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

摘要 美国近50%的成年人患有高血压，高血压是导致心血管疾病的主要因素 疾病。在黑人成年人中高血压的患病率更高(55%)，比其他人更高 种族和民族群体。DASH(阻止高血压的饮食方法)的饮食模式就是一个证据- 基于治疗高血压的策略，已成为美国人饮食指南的一部分。 Dash提倡富含水果和蔬菜、低脂乳制品、高纤维和蛋白质的饮食，并控制 总脂肪、胆固醇和饱和脂肪的含量。这种饮食模式导致的减少量要大得多 与白人相比，黑人的血压更低。尽管Dash效果对黑人来说很有希望， 国家调查和临床试验数据表明，这组患者的依从性有限。 为了了解如何提高黑人对DASH的依从性，在临床试验中有足够的代表性 是必要的。更具包容性和代表性的招聘是广泛产生- 相关临床试验结果。母研究Dash Cloud的总体目标与此相关 补充剂是为了提高干预效果对饮食质量的影响。这项家长研究的目标是在 至少40%的少数族裔。这项补充建议将通过以下方式补充父母试验的目标 考察可能影响黑人受试者参与和成功改善DASH饮食的因素 质量。我们的目标是1)确定黑人成年人饮食质量的障碍和促进因素，以及2)确定 DASH云干预招聘方法的有效性。

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.