Nutrition Intervention of Groceries for Black Residents of Boston to Stop Hypertension (GoFresh) Among Adults With or Without Treated Hypertension Trial: Rationale, Design, and Evidence to Promote Implementation

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 cultural preferences and dietary practices. Methods The GoFresh Trial, a parallel-arm randomized, controlled trial, is 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 DASH-patterned groceries according to their preferences for themselves and up to five family members from local supermarkets. A dietitian assisted participants with grocery selection to ensure that groceries followed a DASH pattern and met potassium/sodium ratio of >2.2 with kilocalories from saturated fat ≤7%. In addition, dietitians provided weekly educational modules on sustainably adopting DASH. Two conceptual frameworks were designed to address five domains related to diet adoption: accessibility and cost, food preparation, social influences, individual beliefs, and cultural adaptations. To support meal preparation, a recipe book and 24 demonstration videos were created in collaboration with Boston chefs to highlight heritage diets like African and Afro-Caribbean. Results Compliance assessments include 24-hour urine paired with 24-hour nutrition recalls, seated blood pressure, and surveys collecting information on food preparation and shopping habits. Conclusion Findings from this study will inform policy related to healthy food access and provide real-world examples of how DASH might be adapted in a real-world context now and in years to come. Trial registration: NCT05121337. Registered on November 16, 2021, at ClinicalTrials.gov: https://clinicaltrials.gov/ct2/show/NCT05121337