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Kidney Week

Abstract: PO1740

Barriers and Facilitators to DASH Diet Adherence Among Black Adults with CKD: A Qualitative Study

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Tyson, Crystal C., Duke University School of Medicine, Durham, North Carolina, United States
  • Svetkey, Laura P., Duke University School of Medicine, Durham, North Carolina, United States
  • Granados, Isa, Duke University School of Medicine, Durham, North Carolina, United States
  • Kennedy, Danielle L., Duke Cancer Institute, Durham, North Carolina, United States
  • Dunbar, Travia Kayla, Duke University School of Medicine, Durham, North Carolina, United States
  • Lin, Pao-Hwa, Duke University School of Medicine, Durham, North Carolina, United States
  • Bennett, Gary G., Duke University, Durham, North Carolina, United States
  • Redd, Cynthia Hinnant, Duke University School of Medicine, Durham, North Carolina, United States
  • Boulware, L. Ebony, Duke University School of Medicine, Durham, North Carolina, United States
  • Fish, Laura Jane, Duke Cancer Institute, Durham, North Carolina, United States
Background

Black individuals are disproportionately burdened by hypertension and chronic kidney disease (CKD). The Dietary Approaches to Stop Hypertension diet (DASH) improves hypertension in Black individuals and is associated with improved CKD outcomes. Yet, adherence to DASH among Black individuals is low. We conducted a qualitative study to assess barriers and facilitators to DASH adherence in Black adults with CKD.

Methods

We conducted focus groups and individual interviews with Black adults with CKD stages 3 or 4 (n=22). Questions included perceptions of CKD and DASH, the cultural-centeredness of DASH, and barriers and facilitators to adopting DASH. Qualitative content analysis was used to analyze interview transcripts.

Results

Among 22 participants (2 focus groups, 8 individual interviews), 13 (59%) had CKD stage 3, 13 (59%) were female, the median age was 61 years, and 19 (90%) had hypertension. Some participants reported having previously heard of DASH, which they perceived as a healthy diet. Participants perceived DASH as culturally-compatible based on 3 emergent themes: 1) Blacks individuals already eat DASH-recommended foods (“Blacks eat pretty much like this”); 2) traditional (e.g., southern or soul-food) recipes can be modified into healthy versions (“you can come up with decent substitutes to make it just as good)”, and 3) diet is not uniform among Black individuals (“I can't say that I eat traditional”). Barriers included unfamiliarity or inexperience measuring portion sizes, inadequate cooking skills, unsupportive household members, and high cost of healthy food. Eleven (52%) reported “rarely” or “never” having leftover money to purchase healthy food after paying monthly bills. Facilitators included having local access to healthy food, living alone or with supportive household members, and having will power and internal/external motivation for change.

Conclusion

Black adults with CKD were interested in adopting DASH and viewed it as a healthy, culturally-compatible diet. Recognizing that diet in Black adults is not uniform, interventions should emphasize person-centered, rather than culture-centered, approaches that minimize barriers and enhance facilitators to adherence.

Funding

  • Other NIH Support