HW450 Unit 8 Coaching Progress Data Evaluation Example

Nine Points Down, Sleep Unchanged: A Unit 8 Evaluation of Twelve Weeks of Coaching Progress Data

[Student Name]

Purdue University Global

HW450: Applied Health Coaching

Unit 8 Progress Data Evaluation

[Instructor Name]

[Date]

The client, readings and logs are composite; the guidance and studies cited are real, and interpreting blood pressure for treatment remains her physician's role.

The Data and How It Was Collected

Each month Teresa did a full monitoring week, a reading every morning and every evening, at her physician's request, and in addition chose to take a morning reading most weekdays. Readings were averaged by week. Because any one reading can mislead, the two national associations behind the home monitoring statement advise basing judgments on averages of many home readings across several days (Shimbo et al., 2020). She logged steps from her phone, wine nights, home-prepared lunches and weekly stress and patience ratings. Sodium was estimated from three-day food records at weeks 0, 4, 8 and 12.

Results by Measure

Home blood pressure, weekly averages. Week 0: 137/87. Week 2: 135/86. Week 4: 134/86, including the week her mother fell. Week 6: 133/84. Week 8: 132/83. Week 10: 129/82. Week 12: 128/81. Over twelve weeks the systolic average fell by about 9 points and the diastolic by about 6.

Estimated sodium. About 3,800 milligrams a day at week 0, 3,300 at week 4, 2,700 at week 8 and 2,500 at week 12.

Steps. Weekly daily average about 3,500 at week 0, rising to about 6,800 at week 12, mostly from the after-dinner walks with her mother and two lunchtime walks.

Wine nights. Six a week at baseline; three a week from week 7 onward, mostly Friday and Saturday plus one weeknight.

Home-prepared lunches. Zero at baseline; three a week in most weeks after week 3, two in the week of her mother's fall.

Stress rating. 8 out of 10 at baseline, 7 at week 12.

Patience rating. Times she "snapped at Mom" fell from about five a week to about three.

Sleep. Still about six and a half broken hours.

The numbers she can control moved; the numbers her mother's illness controls did not.

Reading the Trends

The blood pressure averages moved steadily in one direction across twelve weeks, apart from a pause in the week of the fall, and the change began around the time sodium and steps changed. That timing is consistent with the strategies working, and the size of the change is in the range that sodium reduction and the DASH pattern produced in a controlled feeding trial (Sacks et al., 2001). But the data come from one person, measurement can drift, and other things changed too, including her sister's help from week 5. The evaluation therefore treats the trend as encouraging and the explanation as probable, not proven.

The national guideline's stage 1 band starts at 130 systolic or 80 diastolic and runs to just below 140 and 90 (Whelton et al., 2018). Her latest averages sit near the lower edge of that range. Whether that is enough to continue without medication is her physician's decision at the three-month visit, and the evaluation stops there.

What the Data Credit

The Sunday lunches and the after-dinner walks show the strongest link to the improving measures; both were maintained even in hard weeks. The porch tea ritual halved wine nights, though one weeknight glass persists.

What the Data Question

Stress and sleep barely changed. The strategies chosen for evenings reduced some load, but her mother still wakes at night, and the adult day program has a waiting list. Self-monitoring has been consistently linked to behavior change in weight-loss research (Burke et al., 2011), and Teresa's logs show that the behaviors she tracked changed while the ones she could not influence, sleep in particular, did not. Tracking alone cannot fix that.

What Will Change

1. Sleep and respite become the focus of session seven. Teresa will ask her mother's physician about her mother's night waking, and follow up weekly on the adult day program.

2. Stress support beyond coaching. I will mention the area agency on aging's caregiver support group, which meets Saturday mornings when her husband is home.

3. Keep what is working. No changes to lunches, walks or the tea ritual.

4. Prepare for the physician visit. Teresa will bring her weekly averages and logs, with three questions she wrote herself.

Sharing the Data

Teresa decided which data to share with her physician. She chose the weekly blood pressure averages, the sodium estimates and her step counts, and she wrote three questions: whether her readings were low enough to continue without medication, whether her home cuff needed checking against the clinic's and whether her mother's night waking could be treated. She chose not to share the patience rating, which she said was for herself. Respecting that choice keeps the data hers.

Limits

Readings were self-taken and self-reported, and her cuff has not been checked against the clinic's. Food records estimate sodium roughly. Twelve weeks is short.

Conclusion

Twelve weeks of data show Teresa's sodium falling, her steps nearly doubling, her wine nights halving and her home blood pressure averages declining by about 9 systolic and 6 diastolic points, a pattern consistent with her strategies working. Sleep and stress, driven by her mother's illness, did not move, so the next sessions turn to respite and support, and her physician will judge her readings at the recheck.

References

Burke, L. E., Wang, J., & Sevick, M. A. (2011). Self-monitoring in weight loss: A systematic review of the literature. Journal of the American Dietetic Association, 111(1), 92-102. https://doi.org/10.1016/j.jada.2010.10.008

Sacks, F. M., Svetkey, L. P., Vollmer, W. M., Appel, L. J., Bray, G. A., Harsha, D., Obarzanek, E., Conlin, P. R., Miller, E. R., III, Simons-Morton, D. G., Karanja, N., & Lin, P.-H. (2001). Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. New England Journal of Medicine, 344(1), 3-10. https://doi.org/10.1056/NEJM200101043440101

Shimbo, D., Artinian, N. T., Basile, J. N., Krakoff, L. R., Margolis, K. L., Rakotz, M. K., & Wozniak, G. (2020). Self-measured blood pressure monitoring at home: A joint policy statement from the American Heart Association and American Medical Association. Circulation, 142(4), e42-e63. https://doi.org/10.1161/CIR.0000000000000803

Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Jr., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Jr., Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., Sr., ... Wright, J. T., Jr. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Hypertension, 71(6), e13-e115. https://doi.org/10.1161/HYP.0000000000000065