Breaking Through Resistance: Improving Dietary Compliance for Better Health

Hypertension (HTN), with 50% prevalence in the United States, puts people at risk of developing complications, such as heart attack, heart failure, stroke, or kidney damage if uncontrolled. The literature review showed evidence that tailored, cost-effective, and culturally competent diet education controls or improves blood pressure (BP). This quality improvement (QI) project aimed to review the outcomes of tailored Dietary Approaches to Stop Hypertension (DASH) education in underserved patients with HTN in a Federally Qualified Health Center in the Southwestern United States who were not receiving effective diet education from the primary care nurse practitioner. The intervention consisted of an in-person 1:1 DASH diet presentation, weekly phone call follow-up for one month, and printed DASH diet education. Adult participants (n=11) completed a demographic questionnaire and DASH Quality (DASH-Q) questionnaire (α=.77-.83) to measure their compliance with the diet pre- and post-intervention. Descriptive statistics and two-tailed paired samples t-test with the critical value set at p<0.10 were used for data analysis. The participants were primarily Hispanic women between 40 and 60, and none had tried the DASH diet. The average weekly BP readings were 138/88, 136/86, 134/83, 137/84, and 138/84. The overall average of the DASH-Q scores went from 37.5 to 45.0 (p<0.056). These findings suggest that tailored DASH diet education controls BP and improves adherence to the diet. This supports the need for longer appointment times, scheduling for diet education, or hiring a registered nurse or dietitian to provide effective diet education and weekly follow-ups.