, Pan Z, et al. Hypertension in China: burdens, guidelines and policy responses: a state-of-the-art review. J Hum Hypertens. 2022;36:126–34.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We thank all the staff of the cardiology department, hypertension wards and hospital outpatient clinic of hospital in supporting of this study. Meanwhile, we acknowledge all the researchers involved in this study who have made this trial possible. Furthermore, we also thank all patients for their participation. The study was approved by the ethics review of the Ethics Review Committee of the Third Xiangya Hospital of Central South University (the reference number 20001). Trial Registration number: ChiCTR2100048430. https://www.chictr.org.cn/showproj.aspx?proj=119541

Funding

This work was supported by the Chia Family Foundation Health Fellowship Program of Yale-China Association [grant numbers 2019-2022]; National Natural Science Foundation of China [grant number 72104251]; Natural Science Research Project for Anhui Universities [grant numbers 2023AH050761].

Author information

Authors and Affiliations

  1. Nursing Department, The Third Xiangya Hospital, Central South University, No.138 Tongzipo Road, Yuelu District, Changsha, 410013, China

    Li Qiao, Yinglong Duan, Zhuqing Zhong, Siqing Ding, Qiuxiang Zhang & Feng Zheng

  2. College of Nursing, Anhui University of Chinese Medicine, Hefei, 230012, China

    Li Qiao

  3. Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, No.138 Tongzipo Road, Yuelu District, Changsha, 410013, China

    Jingle Li & Feng Zheng

  4. School of Nursing, Yale University, 400 West Campus, Orange, CT, 06477, USA

    Soohyun Nam

  5. Department of Emergency and Critical Care Medicine, The Third Xiangya Hospital, Central South University, No.138 Tongzipo Road, Yuelu District, Changsha, 410013, China

    Yinglong Duan

  6. Xiangya School of Nursing, Central South University, Changsha, 410013, China

    Ling Cheng

Authors
  1. Li Qiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jingle Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Soohyun Nam
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yinglong Duan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ling Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zhuqing Zhong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Siqing Ding
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Qiuxiang Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Feng Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

LQ and FZ had access to all data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. LQ, FZ, and JL implemented the intervention; YD was responsible for the guidance of intervention technology; LC and QZ were responsible for collecting the data; LQ was responsible for data analysis and draft of the manuscript; SN and FZ were responsible for critical revision of manuscript for important intellectual content; ZZ and SD were responsible for administrative and material support; FZ were responsible for study supervision.

Corresponding author

Correspondence to Feng Zheng.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Qiao, L., Li, J., Nam, S. et al. The effect of health coaching on blood pressure control and disease self-management among patients in rural area in China: a randomized controlled trial. Hypertens Res 47, 1184–1195 (2024). https://doi.org/10.1038/s41440-023-01550-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41440-023-01550-1

Keywords

This article is cited by

Search

Advanced search

Quick links