Abstract MP02: Sociodemographic and Behavioral Factors Associated With Diet Quality Among Low-Income Community Health Center Patients With Hypertension

Abstract

Objective: Identify sociodemographic and behavioral factors related to the diet of low-income adults with hypertension to inform the development of a community health worker (CHW) nutrition security intervention to improve blood pressure. Design: In this cross-sectional analysis, dietary recalls were used to assess Healthy Eating Index-2020 (HEI-2020) total (range: 0 to 100 [best diet quality]) and component scores and sodium intake. Self-reported sociodemographic and behavioral data were entered into a Least Absolute Shrinkage and Selection Operator (LASSO) regression model to determine the relative importance of factors related to diet quality. Setting: Five community health centers in Boston, Massachusetts. Participants: Adults (>20 years old) with a hypertension diagnosis. Results: Participants (N=291) were mostly female (65.0%), on Medicaid (82.8%), food insecure (59.5%), and Hispanic (52.2%). The mean (95% CI) HEI-2020 score was 63.0 (62.3, 65.7) Component scores were low for sodium and whole grains; mean (SE) sodium intake was 2676.9 (45.5) mg/day. The most important factors associated with lower HEI-2020 scores were: not having own housing, male gender, tobacco use, marijuana use, and skipping meals; the most important factors associated with higher HEI-2020 scores were Hispanic ethnicity and receipt of community food resources (5-fold cross-validated R 2 =0.17). Conclusions: In this population of low-income adults with hypertension, diet quality would be improved by reducing sodium and increasing whole grain intake. In the future, a CHW intervention could help provide tailored dietary guidance while addressing social (e.g., community food resources) and behavioral (e.g., meal skipping) factors associated with poor diet in patients with hypertension.