Key result
Healthy food delivery increases ≥13/8 mmHg BP reductions by ~21% among Native American women.
Why the study?
Dietary interventions are used to treat hypertension, but the cost-efficacy of delivering culturally tailored food boxes and produce checks in a Native American population had not been evaluated.
Does the direct delivery of healthy food boxes and produce vouchers improve blood pressure in Native American adults with hypertension?
RCT (n=160)
Group randomization by county
Yes
Does the direct delivery of healthy food boxes and produce vouchers improve blood pressure in Native American adults with hypertension?
Direct delivery of DASH-adherent food boxes and produce vouchers is a cost-effective strategy for lowering blood pressure in Native American women with stage 1 hypertension.
Answers are grounded in this paper and cite their sources.
Supports food delivery programs in hypertension care for Native American women; extends RCT evidence on dietary interventions to indigenous populations.
Background Dietary interventions are used for the treatment of hypertension. We evaluated the cost-efficacy of delivering boxes of healthy, culturally tailored foods and checks that can only be spent on produce in a Native American population. Methods We conducted a group randomized controlled trial from 2018-2020 with N = 2 treatment counties and N = 2 control counties and a total of N = 160 Native American adults with baseline stage 1 or stage 2 hypertension. Participants in the intervention group received monthly boxes of food that adheres to the Dietary Approaches to Stop Hypertension diet as well as checks that could only be spent on produce for 6 months. We measured blood pressure and quality of life at baseline and at a 6-month follow-up in both intervention and control groups. We used ordered logistic regression to estimate the effect of treatment on probability of blood pressure improvements. We then conducted a cost-efficacy analysis. Results We found that treatment was effective in women with stage 1 hypertension at baseline. Based on this finding, we also estimate that this intervention satisfies normative cost-effectiveness thresholds, even when lifetime treatment is needed to preserve the impact, so long as treatment is only continued in those who respond to treatment. Conclusions Direct delivery of healthy foods and checks that can only be spent on produce are a potentially cost-effective intervention for the management of hypertension among Native American women with stage 1 hypertension. Further research is needed to understand why we found an impact only for this group.
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Henderson et al. (2024) conducted an RCT in Hypertension (n=160). Monthly boxes of healthy, culturally tailored foods (DASH diet) and Fresh Checks for produce vs. Free tribal gym membership, a Fitbit, and access to AYA app was evaluated on Probability of dropping blood pressure by ≥13/8 mmHg in women with baseline stage 1 hypertension (Marginal effect 0.21, 95% CI 0.02-0.40, p=<0.05). Delivery of healthy food boxes and produce checks significantly increased the probability of dropping blood pressure by ≥13/8 mmHg by 21 percentage points among Native American women with stage 1 hypertension.
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