Developing and Evaluating a Kitchen Toolkit for DASH Adoption and Adherence in Black Public Housing Residents

Title: The use of a kitchen toolkit as an implementation strategy to increase the adoption of a tailored DASH diet among Black/African Americans living in public housing ABSTRACT Black/African Americans (AAs) have significantly higher hypertension rates compared to other racial/ethnic groups. Low-income AAs, including those living in public housing, are at an even higher risk for hypertension. Implementing a DASH (Dietary Approaches to Stop Hypertension) diet is one evidence-based practice to significantly reduce blood pressure and hypertension risk; however, diet implementation is challenging for low-income AAs because of barriers like inadequate material resources in the kitchen that impede the ability to cook meals at home. Therefore, access to these resources, such as through a kitchen toolkit that provides kitchen equipment/supplies, is an important strategy to increase DASH implementation for this health disparity population. Implementation strategies (e.g., toolkits) in implementation science are methods that increase the likelihood of an evidence-based practice''s adoption, implementation, and sustainability. While feasibility studies examining kitchen toolkits have shown promise in improving eating patterns and clinical outcomes for low-income populations, pilot studies have been limited to heterogeneous samples and focused on non-DASH diets. Therefore, we do not know if using a kitchen toolkit as an implementation strategy is feasible to increase DASH adoption for low-income AAs. This proposed feasibility study will pilot test the use of a kitchen toolkit (kitchen supplies/equipment) (implementation strategy) on promoting DASH adoption in a 12-week tailored DASH intervention for AAs living in public housing. The study will use a single- arm hybrid type II effectiveness-implementation trial design. Using mixed methods, the study aims are to (1) identify material resources in the kitchen that may influence DASH adoption, (2) assess the feasibility and potential utility of the toolkit, and (3) evaluate the effectiveness of the toolkit on DASH adoption and blood pressure. These findings will inform the development of a full-scale type III hybrid effectiveness-implementation trial of the toolkit with other low-income AA populations to increase DASH adoption and implementation. This outcome helps to accomplish AHA’s mission to "be a relentless force for a world of longer, healthier lives” for all by increasing the adoption and implementation of evidence-based dietary practices for health disparity populations.