A Multilevel Assessment of Barriers to Adoption of Dietary Approaches to Stop Hypertension (DASH) among African Americans of Low Socioeconomic Status

Bertoni, Alain G.; Foy, Capri G.; Hunter, Jaimie C.; Quandt, Sara A.; Vitolins, Mara Z.; Whitt-Glover, Melicia C.

doi:10.1353/hpu.2011.0142

Cited by 57 publications

(48 citation statements)

References 26 publications

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“…In a previous study of price considerations for African Americans focused on all healthy foods, potential wastage and time cost for food preparation were concerns [16]. These same concerns arose in formative research prior to dietary intervention for African Americans with hypertension [24]. The present study, as well as others [1], shows that these factors apply specifically to the purchase and use of fruits and vegetables.…”

Section: Discussionsupporting

confidence: 51%

African American and Latino Low Income Families’ Food Shopping Behaviors: Promoting Fruit and Vegetable Consumption and Use of Alternative Healthy Food Options

Fish

Brown

Quandt

2013

J Immigrant Minority Health

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Introduction Minority families often reside in neighborhoods with few supermarkets or alternative healthy food options (e.g., farmers markets, community gardens), making fresh produce difficult to obtain. This qualitative study identified factors influencing fruit and vegetable shopping and use of alternative healthy food options. Methods Forty-eight minority women with children completed interviews regarding food shopping habits and use of and attitudes toward alternative healthy food options. Interviews were subjected to thematic analysis. Results Produce shopping was motivated by costs and family preferences. For African American women, poor cooking skills restricted the variety of fruits and vegetables purchased. Latinas were receptive to alternative healthy food options, but did not use them because these sources were inconvenient. African American women were not receptive to them. Conclusion Improving cooking skills and perceptions of acceptable foods may be as important as increased access to promote greater consumption of fruits and vegetables.

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Section: Discussionsupporting

confidence: 51%

African American and Latino Low Income Families’ Food Shopping Behaviors: Promoting Fruit and Vegetable Consumption and Use of Alternative Healthy Food Options

Fish

Brown

Quandt

2013

J Immigrant Minority Health

Self Cite

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“…3 These studies suggested that these adherence differences were likely influenced by food availability, cost, and culture and that additional adaptations and multilevel interventions may therefore be necessary to maximize impact of the DASH diet in African American communities. 3,8 This is consistent with research that has concluded that, to be effective in decreasing disparities, nutrition interventions must address a combination of individual, social, cultural, and environmental determinants. 9–18 …”

Section: Introductionsupporting

confidence: 75%

“…DASH clinical trials demonstrated a mean decrease of 5.5 mmHg in systolic blood pressure and 3.0 mmHg in diastolic blood pressure. 8 Participants in MOTMGC who reported “high participation” self-reported that they consumed more fruits and vegetables, seasoned their food with less sodium, and used less fat. There was a significant difference between the baseline and post-intervention samples in the intervention county of 4 mmHg in systolic and 2 mmHg in diastolic blood pressure, but not in the comparison county.…”

Section: Discussionmentioning

confidence: 99%

Adaptation of a Modified DASH Diet to a Rural African American Community Setting

Baker

Barnidge

Schootman

et al. 2016

American Journal of Preventive Medicine

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Introduction Cardiovascular disease is the leading cause of death among African Americans in the U.S., with high blood pressure and obesity being two of the main determinants. The Dietary Approaches to Stop Hypertension diet is effective in changing behaviors associated with these health concerns, but has not been adapted to community settings. Methods Men on the Move: Growing Communities (MOTMGC) was evaluated using a quasi-experimental cross-sectional design. Surveys were conducted with rural African Americans aged ≥18 years prior to the intervention (2008) and at the end of the project (2013), with the final analysis conducted in 2015. Using a community-based participatory research approach, MOTMGC provided culturally appropriate education and changes to the environment to improve access to fruits and vegetables, low-fat, and low-sodium foods. Results Declines in prevalence of overweight and obese respondents and hypertension were seen in the intervention but not the comparison county. Participants with high levels of participation reported eating five or more servings of fruits and vegetables a day, a greater variety of fruits and vegetables, less salt, and seasoning their vegetables with less fat more often than those who did not participate in educational activities. Participants reported that as a result of their access to MOTMGC gardens, they were more likely to eat more fruits, vegetables, and locally grown food, and less processed food and fast food. Conclusions Adapting the Dietary Approaches to Stop Hypertension diet to community settings through culturally appropriate community-based efforts can improve dietary behaviors, BMI, and blood pressure.

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“…Consideration of these factors has led to sustainable adoption of healthy behaviors (intake of low-fat diets, increased physical activity) and reduction in cardiovascular risk in local communities in the United States. [10][11][12] buIldIng the evIdence base to address the global burden of hypertensIon…”

Section: Implementation Research To Address Hypertension -Peprah Et Almentioning

confidence: 99%

A Global Perspective on Using Implementation Research to Address Hypertension-Associated Target Organ Damage

et al. 2016

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<p>Hypertension, a major risk factor for cardiovascular disease, imposes a significant public health burden and challenge to address it worldwide. Scaling up delivery of proven, effective interventions for hypertension could significantly advance the goal of reducing the global burden. Although significant progress has been made in many countries, some lament that large-scale initiatives focused on reducing blood pressure in global populations have not effectively addressed this challenge. Late-stage implementation research plays a critical role in determining effective and sustainable scale-up of these initiatives. In this article, we briefly discuss some of the global initiatives that have been funded by the National Heart, Lung, and Blood Institute of the US National Institutes of Health. Intervention delivery strategies in low resource settings must have demonstrated effectiveness and consideration for the social, cultural and physical context (eg, access, affordability, and availability of medications) in which a program is being delivered in order to be sustainable nationally and globally. Hence, the use of implementation research is central to determining sustainable delivery of evidence-based and tailored interventions focused on hypertension control. The sustained control of hypertension in global populations holds tremendous potential for reducing morbidity, premature mortality, and the adverse economic impact of cardiovascular disease in all regions. <em>Ethn Dis. </em>2016; 26(3):395-398; doi:10.18865/ ed.26.3.395 </p>

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A Multilevel Assessment of Barriers to Adoption of Dietary Approaches to Stop Hypertension (DASH) among African Americans of Low Socioeconomic Status

Cited by 57 publications

References 26 publications

African American and Latino Low Income Families’ Food Shopping Behaviors: Promoting Fruit and Vegetable Consumption and Use of Alternative Healthy Food Options

African American and Latino Low Income Families’ Food Shopping Behaviors: Promoting Fruit and Vegetable Consumption and Use of Alternative Healthy Food Options

Adaptation of a Modified DASH Diet to a Rural African American Community Setting

A Global Perspective on Using Implementation Research to Address Hypertension-Associated Target Organ Damage

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