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The Role of Health Coach in Teaching Nutrition

to Hypertension Patients.

Health Coach course

Submitted by: Jawaher Al-beshi

Supervised: Hussain Al-osary

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Introduction:

Hypertension is a common condition that leads to the global illness burden.

Hypertension is a gradual illness that affects the delicate capillary beds in

many organs, including the kidney, or can induce sudden blood artery rupture,

resulting in bleeding in tissues including the brain. It outranks obesity,

diabetes, and smoking as a leading cause of cardiovascular morbidity and

death (Aldiab et al., 2018).

In fact, HTN is the third leading cause of death in the world, and is

responsible for one in every eight deaths worldwide, with a mortality rate of

13% (World Health Organization, 2004). In addition, it is estimated that one-

third of the world’s population (1.5 billion people) will have HTN by 2025 as a

result of aging and increased obesity (Libby et al., 2018). Health coaching

intervention, which have been shown to have good impacts on patients'

adherence to medical therapy and blood pressure management, are essential

to reduce morbidity and death in our hypertensive population (Shannon et al.,

2017). Health coaching has been shown to be an economical and effective

way to enhance control of chronic conditions1, including hypertention

,diabetes and other risk factors for cardiovascular disease, asthma, and

chronic obstructive pulmonary disease ( Benzo et al.,2016).Furthermore, no

studies have evaluated the effectiveness of health coaching intervention in

modifying the diet for patients with hypertension in the Saudi Arabia.
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Objective:
The aim of this study is to evaluate effectiveness of health coaching

intervention in modifying the diet for patients with hypertension.

Research question:

Is there effect effectiveness of health coaching intervention in modifying the

diet for patients with hypertension?

Problem statement:

According to the American Heart Association, hypertension in adults is

defined as a blood pressure (BP) of more than 130 over 80 millimeters of

mercury (mmHg). Hypertension is becoming a global epidemic, affecting

about 1.13 billion people (Elbashir et al., 2020). With fast expansion,

economic development, population aging, changes in lifestyle, and traditional

food patterns, the prevalence of hypertension and prehypertension has grown

substantially. Hypertension was responsible for 13.5 percent of all premature

deaths (7.6 million), 54 percent of strokes, and 47 percent of ischemic heart

disease worldwide. Hypertension rates in Saudi Arabia ranged from 26.1

percent in the 30–70-year-old age group in 1995–2000 to 25.5 percent in the

15–64-year-old age group in 2005, according to reports. According to data

from 2010, hypertension is the major cause of mortality in Saudi Arabia

(Aldiab et al., 2018). Health coaching has several benefits for patients,

physicians, and resources, and it plays an important role in establishing

patient-doctor relationships, enhancing primary health care quality, boosting

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patient compliance with medical advice, and lowering health-care costs

( Elbashir et al., 2020)

Literature review:

With fast expansion, economic development, population aging, changes in

lifestyle, and traditional food patterns, the prevalence of hypertension and

prehypertension has grown substantially. Hypertension was responsible for

13.5 percent of all premature deaths (7.6 million), 54 percent of strokes, and

47 percent of ischemic heart disease worldwide. The Arab Region has the

highest prevalence of hypertension, at 46 percent of individuals aged 25 and

above, while the Americas have the lowest incidence, at 35 percent

(Ozoemena et al., 2019). Hypertension rates in Saudi Arabia ranged from

26.1 percent in the 30–70-year-old age group in 1995–2000 to 25.5 percent in

the 15–64-year-old age group in 2005, according to reports. According to data

from 2010, hypertension is the major cause of mortality in Saudi Arabia

(Aldiab et al., 2018).

In a cross-sectional survey-based examination of 1,019 individuals in Saudi

Arabia, hypertension prevalence was found to be 6% in men, 4.2 percent in

females, and 4.9 percent in all respondents. According to a nationwide study

performed in the Kingdom of Saudi Arabia (KSA) with 10,735 participants,

15.2 percent and 40.6 percent of Saudis, respectively, were hypertension or

borderline hypertensive. The primary risk factors for hypertension in males

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were thought to be age, obesity, diabetes, and hypercholesterolemia

(Gutierrez, et al., 2018).

Methodology

Ethical Approval:

Ethical Approvals: Approvals to conduct this study will obtained from the

Institute Review Board the ------------------ and Ministry of Health in Saudi

Arabia. Also, For the participants who agreed to participate in the study,

consent forms along with an explanation of the study purpose will be given to

the participant to be signed prior to the data collection date. Also, participant

will be informed that they can withdraw from the study at any time.

Search Strategy

Many studies have been published in the last ten years. The effect of

health catching intervention and nutrition of hypertension patients, to get the

most relevant and recent studies in this filed. four databases PubMed, Google

scholar, CINAHL and Science direct, were searched. The search was limited to

studies published between 2015 through2021. Due to the variety of term,

used to health cotching, the following terms were used for this particular

search, Wellness coach, health coach, coaching, health behavior, health

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cotching, intervention hypertension disease, hypertension diet, hypertension

nutrition, and reference lists of some key articles also yielded related studies.

A total of 264 studies were found. All abstract was reviewed. In addition,

studies that did not have an abstract also were reviewed. The studies were

included in this review if they met the inclusion criteria P: (Adults (aged> 18

years) with chronic disease and hypertension, excluding mentally ill and

disabled people ,I: Health coaching by health care professional, C:

Physiological, behavioral, psychological and social outcomes, O: Original

empirical studies: randomized controlled trials or quasi-experimental studies

published during 2015-2021 in English), based on the research question and

PICO (the population (adults with hypertension disease, excluding the

mentally ill and disabled people), intervention (health coaching by neutrinos

for hypertension patients ), comparison of types of outcomes (healthy life

style, behavioral, psychological and social outcomes) and the study design

(randomized controlled trials or quasi-experimental studies published during

2015-2021 in English)). Studies were limited to those published from 2015 to

2021.

Inclusion criteria and study selection

The initial search process found a total of 264 studies. The systematic

selection process was conducted in three phases to minimize the risk of

errors and bias and to ensure that all relevant studies were included. At first,

duplicate publications (n = 20) within the four different databases were

excluded from the review to reduce publication bias. In addition, studies not

published in English (n = 45) were excluded because of a lack of translation.

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Then, potentially relevant studies (n = 135) were independently assessed by

the author by comparing the titles (n = 78) and abstracts (n = 150) against the

predetermined inclusion criteria. Finally, the full texts (n = 20) were read and

screened to check if they met the inclusion criteria. In all cases, consensus

between reviewers was reached by discussion. ten studies were included in

the review before they were quality assessed.

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References:

Aldiab, A., Shubair, M. M., Al-Zahrani, J. M., Aldossari, K. K., Al-Ghamdi, S.,

Househ, M., Razzak, H. A., El-Metwally, A., & Jradi, H. (2018). Prevalence

of hypertension and prehypertension and its associated cardioembolic risk

factors; a population based cross-sectional study in Alkharj, Saudi Arabia.

BMC Public Health, 18(1). https://doi.org/10.1186/s12889-018-6216-9

Bodenheimer, T., Willard-Grace, R., & Ghorob, A. (2014). Expanding the Roles of

Medical Assistants. JAMA Internal Medicine, 174(7), 1025.

https://doi.org/10.1001/jamainternmed.2014.1319

Benzo, R., Vickers, K., Novotny, P. J., Tucker, S., Hoult, J., Neuenfeldt, P., Connett,

J., Lorig, K., & McEvoy, C. (2016). Health Coaching and Chronic Obstructive

Pulmonary Disease Rehospitalization. A Randomized Study. American

Journal of Respiratory and Critical Care Medicine, 194(6), 672–680.

https://doi.org/10.1164/rccm.201512-2503oc

Elbashir, B., Al-dkheel, M., Aldakheel, H., Aruwished, N., & Alodayani, N. (2020).

Hypertension in Saudi Arabia: Assessing Life Style and Attitudes.

International Journal of Translational Medical Research and Public Health,

4(1), 23–29. https://doi.org/10.21106/ijtmrph.112

Gutierrez, J., Alloubani, A., Mari, M., & Alzaatreh, M. (2018). Cardiovascular

Disease Risk Factors: Hypertension, Diabetes Mellitus and Obesity among

Tabuk Citizens in Saudi Arabia. The Open Cardiovascular Medicine Journal,

12(1), 41–49. https://doi.org/10.2174/1874192401812010041

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Libby P, Braunwald E. Systemic hypertension: mechanisms and diagnosis. In: Bonow

RO, Mann DL, Zipes DP, Libby P (eds). Braunwald’s Heart Disease: A

Textbook of Cardiovascular Medicine. Philadelphia, PA: Saunders Elsevier,

2018; 1027– 1048.

Ozoemena, E. L., Iweama, C. N., Agbaje, O. S., Umoke, P. C. I., Ene, O. C., Ofili, P.

C., Agu, B. N., Orisa, C. U., Agu, M., & Anthony, E. (2019). Effects of a

health education intervention on hypertension-related knowledge, prevention

and self-care practices in Nigerian retirees: a quasi-experimental study.

Archives of Public Health, 77(1). https://doi.org/10.1186/s13690-019-0349-x

Willard-Grace, R., Chen, E. H., Hessler, D., DeVore, D., Prado, C., Bodenheimer, T.,

& Thom, D. H. (2015). Health Coaching by Medical Assistants to Improve

Control of Diabetes, Hypertension, and Hyperlipidemia in Low-Income

Patients: A Randomized Controlled Trial. The Annals of Family

Medicine, 13(2), 130–138. https://doi.org/10.1370/afm.1768

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