Background: The seminal Dietary Approaches to Stopping Hypertension (DASH) study demonstrated the effectiveness of diet to control hypertension, however, effective implementation and dissemination of its principles have been limited. Objective: We hypothesize that a smartphone version of the DASH diet that uses automatic data collection, social networks, and “in-the-moment” feedback will be an effective medium for the delivery of DASH. Methods: We conducted a single arm pilot study from August 2015 - August 2016 with a pre-post evaluation design to evaluate the feasibility and preliminary efficacy of a smartphone version of DASH incorporating human health-coaching. Results: Seventeen patients participated; they had a mean age of 59 years (SD 6) and 60% were women. Engagement was high: out of 90 days, the mean number of logged blood pressures was 63 (SD 46), recorded weights was 52 (SD 45), and recorded steps was 55 (SD 36). 73% of coaching phone calls were completed. The mean number of servings documented per patient for the dietary assessment was 709 (SD 541), and patients set a mean number of 5 (SD 2) goals.
Mean systolic and diastolic blood pressure, heart rate, weight, body mass index; or steps did not significantly change over time. Conclusions: Successful lifestyle change interventions require substantial patient motivation, engagement, and access to experts. Our study was underpowered to evaluate for change in clinical outcomes; however, the high engagement of DASH mobile suggests that the “in-the-moment” delivery of DASH mobile may be a way to integrate and sustain behavioral change in HTN management. Future implementations of DASH can include integrated calendars, alarms, social networks, GPS or other smartphone tools to allow the delivery of behavioral feedback and education to the specific to the user’s behavior.
