Digital Free-Choice Produce Selection with Culturally Tailored Dietitian Coaching, to Improve Cardiovascular-Kidney-Metabolic Health

Cardiovascular-kidney-metabolic (CKM) syndrome and its components, including hypertension (HTN), disproportionately impact Black and Hispanic persons. Some drivers of these disparities are unequal access to health care and healthy foods, living in healthy food priority areas (HFPAs, also known as food deserts), or limited nutrition support from dietitians. To address these critical gaps, innovative approaches to sustainably improve food access and uptake of Dietary Approaches to Stop Hypertension (DASH) among Black and Hispanic adults are urgently needed. We propose Digital free-choice produce selection with produce delivery, culturally tailored dietitian coaching, to improve CKM health to address these needs. We will provide virtual free-choice produce selection with personalized dietitian coaching and culturally tailored nutrition messages to Black or Hispanic persons with HTN and CKM syndrome. We will implement this in 2 phases: First, we will co-create the intervention to ensure that the lived experiences of the participants are well represented. In phase 2, we will assess the feasibility and preliminary efficacy of the intervention in a new sample of 30 Black or Hispanic adults with HTN and CKM syndrome stages 1 (excess or dysfunctional adiposity) & 2 (uncontrolled blood pressure, prediabetes). The design will be a wait-list control trial (15 in intervention, 15 in waitlist control) delivered over 12 weeks, and the outcomes will be systolic blood pressure (SBP) and DASH diet adherence. The waitlist control group will receive the intervention after the first 12 weeks. This proposal presents an opportunity to address barriers of unmet nutrition/social needs, food access, and health literacy, with the goal of improving CKM health.