Our Whole Lives for Hypertension and Cardiac Risk Factors—Combining a Teaching Kitchen Group Visit With a Web-Based Platform: Feasibility Trial

Abstract

Background Hypertension (HTN) affects millions of Americans. Our Whole Lives: an eHealth toolkit for Hypertension and Cardiac Risk Factors (OWL-H) is an eHealth platform that teaches evidence-based lifestyle strategies, such mindfulness and cooking skills, to improve self-management of HTN. Objective The primary goal of this pilot study was to evaluate the feasibility of OWL-H combined with teaching kitchen medical group visits (TKMGVs) in a low-income population of participants with HTN. Methods We conducted a pre-post 8-week study to assess the feasibility of a hybrid program (a web-based 9-module self-management program, which includes mindfulness and Mediterranean and Dietary Approaches to Stop Hypertension diet) accompanied by 3 in-person TKMGVs among patients with HTN. Data including demographics, platform use, and satisfaction after using OWL-H were examined. Outcome data collected at baseline and 8 weeks included the Mediterranean Diet Questionnaire, Hypertension Self-Care Profile Self-Efficacy Instrument, Blood Pressure Knowledge Questionnaire, and the number of self-reported blood pressure readings. For the statistical analysis, we used descriptive statistics, paired sample t tests (1-tailed), and qualitative methods. Results Of the 25 enrolled participants, 22 (88%) participants completed the study. Participants’ average age was 57 (SD 12.1) years, and 46% (11/24) of them reported a household income <US $30,000 per year. Among the 22 participants who logged in to OWL-H, the average number of mindfulness practices completed was 7 and the average number of module sessions accessed was 4. In all, 73% (16/22) of participants reported that they were “very satisfied” with using OWL-H to help manage their HTN. Participants’ blood pressure knowledge significantly increased from baseline (mean 5.58, SD 1.44) to follow-up (mean 6.13, SD 1.23; P=.03). Participants significantly increased their adherence to a Mediterranean diet from baseline (mean 7.65, SD 2.19) to follow-up (mean 9, SD 1.68; P=.004). Participants’ self-efficacy in applying heart-healthy habits, as measured by the Hypertension Self-Care Profile Self-Efficacy Instrument, increased from baseline (mean 63.67, SD 9.06) to follow-up (mean 65.54, SD 7.56; P=.14). At the 8-week follow-up, 82% (18/22) of the participants had self-reported their blood pressure on the OWL-H platform at least once during the 8 weeks. Conclusions The eHealth platform for HTN self-management, OWL-H, and accompanying in-person TKMGVs have the potential to effectively improve lifestyle management of HTN. Trial Registration ClinicalTrials.gov NCT03974334; https://clinicaltrials.gov/ct2/show/NCT03974334

Web-Based Nutrition and Physical Activity Education Intervention to Ameliorate Cardiometabolic Risks: A Single-Arm and Non-Randomized Feasibility Study

“… 21 Participant characteristics were comparable to the present study, in which most participants had tertiary education. 21 One possible explanation for the higher rate could be that the program combined web-based learning with a face-to-face cooking class every fortnight. Another feasibility study of online education also found a completion rate of 88% after 12 weeks of intervention among 26 participants.…”

“…The results of the present study contradicted the findings of another study. 21 Gardiner and colleagues conducted an 8-week pilot study to assess the feasibility of web-based nutrition education for low-income populations with hypertension and reported a high completion rate of 88%. 21 Participant characteristics were comparable to the present study, in which most participants had tertiary education.…”

“… 21 Gardiner and colleagues conducted an 8-week pilot study to assess the feasibility of web-based nutrition education for low-income populations with hypertension and reported a high completion rate of 88%. 21 Participant characteristics were comparable to the present study, in which most participants had tertiary education. 21 One possible explanation for the higher rate could be that the program combined web-based learning with a face-to-face cooking class every fortnight.…”

“…However, in the present study, the components in the previous studies, as mentioned above, were not present, which may contribute to the lower completion rate. 21 , 22 …”

Importance of Nutrition Security to CVD Prevention Efforts in the USA

“…Although more research is needed, emerging evidence suggests produce prescription programs can increase fruit and vegetable consumption and reduce household food insecurity; however, the mixed evidence for effects on diet-related health outcomes (i.e., weight, blood pressure, HbA1c) is in part due to suboptimal redemption rates, short intervention durations, and barriers such as limited employee training at voucher-redemption locations [ 101 •, 102 ]. Similarly, while teaching kitchens are seemingly feasible, participation rates can be low [ 103 ], and few studies have actually assessed hospital-based food pantries [ 101 •]. More evaluations are needed to understand the acceptability, uptake, and potential impact of these interventions among nutrition insecure groups specifically.…”