A process for preparing an article having a low-fouling surface on a substrate, the substrate having a surface, a bulk beneath the surface, and a near-surface zone lying between the surface and the bulk, the surface, near-surface zone and bulk containing a composite, the composite comprising a continuous phase of a first material and particles of a second material dispersed in the continuous phase, the first material being polymeric and the first and second material being different, the process comprising (a) treating the substrate surface to reduce the second material from the substrate surface and (b) forming a grafted polymer layer on the treated substrate surface, the treated surface and the grafted polymer layer, in combination, constituting a low-fouling surface having a fibrinogen adsorption of less than about 125 ng/cm2 in a fibrinogen binding assay in which the low-fouling surface is incubated for 60 minutes at 37° C. in a composition containing 70 μg/ml fibrinogen derived from human plasma and 1.4 μg/ml I-125 radiolabeled fibrinogen, wherein, after the surface is treated, the particles have an average particle size and a distribution such that the number density of the particles in the near-surface zone is less than the overall number density of the particles in the composite, the near-surface zone extends a distance, D, from the substrate surface and into the substrate, and D has a value that does not exceed twice the average particle size.