Crusan Ambria, Roozen Kerrie L, Godoy-Henderson Clara, Evans Angela, Reeves Katie
Department of Nutrition and Dietetics, Henrietta Schmoll School of Health Sciences, St. Catherine University, 2004 Randolph Avenue, St. Paul, MN, USA.
Department of Health Services Research, Policy and Administration, School of Public Health, University of Minnesota, Minneapolis, MN, 55455, USA.
BMC Nutr. 2025 May 16;11(1):97. doi: 10.1186/s40795-025-01089-z.
Effective nutrition interventions for hypertension (HTN), including the Dietary Approaches to Stop Hypertension (DASH) Eating Plan, fail to consider cultural preferences and barriers to obtaining and utilizing fruits and vegetables (F/V). A paucity exists in the literature regarding nutrition interventions tailored for Hispanic/Latine communities. This project aims to determine the outcomes associated with improved access to a culturally-appropriate, medically-tailored foods for Hispanic/Latine individuals with HTN via an iterative process: 1) conceptualization of culturally-appropriate F/V for a DASH box using a patient/provider survey, 2) formative DASH box development utilizing individual interviews for food preference feedback, and 3) free-living pilot trial of DASH box intervention to determine impacts on cardiometabolic markers.
Using community-based participatory research methods, findings from 50 surveys revealed F/V preferences which supported the conceptualization of 6 boxes, including F/V and staple foods to encourage DASH Eating Plan adherence. Boxes were displayed during 15 interviews gathering feedback on acceptability. Themes were assessed using the Framework Method and finalized via consensus building. A 28-day open trial enrolling 21 participants collected pre- and post- measurements of blood pressure (BP), weight, waist circumference (WC), and skin carotenoid levels. Weekly DASH boxes and diet education were provided. Pre-to post-changes in cardiometabolic markers were calculated via t-tests.
Thematic analysis determined participants prefer fresh F/V, use staple items to compliment F/V, and experience barriers (time, money, transportation) to accessing or using F/V. Post intervention, there was a significant improvement in systolic BP (mean difference of -4.17.8 mmHg, p = 0.01), diastolic BP (-3.76.4 mmHg, p = 0.004), and WC (-0.81.1 inches, p = 0.003). While mean difference in weight (-1.24.8 pounds, p = 0.26) and skin carotenoid levels (26.774.1, p = 0.06) changed, results were not significant.
This pilot study provides formative contributions regarding culturally-appropriate interventions for chronic disease management, suggesting a medically-tailored DASH box may be effective in lowering BP and other cardiometabolic risk factors for Hispanic/Latine individuals with HTN.
ClinicalTrials.gov, Identifier NCT05802134, Registered 3/24/2023, https://clinicaltrials.gov/study/NCT05802134 .
针对高血压（HTN）的有效营养干预措施，包括终止高血压膳食疗法（DASH）饮食计划，未能考虑文化偏好以及获取和食用水果与蔬菜（F/V）的障碍。关于为西班牙裔/拉丁裔社区量身定制的营养干预措施的文献匮乏。本项目旨在通过一个迭代过程确定与改善西班牙裔/拉丁裔高血压患者获取适合其文化背景、医学定制食物的机会相关的结果：1）使用患者/提供者调查问卷对DASH盒中适合文化背景的F/V进行概念化；2）通过个人访谈获取食物偏好反馈来进行DASH盒的形成性开发；3）对DASH盒干预进行自由生活试点试验，以确定对心脏代谢标志物的影响。
采用基于社区的参与性研究方法，50份调查问卷的结果揭示了F/V偏好，这些偏好支持了6个盒子的概念化，包括F/V和主食，以鼓励坚持DASH饮食计划。在15次收集可接受性反馈的访谈中展示了这些盒子。使用框架法评估主题，并通过达成共识来最终确定。一项为期28天的开放试验招募了21名参与者，收集了血压（BP）、体重、腰围（WC）和皮肤类胡萝卜素水平的前后测量值。每周提供DASH盒和饮食教育。通过t检验计算心脏代谢标志物的前后变化。
主题分析确定参与者更喜欢新鲜的F/V，使用主食来搭配F/V，并且在获取或食用F/V方面存在障碍（时间、金钱、交通）。干预后，收缩压有显著改善（平均差异为-4.1±7.8 mmHg，p = 0.01），舒张压（-3.7±6.4 mmHg，p = 0.004）和WC（-0.8±1.1英寸，p = 0.003）。虽然体重（-1.2±4.8磅，p = 0.26）和皮肤类胡萝卜素水平（26.7±74.1，p = 0.06）的平均差异发生了变化，但结果并不显著。
这项试点研究为慢性病管理的文化适宜性干预提供了形成性贡献，表明医学定制的DASH盒可能对降低西班牙裔/拉丁裔高血压患者的血压和其他心脏代谢风险因素有效。
ClinicalTrials.gov，标识符NCT05802134，于2023年3月24日注册，https://clinicaltrials.gov/study/NCT05802134 。
