Integrating Free-choice Marketplace, dieTitian coacHing, cultuRally Tailored messagIng to improVE Blood Pressure

Inclusion criteria

• 21-70 years
• Self-identify as Black/African American or Hispanic/Latino
• Have Stage 2 CKM defined as:
• Systolic BP ≥130mmHg (measured at screening) AND at least one of:
• Hypertension (ICD-10: I10-I16)
• Prediabetes (HbA1c 5.7-6.4%) or Type 2 Diabetes (HbA1c ≥6.5%)
• Stage 3 chronic kidney disease (CKD) (eGFR 30-59 mL/min/1.73m²)
• Live in census tracts identified by the Montgomery/ Prince George's/Baltimore City County Departments of Planning as HFPA:
• Healthy Food Availability Index score is low (0-9.5),
• Median household income ≤185% of Federal Poverty Level
• 30% of households have no vehicle,
• Distance to supermarket \>1/4 mile. 5. Have refrigeration, food preparation appliances (microwave, stove), and cell phones for the App

Exclusion criteria

• Age \<21 years
• Diagnosis of end-stage renal disease (ESRD), dialysis
• Serious medical condition that either limits life expectancy or requires active management (e.g., cancer)
• Significant food allergies, preferences, intolerances, or dietary requirements that would interfere with diet adherence
• Active alcohol or substance use disorder (i.e., not sober/abstinent for ≥ 30 days)
• Patients with cognitive impairment or other condition preventing their participation in the intervention
• Pregnant, breastfeeding, or planning pregnancy
• Current participation in a care management program related to health conditions (e.g., weight reduction, smoking cessation) or another clinical trial that could interfere with the study protocol
• Planning to move out of the geographic area in 12 months