BackgroundOnly a limited number of studies have investigated challenges heart failure (HF) patients face in adhering to dietary recommendations for HF management, and none have focused on racially diverse, lower socioeconomic status (SES) populations at high risk for adverse outcomes.ObjectiveThe objective of this study was to explore and understand the dietary preferences and challenges of older, lower SES adults with HF.Study Design, Setting, ParticipantsWe conducted an exploratory, qualitative study using structured telephone interviews. Convenience sampling was used to recruit 21 adults with HF, aged 50 years or older, from the Minneapolis-St. Paul metropolitan area.Measurable Outcome/AnalysisResponses to open-ended questions about participants’ experiences managing their diet, grocery shopping, and cooking were analyzed from interview audio recordings using thematic analysis. Responses to closed-ended questions, including those about demographics and health and nutrition characteristics, were analyzed using descriptive statistics.ResultsThe dietary recommendations and goals most frequently mentioned by participants were limiting sodium and increasing intake of fruits and vegetables. Many participants reported that high food prices and a limited budget made it difficult to follow their diet and make healthy choices when grocery shopping. The food environment, particularly the high-salt content in food products and the promotion of unhealthy food in stores, presented additional challenges. Participants suggested a variety of ways to make following their diet, shopping, and cooking easier including online grocery ordering and delivery, pre-prepared ingredients, and assistance with meal planning, shopping, cooking, and cleaning up. The idea of a medically tailored home-delivered meal service was well-received by most study participants.ConclusionsOur findings provide a starting point for developing programs and policies to help older, lower SES HF patients follow their diet and improve their health, thereby reducing health disparities. Since finances are a key concern, programs and policies need to be designed with cost in mind. Only a limited number of studies have investigated challenges heart failure (HF) patients face in adhering to dietary recommendations for HF management, and none have focused on racially diverse, lower socioeconomic status (SES) populations at high risk for adverse outcomes. The objective of this study was to explore and understand the dietary preferences and challenges of older, lower SES adults with HF. We conducted an exploratory, qualitative study using structured telephone interviews. Convenience sampling was used to recruit 21 adults with HF, aged 50 years or older, from the Minneapolis-St. Paul metropolitan area. Responses to open-ended questions about participants’ experiences managing their diet, grocery shopping, and cooking were analyzed from interview audio recordings using thematic analysis. Responses to closed-ended questions, including those about demographics and health and nutrition characteristics, were analyzed using descriptive statistics. The dietary recommendations and goals most frequently mentioned by participants were limiting sodium and increasing intake of fruits and vegetables. Many participants reported that high food prices and a limited budget made it difficult to follow their diet and make healthy choices when grocery shopping. The food environment, particularly the high-salt content in food products and the promotion of unhealthy food in stores, presented additional challenges. Participants suggested a variety of ways to make following their diet, shopping, and cooking easier including online grocery ordering and delivery, pre-prepared ingredients, and assistance with meal planning, shopping, cooking, and cleaning up. The idea of a medically tailored home-delivered meal service was well-received by most study participants. Our findings provide a starting point for developing programs and policies to help older, lower SES HF patients follow their diet and improve their health, thereby reducing health disparities. Since finances are a key concern, programs and policies need to be designed with cost in mind.