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.