Nourish: A Digital Health Program to Promote the DASH Eating Plan Among Adults With High Blood Pressure

Not Applicable

Completed

Brief Summary: The goal of Nourish is to help adults with high blood pressure enjoy an eating pattern called DASH (Dietary Approaches to Stop Hypertension) to lower blood pressure and improve health. Nourish will use a mobile app and information about DASH to help study participants follow the DASH dietary plan by tracking what they eat and drink every day. The primary outcome of the study is 6-month change in following the DASH eating plan, as measured by 24-hour dietary recalls. The secondary outcome is change in blood pressure. Study participation will last one year.

Detailed Description: Over 100 million Americans suffer from high blood pressure and are at increased risk for cardiovascular disease. Evidence supports the DASH (Dietary Approaches to Stop Hypertension) dietary pattern to reduce blood pressure. DASH is rich in fruits and vegetables, legumes, lean protein, and low-fat dairy, and reduced in red meats, sweets and processed foods. The Nourish trial will look at the effect of the intervention on changes in dietary quality and blood pressure among men and women with high blood pressure. Participants who join Nourish will be asked to track what they eat and drink every day through a smartphone app and to participate in online study visits. Some participants will also receive additional support from a registered dietitian. We are doing this study to understand how technology can help adults with high blood pressure follow a heart-healthy eating plan to improve their blood pressure.

Recruitment & Eligibility

Inclusion Criteria

Systolic blood pressure of 120-159 mmHg or diastolic blood pressure of 80-99 mmHg, whether or not taking blood pressure medications.
BMI ≥ 18.5 kg/m2
Smartphone with a data plan
Willing to receive daily text messages
Valid email address
Willing and able to participate in online study videoconferencing visits (Zoom)
Lives in the U.S.
Reads and writes in English

Exclusion Criteria

Participating in another related research study
Cardiovascular disease event (e.g. stroke, myocardial infarction) in prior 6 months
Bariatric surgery in the last 12 months or planned during the study period
Active cancer
Recent hospitalization due to psychiatric condition or event
Pregnancy- current or planned during the study period
Documented dementia
Lives with someone else participating in the Nourish study

To learn more about the study and to see if eligible to participate, visit www.nourishstudy.org

Arm && Interventions

Group	Intervention	Description
Intervention	Tracking plus coaching	Participants will track their daily dietary intake for six months using an app and will receive automated feedback daily via text message based on DASH nutrients. Participants in-need of coaching based on their adherence to the key nutrients in the DASH dietary pattern or engagement in the intervention will receive responsive digital coaching from Nourish registered dietitians.

Primary Outcome Measures

Name	Time	Method
Change in Dietary Intake as Measured by Dietary Approaches to Stop Hypertension (DASH) Score	Baseline and 6 months	Participants entered their dietary intake online via the National Cancer Institute's Automated Self-Administered 24-hour (ASA24) Dietary Assessment tool to record 2 separate 24-hour dietary recalls (1 weekday and 1 weekend day). DASH dietary nutrients are then converted into a score using the method described in Mellen et al (2008). Scores ranged from 0 to 9 where a higher score indicates better adherence to the DASH dietary pattern. Change in DASH score = 6-month DASH score - Baseline DASH score.

Secondary Outcome Measures

Name	Time	Method
Change in Diastolic Blood Pressure	Baseline and 6 months	Diastolic blood pressure measured in millimeters of mercury (mmHg) using the upper arm three times at 1-minute intervals after 5 minutes of quiet sitting. Blood pressure was measured 3 times at 1 minute intervals. The final 2 measurements were averaged together for analysis. Change in diastolic blood pressure = 6-month diastolic blood pressure - Baseline diastolic blood pressure.
Change in Systolic Blood Pressure	Baseline and 6 months	Systolic blood pressure measured in millimeters of mercury (mmHg) using the upper arm three times at 1-minute intervals after 5 minutes of quiet sitting. Blood pressure was measured 3 times at 1 minute intervals. The final 2 measurements were averaged together for analysis. Change in systolic blood pressure = 6-month systolic blood pressure - Baseline systolic blood pressure.

Locations (1): Duke University Medical Center
🇺🇸
Durham, North Carolina, United States