Nutrition intervention of groceries for Black residents of Boston to stop hypertension (GoFresh) among adults with or without treated hypertension trial: rationale, design, and guiding domains

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BACKGROUND: The Dietary Approaches to Stop Hypertension (DASH) Eating Plan is proven to lower blood pressure; however, the original DASH diet involved a set menu of meals prepared in a metabolic kitchen. There is little evidence mapping this dietary pattern to real-world groceries, tailored to a range of personal preferences and dietary practices. METHODS: The GoFresh Trials, two parallel-arm randomized, controlled trials, are studying the impact of DASH-patterned, home-delivered groceries on the blood pressure of Black adults living in communities with reduced access to grocery stores. Participants were able to choose the groceries according to their preferences for themselves and up to five family members from local supermarkets. A dietitian assisted participants with selection to ensure that groceries followed a DASH pattern and met a potassium/sodium ratio of > 2.0 with kilocalories from saturated fat ≤ 7%. Dietitians also provided weekly educational modules on sustainably adopting DASH. To support meal preparation, a recipe book and 24 demonstration videos were created in collaboration with Boston Chefs. A community advisory board participated in the conception of intervention materials to ensure the program was feasible and grounded in community priorities. RESULTS: Compliance assessments include 24-h urine paired with 24-h nutrition recalls, seated blood pressure, and surveys on food preparation and shopping habits. A knowledge assessment and palatability form were used to assess changes in DASH knowledge and acceptability before and after the intervention. CONCLUSION: By describing the unique features and development process of GoFresh, this paper offers practical guidance for adapting and scaling similar nutrition interventions in other communities. TRIAL REGISTRATION: ClinicalTrials.gov NCT05121337. Registered on November 16, 2021. https://clinicaltrials.gov/ct2/show/NCT05121337 .

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