Delivering a Digital Health Intervention to Improve Food Access and Dietary Quality Among Adults With Hypertension

Feasibility of Delivering a Digital Health Intervention to Improve Food Access and Dietary Quality Among Adults With Hypertension

A total of 65 participants with hypertension and low access to high quality food will be enrolled to test the feasibility of using commercially available grocery delivery services, simultaneous to a robust behavioral intervention, to improve adherence to the Dietary Approaches to Stop Hypertension (DASH) eating pattern. The behavioral intervention will include skills training, nutrient goal setting, self-monitoring via dietary tracking, personalized text message feedback, and adaptive health coaching. Participants will also receive a membership to Instacart+ and weekly grocery list recommendations from a health coach. The primary outcome will be indicators of feasibility, including acceptability, demand, implementation and practicality and adaption. Change in DASH adherence and blood pressure will also be evaluated. The intervention period for participants will be 4 months.

Study Overview

• Status: Completed
• Conditions: Hypertension
• Intervention / Treatment: Behavioral: Access Nourish

• Study Type: Interventional
• Enrollment (Actual): 67
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Maryland
    • Baltimore, Maryland, United States, 21205
      • Johns Hopkins

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Adult 18 years of age or older
• Has hypertension, defined as a systolic BP of 130-159 mmHg and/or diastolic BP of 80-99 mmHg, whether or not taking hypertension medication.
• Resides in a census tract defined as low access by the United States Department of Agriculture (USDA)
• Resides in a zip code serviced by the grocery delivery app
• BMI 18.5 kg/m2+
• Has a smartphone with a data plan
• Willing to receive daily text messages
• Can participate in online videoconference visits
• Can read and write in English

Exclusion Criteria:

• Participating in another related research study
• Cardiovascular disease event in the last 6 months
• Active cancer
• Recent hospitalization due to psychiatric condition or event
• Pregnancy or planned during the study period
• BMI 37 kg/m2 or higher
• Documented dementia
• On kidney dialysis
• Instructed to eat a low potassium diet
• Planned or recent bariatric surgery

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Assess the feasibility of Access Nourish in a 4-month study among adults with hypertension li; All participants will be prospectively assigned to receive a behavioral intervention that includes skills training, nutrient goal setting, self-monitoring via dietary tracking, personalized text message feedback, and adaptive health coaching. Participants will also receive a membership to Instacart+ and weekly grocery list recommendations from a health coach. All intervention will be delivered remotely using smartphone technology.

Behavioral: Access Nourish; A total of 65 participants with hypertension and low access to high quality food will be enrolled to test the feasibility of using commercially available grocery delivery services, simultaneous to a robust behavioral intervention, to improve adherence to the DASH eating pattern. The behavioral intervention will include skills training, nutrient goal setting, self-monitoring via dietary tracking, personalized text message feedback, and adaptive health coaching. Participants will also receive a membership to Instacart+ and weekly grocery list recommendations from a health coach. Participants will be able to complete all intervention components via smartphone. The intervention period for participants will be 4 months.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility as assessed by survey	Feasibility will be measured by a 23-item questionnaire used to assess participants' perceptions of the feasibility, usability, acceptability, practicality, and satisfaction with the intervention. Each item is rated on a 5-point Likert scale, with higher scores indicating greater feasibility and acceptability. The survey evaluates key components of the program, including grocery lists, grocery delivery, health coaching, and app-based tracking.	4 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in DASH Score as assessed by the Automated Self-Administered 24-hour (ASA24)	Participants will enter dietary intake online via the National Cancer Institute's Automated Self-Administered 24-hour (ASA24) Dietary Assessment tool. DASH dietary nutrients are then converted into a score. Scores ranged from 0 to 9 where a higher score indicates better adherence to the DASH dietary pattern. Change in DASH score = 4-month DASH score - Baseline DASH score.	Baseline and 4 months
Change in Systolic Blood Pressure	Systolic blood pressure will be measured in millimeters of mercury (mmHg) using the upper arm three times at 1-minute intervals after 5 minutes of quiet sitting. The final 2 measurements will be averaged together for analysis. Change in systolic blood pressure = 4-month systolic blood pressure - Baseline systolic blood pressure.	Baseline and 4 months
Change in Diastolic Blood Pressure	Diastolic blood pressure will be measured in millimeters of mercury (mmHg) using the upper arm three times at 1-minute intervals after 5 minutes of quiet sitting. The final 2 measurements will be averaged together for analysis. Change in diastolic blood pressure = 4-month diastolic blood pressure - Baseline diastolic blood pressure.	Baseline and 4 months

Collaborators and Investigators

• Sponsor: Johns Hopkins University
• Collaborators: National Institute of Nursing Research (NINR)
• Investigators: Principal Investigator: Gary Bennett, PhD, Duke University; Principal Investigator: Hailey Miller, RN, PhD, Johns Hopkins University

Study record dates

Study Major Dates

• Study Start (Actual): February 27, 2025
• Primary Completion (Actual): December 18, 2025
• Study Completion (Actual): December 18, 2025

Study Registration Dates

• First Submitted: December 16, 2024
• First Submitted That Met QC Criteria: December 18, 2024
• First Posted (Actual): December 19, 2024

Study Record Updates

• Last Update Posted (Actual): February 12, 2026
• Last Update Submitted That Met QC Criteria: February 11, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Hypertension; Nutrition; Digital Health; Health Behavior; Food Access
• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Behavior; Hypertension; Health Behavior
• Other Study ID Numbers: IRB00447049; R21NR021041 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No