Implementing DASH-Aligned Meals and Self-Measured Blood Pressure to Reduce Hypertension at Senior Centers: A RE-AIM Analysis
Low-income, minority seniors face high rates of hypertension that increase cardiovascular risk. Senior centers offer services, including congregate meals, that can be a valuable platform to reach older adults in underserved communities. We implemented two evidence-based interventions not previously...
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| Veröffentlicht in: | Nutrients 2022-11, Vol.14 (22), p.4890 |
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| creator | Hashemi-Arend, Anuradha Vasquez, Kimberly S Guishard, Dozene Naji, Moufdi Ronning, Andrea George-Alexander, Glenis Vasquez, Dacia Sylvester, Clewert Pagano, William Khalida, Chamanara Coffran, Cameron Ezeonu, Teeto Fofana, Kadija Bielopolski, Dana Vaughan, Roger Qureshi, Adam Tobin, Jonathan N Kost, Rhonda G |
| description | Low-income, minority seniors face high rates of hypertension that increase cardiovascular risk. Senior centers offer services, including congregate meals, that can be a valuable platform to reach older adults in underserved communities. We implemented two evidence-based interventions not previously tested in this setting: DASH-aligned congregate meals and Self-Measured Blood Pressure (SMBP), to lower blood pressure (BP) at two senior centers serving low-income, racially diverse communities. The study enrolled congregate meal program participants, provided training and support for SMPB, and nutrition and BP education. DASH-aligned meals delivered 40% (lunch) or 70% (breakfast and lunch) of DASH requirements/day. Primary outcomes were change in BP, and BP control, at Month 1. Implementation data collected included client characteristics, menu fidelity, meal attendance, SMBP adherence, meal satisfaction, input from partner organizations and stakeholders, effort, and food costs. We used the RE-AIM framework to analyze implementation. Study Reach included 94 older, racially diverse participants reflecting neighborhood characteristics. Effectiveness: change in systolic BP at Month 1 trended towards significance (-4 mmHg,
= 0.07); change in SMBP reached significance at Month 6 (-6.9 mmHg,
= 0.004). We leveraged existing community-academic partnerships, leading to Adoption at both target sites. The COVID pandemic interrupted Implementation and Maintenance and may have attenuated BP effectiveness. DASH meals served were largely aligned with planned menus. Meal attendance remained consistent; meal satisfaction was high. Food costs increased by 10%. This RE-AIM analysis highlights the acceptability, feasibility, and fidelity of this DASH/SMBP health intervention to lower BP at senior centers. It encourages future research and offers important lessons for organizations delivering services to older adults and addressing cardiovascular risk among vulnerable populations. |
| doi_str_mv | 10.3390/nu14224890 |
| format | Article |
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= 0.07); change in SMBP reached significance at Month 6 (-6.9 mmHg,
= 0.004). We leveraged existing community-academic partnerships, leading to Adoption at both target sites. The COVID pandemic interrupted Implementation and Maintenance and may have attenuated BP effectiveness. DASH meals served were largely aligned with planned menus. Meal attendance remained consistent; meal satisfaction was high. Food costs increased by 10%. This RE-AIM analysis highlights the acceptability, feasibility, and fidelity of this DASH/SMBP health intervention to lower BP at senior centers. It encourages future research and offers important lessons for organizations delivering services to older adults and addressing cardiovascular risk among vulnerable populations.</description><identifier>ISSN: 2072-6643</identifier><identifier>EISSN: 2072-6643</identifier><identifier>DOI: 10.3390/nu14224890</identifier><identifier>PMID: 36432576</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Adults ; Aged ; Blood Pressure ; Cardiovascular diseases ; Care and treatment ; COVID-19 - epidemiology ; COVID-19 - prevention & control ; DASH diet ; Diet ; Dietitians ; Education ; Food ; Food and nutrition ; Fruits ; Health aspects ; Health promotion ; Health risks ; Hispanic Americans ; Humans ; Hypertension ; Hypertension - epidemiology ; Hypertension - prevention & control ; Intervention ; Lunch ; Lunches ; Meals ; Measurement ; Minority & ethnic groups ; Neighborhoods ; Nursing home patients ; Nutrition ; Nutrition research ; Older people ; Organizations ; Practice research ; Regulation ; Senior citizen centers ; Socioeconomic factors ; Telemedicine</subject><ispartof>Nutrients, 2022-11, Vol.14 (22), p.4890</ispartof><rights>COPYRIGHT 2022 MDPI AG</rights><rights>2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 by the authors. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c432t-be3c089b4eae9d7daa19fb5a2b3d89b444fcedcdb347019f0cdb0db1fe50f6fd3</cites><orcidid>0000-0002-3000-6556 ; 0000-0003-1064-2026 ; 0000-0003-4722-539X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9699075/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9699075/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36432576$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hashemi-Arend, Anuradha</creatorcontrib><creatorcontrib>Vasquez, Kimberly S</creatorcontrib><creatorcontrib>Guishard, Dozene</creatorcontrib><creatorcontrib>Naji, Moufdi</creatorcontrib><creatorcontrib>Ronning, Andrea</creatorcontrib><creatorcontrib>George-Alexander, Glenis</creatorcontrib><creatorcontrib>Vasquez, Dacia</creatorcontrib><creatorcontrib>Sylvester, Clewert</creatorcontrib><creatorcontrib>Pagano, William</creatorcontrib><creatorcontrib>Khalida, Chamanara</creatorcontrib><creatorcontrib>Coffran, Cameron</creatorcontrib><creatorcontrib>Ezeonu, Teeto</creatorcontrib><creatorcontrib>Fofana, Kadija</creatorcontrib><creatorcontrib>Bielopolski, Dana</creatorcontrib><creatorcontrib>Vaughan, Roger</creatorcontrib><creatorcontrib>Qureshi, Adam</creatorcontrib><creatorcontrib>Tobin, Jonathan N</creatorcontrib><creatorcontrib>Kost, Rhonda G</creatorcontrib><title>Implementing DASH-Aligned Meals and Self-Measured Blood Pressure to Reduce Hypertension at Senior Centers: A RE-AIM Analysis</title><title>Nutrients</title><addtitle>Nutrients</addtitle><description>Low-income, minority seniors face high rates of hypertension that increase cardiovascular risk. Senior centers offer services, including congregate meals, that can be a valuable platform to reach older adults in underserved communities. We implemented two evidence-based interventions not previously tested in this setting: DASH-aligned congregate meals and Self-Measured Blood Pressure (SMBP), to lower blood pressure (BP) at two senior centers serving low-income, racially diverse communities. The study enrolled congregate meal program participants, provided training and support for SMPB, and nutrition and BP education. DASH-aligned meals delivered 40% (lunch) or 70% (breakfast and lunch) of DASH requirements/day. Primary outcomes were change in BP, and BP control, at Month 1. Implementation data collected included client characteristics, menu fidelity, meal attendance, SMBP adherence, meal satisfaction, input from partner organizations and stakeholders, effort, and food costs. We used the RE-AIM framework to analyze implementation. Study Reach included 94 older, racially diverse participants reflecting neighborhood characteristics. Effectiveness: change in systolic BP at Month 1 trended towards significance (-4 mmHg,
= 0.07); change in SMBP reached significance at Month 6 (-6.9 mmHg,
= 0.004). We leveraged existing community-academic partnerships, leading to Adoption at both target sites. The COVID pandemic interrupted Implementation and Maintenance and may have attenuated BP effectiveness. DASH meals served were largely aligned with planned menus. Meal attendance remained consistent; meal satisfaction was high. Food costs increased by 10%. This RE-AIM analysis highlights the acceptability, feasibility, and fidelity of this DASH/SMBP health intervention to lower BP at senior centers. It encourages future research and offers important lessons for organizations delivering services to older adults and addressing cardiovascular risk among vulnerable populations.</description><subject>Adults</subject><subject>Aged</subject><subject>Blood Pressure</subject><subject>Cardiovascular diseases</subject><subject>Care and treatment</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - prevention & control</subject><subject>DASH diet</subject><subject>Diet</subject><subject>Dietitians</subject><subject>Education</subject><subject>Food</subject><subject>Food and nutrition</subject><subject>Fruits</subject><subject>Health aspects</subject><subject>Health promotion</subject><subject>Health risks</subject><subject>Hispanic Americans</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension - prevention & control</subject><subject>Intervention</subject><subject>Lunch</subject><subject>Lunches</subject><subject>Meals</subject><subject>Measurement</subject><subject>Minority & ethnic groups</subject><subject>Neighborhoods</subject><subject>Nursing home patients</subject><subject>Nutrition</subject><subject>Nutrition research</subject><subject>Older people</subject><subject>Organizations</subject><subject>Practice research</subject><subject>Regulation</subject><subject>Senior citizen centers</subject><subject>Socioeconomic factors</subject><subject>Telemedicine</subject><issn>2072-6643</issn><issn>2072-6643</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNptkk1v1DAQhiMEolXphR-ALHFBSGmd2EnWHJDCUtiVWoFaOFtOPF5cOfbWTpBW4sczUb-r2gfPjJ95xx-TZW8LesSYoMd-KnhZ8oWgL7L9kjZlXtecvXxg72WHKV3SeTS0qdnrbI9huKyaej_7tx62Dgbwo_Ub8rW9WOWtsxsPmpyBcokor8kFOJOjm6aI8S8uBE1-RkizT8ZAzkFPPZDVbgtxBJ9s8ESNmOZtiGSJ4hDTJ9KS85O8XZ-R1iu3Sza9yV4ZrAGHN-tB9vvbya_lKj_98X29bE_zHo855h2wni5Ex0GB0I1WqhCmq1TZMT2HOTc96F53jDcUtyiaVHeFgYqa2mh2kH2-1t1O3YAkHigqJ7fRDiruZFBWPt7x9o_chL9S1ELQpkKBDzcCMVxNkEY52NSDc8pDmJIsG06roih5gej7J-hlmCJeeKaY4LxZiPKe2igH0noTsG4_i8q24TV-TlEJpI6eoXBqGGwfPBiL8UcJH68T-hhSimDu7lhQObeLvG8XhN89fJU79LY52H-E-rpm</recordid><startdate>20221118</startdate><enddate>20221118</enddate><creator>Hashemi-Arend, Anuradha</creator><creator>Vasquez, Kimberly S</creator><creator>Guishard, Dozene</creator><creator>Naji, Moufdi</creator><creator>Ronning, Andrea</creator><creator>George-Alexander, Glenis</creator><creator>Vasquez, Dacia</creator><creator>Sylvester, Clewert</creator><creator>Pagano, William</creator><creator>Khalida, Chamanara</creator><creator>Coffran, Cameron</creator><creator>Ezeonu, Teeto</creator><creator>Fofana, Kadija</creator><creator>Bielopolski, Dana</creator><creator>Vaughan, Roger</creator><creator>Qureshi, Adam</creator><creator>Tobin, Jonathan N</creator><creator>Kost, Rhonda G</creator><general>MDPI AG</general><general>MDPI</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3000-6556</orcidid><orcidid>https://orcid.org/0000-0003-1064-2026</orcidid><orcidid>https://orcid.org/0000-0003-4722-539X</orcidid></search><sort><creationdate>20221118</creationdate><title>Implementing DASH-Aligned Meals and Self-Measured Blood Pressure to Reduce Hypertension at Senior Centers: A RE-AIM Analysis</title><author>Hashemi-Arend, Anuradha ; Vasquez, Kimberly S ; Guishard, Dozene ; Naji, Moufdi ; Ronning, Andrea ; George-Alexander, Glenis ; Vasquez, Dacia ; Sylvester, Clewert ; Pagano, William ; Khalida, Chamanara ; Coffran, Cameron ; Ezeonu, Teeto ; Fofana, Kadija ; Bielopolski, Dana ; Vaughan, Roger ; Qureshi, Adam ; Tobin, Jonathan N ; Kost, Rhonda G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c432t-be3c089b4eae9d7daa19fb5a2b3d89b444fcedcdb347019f0cdb0db1fe50f6fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adults</topic><topic>Aged</topic><topic>Blood Pressure</topic><topic>Cardiovascular diseases</topic><topic>Care and treatment</topic><topic>COVID-19 - 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Senior centers offer services, including congregate meals, that can be a valuable platform to reach older adults in underserved communities. We implemented two evidence-based interventions not previously tested in this setting: DASH-aligned congregate meals and Self-Measured Blood Pressure (SMBP), to lower blood pressure (BP) at two senior centers serving low-income, racially diverse communities. The study enrolled congregate meal program participants, provided training and support for SMPB, and nutrition and BP education. DASH-aligned meals delivered 40% (lunch) or 70% (breakfast and lunch) of DASH requirements/day. Primary outcomes were change in BP, and BP control, at Month 1. Implementation data collected included client characteristics, menu fidelity, meal attendance, SMBP adherence, meal satisfaction, input from partner organizations and stakeholders, effort, and food costs. We used the RE-AIM framework to analyze implementation. Study Reach included 94 older, racially diverse participants reflecting neighborhood characteristics. Effectiveness: change in systolic BP at Month 1 trended towards significance (-4 mmHg,
= 0.07); change in SMBP reached significance at Month 6 (-6.9 mmHg,
= 0.004). We leveraged existing community-academic partnerships, leading to Adoption at both target sites. The COVID pandemic interrupted Implementation and Maintenance and may have attenuated BP effectiveness. DASH meals served were largely aligned with planned menus. Meal attendance remained consistent; meal satisfaction was high. Food costs increased by 10%. This RE-AIM analysis highlights the acceptability, feasibility, and fidelity of this DASH/SMBP health intervention to lower BP at senior centers. It encourages future research and offers important lessons for organizations delivering services to older adults and addressing cardiovascular risk among vulnerable populations.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>36432576</pmid><doi>10.3390/nu14224890</doi><orcidid>https://orcid.org/0000-0002-3000-6556</orcidid><orcidid>https://orcid.org/0000-0003-1064-2026</orcidid><orcidid>https://orcid.org/0000-0003-4722-539X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MDPI - Multidisciplinary Digital Publishing Institute; MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central; PubMed Central Open Access |
| subjects | Adults Aged Blood Pressure Cardiovascular diseases Care and treatment COVID-19 - epidemiology COVID-19 - prevention & control DASH diet Diet Dietitians Education Food Food and nutrition Fruits Health aspects Health promotion Health risks Hispanic Americans Humans Hypertension Hypertension - epidemiology Hypertension - prevention & control Intervention Lunch Lunches Meals Measurement Minority & ethnic groups Neighborhoods Nursing home patients Nutrition Nutrition research Older people Organizations Practice research Regulation Senior citizen centers Socioeconomic factors Telemedicine |
| title | Implementing DASH-Aligned Meals and Self-Measured Blood Pressure to Reduce Hypertension at Senior Centers: A RE-AIM Analysis |
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