LAUSR

Introduction: Heart-healthy diets are important in preventing hypertension (HTN) and hypertensive disorders of pregnancy (HDP), leading causes of preventable maternal mortality. However, perspectives of pregnant people with these conditions on barriers and facilitators of healthy eating are not well established. This study explored these experiences through qualitative feedback. Hypothesis: There are pregnancy-specific barriers and facilitators impacting healthy eating in people with HTN or at risk for HDP. Methods: Pregnant people with HTN or at risk for HDP were recruited from a large academic medical center for an electronic survey assessing barriers and facilitators to healthy eating. Participants answered open-ended questions about barriers to healthy diets and agents for change. Qualitative responses were analyzed using thematic analysis. Results: Of 46 participants (mean age 31.6 (SD 5.5) years, 35.1% Hispanic), 71.7% (33) responded to the question about barriers to healthy eating, with 56.5% (26) reporting specific barriers and 15.2% (7) reporting no barriers. Major themes for barriers included: (1) lack of education on what is “healthy;” (2) intrinsic factors (i.e., motivation, portion control, food cravings, and food aversions); (3) lack of access due to social determinants (i.e., time, finance, housing, culture and social factors); and (4) current health problems. Furthermore, 67.4% described facilitators to support healthy eating ( Table ), with themes of (1) external support, (2) discipline/routine; (3) increased affordability; and (4) menu/grocery guidance. Conclusion: Given lack of access and food preferences were common barriers to healthy eating, pregnant people with HTN or those at risk for HDP may benefit from food insecurity screening and individualized guidance from healthcare professionals. With personalized meal plans, specific recipes, and ingredient lists attainable in terms of cost, time, and social/cultural factors, these patients may be better supported for healthy eating.