(SYM07-02-25) Factors Affecting Implementation of a Medically-Tailored Grocery Intervention for Hispanic/Latine Individuals With Hypertension

Objectives: To examine facilitators, barriers, and implementation outcomes (fidelity, quality, and participant responsiveness) for participation in a medically-tailored grocery intervention aligned with the Dietary Approaches to Stop Hypertension (DASH) Eating Plan designed for Hispanic/Latine patients with hypertension. We identified opportunities to improve quality and adaptations for scaling up a culturally tailored, evidence-based nutrition intervention (EBNI).

Methods: Community-based participatory research practices were used to develop a pilot 28-day DASH EBNI for 21 patients. Follow-up telephone interviews were conducted with 10 EBNI participants (5 with 50-75% and 5 with 100%+ compliance) one month post study. Compliance was determined by weekly reported servings of fruits and vegetables (F&V), aligning with DASH recommendations. Questions mapped to the Ecological Framework were used to assess implementation such as quality, fidelity, facilitators and barriers via community factors and provider and innovation characteristics. Interview themes were determined by the Framework Method.

Results: Thematic review of ten interviews reflected high study quality and appropriateness based on cultural appropriateness (innovation). Key facilitators included increased access and availability of foods and research team support (provider characteristics). Barrier reduction like cost of groceries and time to obtain foods were reported (community factors). Barriers to patient adoption, time to prepare foods, and adapting to F&V intake were present during the EBNI and impacted compliance. EBNI fidelity was high as 100% of interview participants noted the experience was delivered as described. The research team met >99% of protocol elements for all 21 EBNI participants. Average compliance reached 100% in week 4, suggesting successful implementation and feasibility. Possible adaptations include expanding family access and increasing Medical Nutrition Therapy.

Conclusions: Based on the assessed implementation aspects, EBNIs tailored to cultural food choices are uniquely positioned to reduce cardiovascular disease outcomes in the Hispanic/Latine community through the delivery of medically-tailored grocery intervention.

Funding Sources: NIMHD; GHR Foundation