Health Coaching on NexJ Connected Wellness Reduces Pre - Hypertension: A Population Health Study

Health Coaching on NexJ Connected Wellness Reduces Pre - Hypertension: A Population Health Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Health Coaching on NexJ Connected Wellness Reduces Pre - Hypertension: A Population Health Study Wayne Noah, Meysam Pirbaglou, Paul Ritvo This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6874753/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Hypertension affects millions worldwide, elevating stroke, and heart disease risks. While the transition from pre- to diagnosed hypertension can be prevented by lifestyle and pharmacological modifications, non-adherence to pharmacotherapy, physical activity, dietary, tobacco intake, alcohol intake, and stress reduction recommendations curtail this transition. Health coaching can function as an effective adjunct to primary-secondary medical care by increasing the adherence to lifestyle behaviors, pharmacotherapies. The objective of this paper is to evaluate the effectiveness of a multi-tier health coaching intervention, personalized for pre-hypertension involving three coaching intervention tiers of increasing intensity, assisted by a digital health platform. Methods Communities across Canada were recruited for Activate, a hypertension prevention program sponsored by the Heart and Stroke Foundation of Canada. Upon registration, participants were triaged to one of three coach intensity tiers based on self-reported adherence to physical activity, dietary, smoking, and stress management recommendations for hypertension prevention. Once triaged, they participated in a 6-month health coach intervention that included synchronous and asynchronous interactions with a personal health coach through NexJ Connected Wellness, a digital health platform. Participants were further provided with health education materials and the online tracking of health behaviors. Results Altogether, 4436 participants were recruited between May 2018 and January 2020. Results from 1113 participants (24% retention) demonstrated an overall mean reduction of 4.61mmHg in systolic blood pressure (SBP) from baseline with no difference between coaching intensity tiers. No significant between-tier differences were found in changes to blood pressure. 580 (52.1%) of participants demonstrated clinically-significant reductions (≥ 5 mmHg) in SBP. Conclusions A tiered approach that titrated coaching intensity according to participants’ adherence to lifestyle recommendations, demonstrated significant blood pressure reductions across different coaching tiers. Trial Registration ISRCTN26475151, Nov 28, 2025 Hypertension health coaching digital health remote monitoring behavior change disease prevention Full Text Additional Declarations Competing interest reported. NW is an employee and holds stock in NexJ Health, Inc. Supplementary Files ActivateOnboardingQuestionnaire.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6874753","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":559893951,"identity":"a7dbd226-8809-4ebd-b873-47e84d6307d7","order_by":0,"name":"Wayne 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NW is an employee and holds stock in NexJ Health, Inc.","formattedTitle":"Health Coaching on NexJ Connected Wellness Reduces Pre - Hypertension: A Population Health Study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Hypertension, health coaching, digital health, remote monitoring, behavior change, disease prevention","lastPublishedDoi":"10.21203/rs.3.rs-6874753/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6874753/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e \u003cp\u003eHypertension affects millions worldwide, elevating stroke, and heart disease risks. While the transition from pre- to diagnosed hypertension can be prevented by lifestyle and pharmacological modifications, non-adherence to pharmacotherapy, physical activity, dietary, tobacco intake, alcohol intake, and stress reduction recommendations curtail this transition. Health coaching can function as an effective adjunct to primary-secondary medical care by increasing the adherence to lifestyle behaviors, pharmacotherapies. The objective of this paper is to evaluate the effectiveness of a multi-tier health coaching intervention, personalized for pre-hypertension involving three coaching intervention tiers of increasing intensity, assisted by a digital health platform.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eCommunities across Canada were recruited for Activate, a hypertension prevention program sponsored by the Heart and Stroke Foundation of Canada. Upon registration, participants were triaged to one of three coach intensity tiers based on self-reported adherence to physical activity, dietary, smoking, and stress management recommendations for hypertension prevention. Once triaged, they participated in a 6-month health coach intervention that included synchronous and asynchronous interactions with a personal health coach through NexJ Connected Wellness, a digital health platform. Participants were further provided with health education materials and the online tracking of health behaviors.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAltogether, 4436 participants were recruited between May 2018 and January 2020. Results from 1113 participants (24% retention) demonstrated an overall mean reduction of 4.61mmHg in systolic blood pressure (SBP) from baseline with no difference between coaching intensity tiers. No significant between-tier differences were found in changes to blood pressure. 580 (52.1%) of participants demonstrated clinically-significant reductions (\u0026ge;\u0026thinsp;5 mmHg) in SBP.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003e A tiered approach that titrated coaching intensity according to participants\u0026rsquo; adherence to lifestyle recommendations, demonstrated significant blood pressure reductions across different coaching tiers.\u003c/p\u003e\u003ch2\u003eTrial Registration\u003c/h2\u003e \u003cp\u003eISRCTN26475151, Nov 28, 2025\u003c/p\u003e","manuscriptTitle":"Health Coaching on NexJ Connected Wellness Reduces Pre - Hypertension: A Population Health Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-16 16:33:13","doi":"10.21203/rs.3.rs-6874753/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"44f28fd9-b3ac-4ba3-bb21-674496bd49ad","owner":[],"postedDate":"December 16th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-08T14:33:50+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-16 16:33:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6874753","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6874753","identity":"rs-6874753","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}