Integrating Free-choice Marketplace, dieTitian coacHing, cultuRally Tailored messagIng to improVE Blood Pressure
Johns Hopkins University
Summary
iTHRIVE intervention is a 2-arm randomized controlled trial testing the effects of digital FARMacy, personalized dietitian coaching with produce prescriptions, and home blood pressure measurement in 100 hypertensive adults living in high food priority areas in counties in Maryland.
Description
Cardiovascular-kidney-metabolic (CKM) syndrome is a devastating public health crisis that affects nearly 90% of US adults. CKM accounts for \>30% of all US deaths and \>5 million hospitalizations annually and imposes an annual economic burden of ≥$1 trillion, with a disproportionate impact on Black, Hispanic adults. Inequitable access to care, high-quality food, culturally tailored dietitian support, and living in "food deserts" (also known as Healthy Food Priority Areas (HFPAs) exacerbate CKM disparities. Innovative approaches are urgently needed to sustainably improve food access and CKM hea…
Eligibility
- Age range
- 21–70 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * 21-70 years * Self-identify as Black/African American or Hispanic/Latino * Have Stage 2 CKM defined as: * Systolic BP ≥130mmHg (measured at screening) AND at least one of: * Hypertension (ICD-10: I10-I16) * Prediabetes (HbA1c 5.7-6.4%) or Type 2 Diabetes (HbA1c ≥6.5%) * Stage 3 chronic kidney disease (CKD) (eGFR 30-59 mL/min/1.73m²) * Live in census tracts identified by the Montgomery/ Prince George's/Baltimore City County Departments of Planning as HFPA: * Healthy Food Availability Index score is low (0-9.5), * Median household income ≤185% of Federal Poverty Level *…
Interventions
- BehavioraliTHRIVE intervention
Integration of three traditionally siloed components: 1. Digitally enabled food access 2. Personalized nutrition support 3. Clinical care-rision of home blood pressure device with app
- BehavioralActive comparator
Active comparator arm will receive enhanced usual care that consists of: 1. Standard produce bag 2. Home blood pressure Device without app 3. General dietary advice
Location
- Johns Hopkins School of NursingBaltimore, Maryland