Abstract The DASH (Dietary Approaches to Stop Hypertension) eating pattern has been shown to reduce systolic and diastolic blood pressure by clinically meaningful levels (10.7 and 4.7 mm Hg, respectively) among adults with hypertension. Accordingly, national treatment guidelines recommend the DASH as a first-line treatment for the 116 million US adults with hypertension. However, DASH adherence among U.S. adults with hypertension remains exceedingly low. A major barrier to DASH uptake is poor accessibility to and high cost of healthful foods. Approximately 38% of U.S. census tracts have limited access to high-quality foods; these communities generally lack supermarkets or large grocery stores, which facilitate both availability and affordable food pricing. Healthful food access is especially constrained in lower-income and predominately racial/ethnic minority neighborhoods. To best address the considerable population health challenge of hypertension, we need innovative approaches to expand equitable access to the DASH eating pattern. Members of our team are currently conducting Nourish (R01HL146768), a digital behavioral health intervention delivered via a smartphone application (app), to improve adherence to DASH among adults with hypertension. The intervention components include DASH education and skills training, self-monitoring, personalized feedback, goal setting, and responsive health coaching. We expect that the Nourish intervention, if successful, can be scaled and disseminated to millions of adults. However, access challenges remain; without additional intervention, a large proportion of U.S. adults will still have limited access to high-quality foods--a critical barrier to adopting the DASH eating pattern. In the current proposal, we will leverage the rapidly mounting availability of grocery delivery services to deliver Access Nourish, an intervention that will provide tailored grocery lists and at-home grocery delivery options through a commercially available smartphone app. We will test the feasibility of Access Nourish among n=65 patients with hypertension living in low access census tracts, as defined by the USDA. We will deliver Access Nourish in addition to the existing intervention components of Nourish, described above, to provide a comprehensive intervention package that targets behavioral mechanisms to increase DASH adherence and improves food access. Feasibility will be assessed via participant accrual; participant retention; and other indicators of feasibility, including acceptability, demand, implementation, practicality, and adaptation of the intervention. We will also conduct qualitative interviews to elicit barriers and facilitators to using an online grocery delivery app. We believe this approach will yield meaningful information regarding the utility of these tools in improving access and adherence to effective hypertension management interventions. Subject to future efficacy testing, this intervention can be scaled to...