Abstract: PO1739
Experiences of Participants of a Dietary Intervention Trial for African Americans with Hypertension and CKD
Session Information
- Health Maintenance, Nutrition, and Metabolism
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
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.
| Themes | Representative 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