DASH to wellness: emphasizing self-regulation through e-health in adults with prehypertension.

OBJECTIVE High prevalence rates of prehypertension require nonpharmaceutical lifestyle interventions. The objective of this study was to assess the feasibility and initial efficacy of a primarily electronically delivered intervention for prehypertension. METHODS Twenty-three adults with prehypertension (M age of 54.3; systolic blood pressure [BP], 126.3 mmHg; weight, 87.8 kg; body mass index, 31.5; 6514 steps/day) were randomized to DASH 2 wellness only standard of care or to DASH 2 wellness plus. Both groups received instruction on the DASH eating plan, instructions to increase steps per day and use of a weight scale and pedometer, and information about social-cognitive theory-based self-regulation strategies. D2W plus also involved home blood pressure monitoring and monitoring steps per day, nutrition, and body weight. Through weekly newsletters, participants engaged in electronic reporting and goal setting and received feedback on progress. RESULTS D2W plus showed a larger increase in daily steps (M = 2,900) than D2W only (M = 636); a larger decrease in systolic BP (mmHg), M = 15.1 versus M = 4.6, and a larger decrease in weight (in kg), M = 4.8 versus M = 1.5. CONCLUSIONS Concentrating efforts not only toward adoption and initiation of innovative risk-reduction strategies but also toward the provision for long-term maintenance of a healthy lifestyle once initial changes have been accomplished is paramount. The D2W plus program could be adapted for such use in health care and other settings for treating prehypertension.