Hypertension
Conditions
Keywords
Digital Health, Health Behavior, Nutrition, Hypertension, Food Access
Brief summary
A total of 65 participants with hypertension and low access to high quality food will be enrolled to test the feasibility of using commercially available grocery delivery services, simultaneous to a robust behavioral intervention, to improve adherence to the Dietary Approaches to Stop Hypertension (DASH) eating pattern. The behavioral intervention will include skills training, nutrient goal setting, self-monitoring via dietary tracking, personalized text message feedback, and adaptive health coaching. Participants will also receive a membership to Instacart+ and weekly grocery list recommendations from a health coach. The primary outcome will be indicators of feasibility, including acceptability, demand, implementation and practicality and adaption. Change in DASH adherence and blood pressure will also be evaluated. The intervention period for participants will be 4 months.
Interventions
BEHAVIORALAccess Nourish
A total of 65 participants with hypertension and low access to high quality food will be enrolled to test the feasibility of using commercially available grocery delivery services, simultaneous to a robust behavioral intervention, to improve adherence to the DASH eating pattern. The behavioral intervention will include skills training, nutrient goal setting, self-monitoring via dietary tracking, personalized text message feedback, and adaptive health coaching. Participants will also receive a membership to Instacart+ and weekly grocery list recommendations from a health coach. Participants will be able to complete all intervention components via smartphone. The intervention period for participants will be 4 months.
Sponsors
Johns Hopkins University
National Institute of Nursing Research (NINR)
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult 18 years of age or older * Has hypertension, defined as a systolic BP of 130-159 mmHg and/or diastolic BP of 80-99 mmHg, whether or not taking hypertension medication. * Resides in a census tract defined as low access by the United States Department of Agriculture (USDA) * Resides in a zip code serviced by the grocery delivery app * BMI 18.5 kg/m2+ * Has a smartphone with a data plan * Willing to receive daily text messages * Can participate in online videoconference visits * Can read and write in English
Exclusion criteria
* Participating in another related research study * Cardiovascular disease event in the last 6 months * Active cancer * Recent hospitalization due to psychiatric condition or event * Pregnancy or planned during the study period * BMI 37 kg/m2 or higher * Documented dementia * On kidney dialysis * Instructed to eat a low potassium diet * Planned or recent bariatric surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility as assessed by survey | 4 months | Feasibility will be measured by a 23-item questionnaire used to assess participants' perceptions of the feasibility, usability, acceptability, practicality, and satisfaction with the intervention. Each item is rated on a 5-point Likert scale, with higher scores indicating greater feasibility and acceptability. The survey evaluates key components of the program, including grocery lists, grocery delivery, health coaching, and app-based tracking. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in DASH Score as assessed by the Automated Self-Administered 24-hour (ASA24) | Baseline and 4 months | Participants will enter dietary intake online via the National Cancer Institute's Automated Self-Administered 24-hour (ASA24) Dietary Assessment tool. DASH dietary nutrients are then converted into a score. Scores ranged from 0 to 9 where a higher score indicates better adherence to the DASH dietary pattern. Change in DASH score = 4-month DASH score - Baseline DASH score. |
| Change in Systolic Blood Pressure | Baseline and 4 months | Systolic blood pressure will be measured in millimeters of mercury (mmHg) using the upper arm three times at 1-minute intervals after 5 minutes of quiet sitting. The final 2 measurements will be averaged together for analysis. Change in systolic blood pressure = 4-month systolic blood pressure - Baseline systolic blood pressure. |
| Change in Diastolic Blood Pressure | Baseline and 4 months | Diastolic blood pressure will be measured in millimeters of mercury (mmHg) using the upper arm three times at 1-minute intervals after 5 minutes of quiet sitting. The final 2 measurements will be averaged together for analysis. Change in diastolic blood pressure = 4-month diastolic blood pressure - Baseline diastolic blood pressure. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORHailey Miller, RN, PhD
Johns Hopkins University
PRINCIPAL_INVESTIGATORGary Bennett, PhD
Duke University
Outcome results
None listed