4.5 Article

Implementing DASH-aligned Congregate Meals and Self-Measured Blood Pressure in two senior centers: An open label study

Journal

NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
Volume 32, Issue 8, Pages 1998-2009

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.numecd.2022.05.018

Keywords

Cardiovascular risk; Hypertension; Self-efficacy; Community-based; Seniors; DASH diet; Nutritional intervention; Implementation research

Funding

  1. U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. [90INNU0007-01-00]
  2. National Center for Advancing Translational Sciences (NCATS, National Institutes of Health (NIH) Clinical and Translational Science Award (CTSA) program) [UL1 TR001866, UL1 TR000043]
  3. 2011 CTSA Community-Engaged Research Administrative Supplement Award NIH-NCATS grant [UL1 TR000043-07S1]
  4. Agency for Healthcare Research and Quality grant [1 P30-HS-021667]

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This study tested the effectiveness of implementing two evidence-based interventions, DASH-aligned meals and support for home self-measured blood pressure monitoring, at senior centers serving low-income, racially diverse communities. The results showed that this approach was feasible and showed promising evidence of reducing blood pressure.
Background and aims: Cardiovascular Disease (CVD) poses significant health risks for seniors, especially among low-income and minority communities. Senior centers offer multiple services. We tested whether implementing two evidence-based interventions- DASH-aligned meals provided through an existing congregate meal program, and support for home Self-Measured Blood Pressure (SMBP) monitoring-lowers blood pressure among participants at two senior centers serving low-income, racially diverse communities. Methods and results: Open-label study, enrolling clients aged >= 60, eating >= 4 meals/week at two NYC senior centers. Participants received DASH-aligned congregate meals, and training in nutrition, BP management education, and personal SMBP device. Co-Primary outcomes: a) change in systolic BP measured by independent health professionals, and b) change in percent with controlled BP (Eighth Joint National Committee (JNC-8) Guidelines), at Month 1 compared to Baseline. Secondary outcomes: Changes in BP at Months 3 and 5/6 (last measure). We enrolled 94 participants; COVID closures interrupted implementation mid-study. Mean systolic BP at Month-1 changed by -4.41 mmHg (n = 61 p = 0.07) compared to Baseline. Participants with controlled BP increased (15.7%) at Month 1. Change in mean BP at Month 1 was significantly correlated with BMI (p = 0.02), age (p = 0.04), and baseline BP (p < 0.001). Mean systolic SMBP changed by -6.9 mmHg (p = 0.004) at Months 5/6. Conclusions: Implementing an evidence-based multi-component BP-lowering intervention within existing congregate meal programs at senior centers serving minority and low-income communities is feasible, and early findings show promising evidence of effectiveness. This approach to cardiovascular risk reduction should be further tested for widespread adoption and impact. (C) 2022 The Authors. Published by Elsevier B.V. on behalf of The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University.

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