Optimizing Inclusion of Blacks Within a Dietary Change Intervention to Reduce Hypertension

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ABSTRACT Nearly 50% of adults in the United States have high blood pressure, a leading contributor to cardiovascular disease. The prevalence of high blood pressure is even greater among black adults (55%), more than other racial and ethnic groups. The DASH (Dietary Approaches to Stop Hypertension) dietary pattern is an evidence- based strategy to treat high blood pressure that has become part of the Dietary Guidelines for Americans. DASH promotes a diet rich in fruits and vegetables, low-fat dairy, high fiber and protein, and controlled amounts of total fat, cholesterol and saturated fat. This dietary pattern leads to a significantly greater reduction in blood pressure among blacks compared to whites. Though DASH effects are promising for blacks, adherence has been limited in this group as evidenced by national survey and clinical trial data. To understand how DASH adherence can be improved among blacks, sufficient representation in clinical trials is necessary. More inclusive and representative recruitment is a critical starting point to producing broadly- relevant clinical trial results. The overarching aim of DASH Cloud, the parent study, connected to this supplement is to improve the efficacy of the intervention on diet quality. The parent study aims to recruit at least 40% racial/ethnic minorities. This supplemental proposal will complement the parent trial aims by examining factors that may influence black subjects’ participation and success in improving DASH dietary quality. We aim to 1) determine the barriers and facilitators of dietary quality in black adults, and 2) determine the effectiveness of DASH Cloud intervention recruitment methods.