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Abstract: PO1739

Experiences of Participants of a Dietary Intervention Trial for African Americans with Hypertension and CKD

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Brown, Kristal Lyn, Johns Hopkins University, Baltimore, Maryland, United States
  • Lou, Sophia, Johns Hopkins University, Baltimore, Maryland, United States
  • Stephens, Mary Ann Chutuape, Johns Hopkins University, Baltimore, Maryland, United States
  • Zhou, Zehui, Johns Hopkins University, Baltimore, Maryland, United States
  • Sheikh, Tahiyat, Johns Hopkins University, Baltimore, Maryland, United States
  • Saint-Jean, Denise E., Johns Hopkins University, Baltimore, Maryland, United States
  • Omenyi, Chiazam, Johns Hopkins University, Baltimore, Maryland, United States
  • Brody, Rebecca, Johns Hopkins University, Baltimore, Maryland, United States
  • Miller, Edgar R., Johns Hopkins University, Baltimore, Maryland, United States
  • Crews, Deidra C., Johns Hopkins University, Baltimore, Maryland, United States

Group or Team Name

  • Five Plus Nuts and Beans for Kidneys Investigators
Background

African Americans are disproportionately affected by hypertension (HTN) and CKD and evidence suggests dietary modifications towards a more Dietary Approaches to Stop Hypertension (DASH)-accordant diet could improve outcomes for this population. We aimed to explicate barriers and facilitators of healthy eating, and the perceived benefits of the intervention among completed participants of a dietary intervention trial for African Americans with HTN and CKD. Participants were randomized to one of two groups: 1) Self-Shopping DASH (S-DASH) diet group with $30/week grocery allowance for 4 mo. but no specific guidance on purchases, followed by no food allowance for 8 mo.; or 2) Coaching DASH (C-DASH) diet advice group with a $30/week food allowance and assistance in purchasing foods for 4 mo., followed by intermittent coaching without food allowance for 8 mo.

Methods

We performed a content analysis of transcripts from semi-structured interviews with participants who completed the trial (13 C-DASH; 12 S-DASH were randomly selected). Thematic analyses followed 5 stages: 1) reading and rereading all transcripts and utilizing audio recordings as needed for clarity; 2) three coders reading two of the same transcripts, coding them, and comparing codes which were then used to create the initial coding framework; 3) defining codes, coding additional transcripts, discussing/revising the coding framework; 4) formulating initial themes and 5) diagramming relationships among initial themes to merge overlapping themes.

Results

Participants were a mean age of 62 ± 9.3 years, 36% were male. Key themes included healthy diet facilitators (food tracking, motivation, social support, and perception of healthy foods); barriers (transportation, past eating habits, stress and COVID mitigation); and impact of the trial on knowledge and health.

Conclusion

Participants of a dietary intervention trial for African Americans with HTN and CKD identified several facilitators and barriers to healthy eating that could inform future efforts to address disease burden in this population.

ThemesRepresentative Quotes
Healthy Diet Facilitators[in reference to materials from the study and grocery allowance] made it easier, I guess, with both phases of it, with giving me all the feedback and stuff like that. You all would give me feedback like doing a good job, keep up the good work, you know, positive reinforcement, whatever you call it. All that made a big difference. (S-DASH)

[in reference to support system and ability to eat healthy] Well, like my daughter, she would help, she would go get the foods for me, pick the foods up for me when I couldn't get there. So, she would make sure that, you know, if I couldn't get there, she made sure I would get the foods and get them to me. And she followed me, once I started eating more fruits and vegetables, she started eating more, you know. (C-DASH)
Healthy Diet Barriers[in reference to things that were difficult to change] … because fresh vegetables are more expensive than canned vegetables. So that was a -- that was another kind of hurdle that I kind of really didn’t follow. (S-DASH)

[in reference to grocery shopping options and if shopping behaviors changed in the study] And we had a—where I live at now, we had, like, a farmer's market that would come every week as well, but when COVID came, they don't come anymore. (C-DASH)
Impact of Trial on Knowledge and Health [in reference to how study affected health] Well, it—like I said, it helped me control my pressure a little bit. It's making me more aware and pay attention to my labs plus it's helping me maintain my weight." (C-DASH)

[in reference to eating changes since being in the study] And they told me to watch, I started watching my labels as far as the sodium and stuff. (S-DASH)

Funding

  • Other NIH Support