# Feasibility of delivering a digital health intervention to improve food access and dietary quality among adults with hypertension

> **NIH NIH R21** · JOHNS HOPKINS UNIVERSITY · 2024 · $449,410

## Abstract

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...

## Key facts

- **NIH application ID:** 10786367
- **Project number:** 1R21NR021041-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Gary G Bennett
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $449,410
- **Award type:** 1
- **Project period:** 2024-06-07 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10786367

## Citation

> US National Institutes of Health, RePORTER application 10786367, Feasibility of delivering a digital health intervention to improve food access and dietary quality among adults with hypertension (1R21NR021041-01). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10786367. Licensed CC0.

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