scholarly journals Protocol for the Process Evaluation of a Complex, Statewide Intervention to Reduce Salt Intake in Victoria, Australia

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 998 ◽  
Author(s):  
Kathy Trieu ◽  
Stephen Jan ◽  
Mark Woodward ◽  
Carley Grimes ◽  
Bruce Bolam ◽  
...  
Keyword(s):  
Process Evaluation ◽  
Complex Disease ◽  
Salt Intake ◽  
Complex Interventions ◽  
Reduction Process ◽  
Population Based ◽  
Structured Interviews ◽  
Salt Reduction ◽  
Campaign Evaluation ◽  
Reduced Salt

Systematic reviews of trials consistently demonstrate that reducing salt intake lowers blood pressure. However, there is limited evidence on how interventions function in the real world to achieve sustained population-wide salt reduction. Process evaluations are crucial for understanding how and why an intervention resulted in its observed effect in that setting, particularly for complex interventions. This project presents the detailed protocol for a process evaluation of a statewide strategy to lower salt intake in Victoria, Australia. We describe the pragmatic methods used to collect and analyse data on six process evaluation dimensions: reach, dose or adoption, fidelity, effectiveness, context and cost, informed by Linnan and Steckler’s framework and RE-AIM. Data collection methods include routinely collected administrative data; surveys of processed foods, the population, food industry and organizations; targeted campaign evaluation and semi-structured interviews. Quantitative and qualitative data will be triangulated to provide validation or context for one another. This process evaluation will contribute new knowledge about what components of the intervention are important to salt reduction strategies and how the interventions cause reduced salt intake, to inform the transferability of the program to other Australian states and territories. This protocol can be adapted for other population-based, complex, disease prevention interventions.

scholarly journals Reducing the population's sodium intake: the UK Food Standards Agency's salt reduction programme

2011 ◽  
Vol 15 (2) ◽  
pp. 254-261 ◽  
Author(s):  
Laura A Wyness ◽  
Judith L Butriss ◽  
Sara A Stanner
Keyword(s):  
Blood Pressure ◽  
Salt Intake ◽  
Sodium Intake ◽  
Salt Reduction ◽  
Campaign Evaluation ◽  
Food Standards ◽  
Reporting Framework ◽  
Population Average ◽  
Scientific Papers ◽  
The Uk

AbstractObjectiveTo describe the UK Food Standards Agency's (FSA) salt reduction programme undertaken between 2003 and 2010 and to discuss its effectiveness.DesignRelevant scientific papers, campaign materials and evaluations and consultation responses to the FSA's salt reduction programme were used.SettingAdult salt intakes, monitored using urinary Na data collected from UK-wide surveys, indicate a statistically significant reduction in the population's average salt intake from 9·5 g/d in 2000–2001 to 8·6 g/d in 2008, which is likely to have health benefits.SubjectsReducing salt intake will have an impact on blood pressure; an estimated 6 % of deaths from CHD in the UK can be avoided if the number of people with high blood pressure is reduced by 50 %.ResultsSalt levels in food, monitored using commercial label data and information collected through an industry self-reporting framework, indicated that substantial reductions of up to 70 % in some foods had been achieved. The FSA's consumer campaign evaluation showed increased awareness of the benefits of reducing salt intake on health, with 43 % of adults in 2009 claiming to have made a special effort to reduce salt in their diet compared with 34 % of adults in 2004, before the campaign commenced.ConclusionsThe UK's salt reduction programme successfully reduced the average salt intake of the population and increased consumers’ awareness. Significant challenges remain in achieving the population average salt intake of 6 g/d recommended by the UK's Scientific Advisory Committee on Nutrition. However, the UK has demonstrated the success of its programme and this approach is now being implemented elsewhere in the world.

scholarly journals Salt and potassium intake among adult Ghanaians: WHO-SAGE Ghana Wave 3

BMC Nutrition ◽  
2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Elias K. Menyanu ◽  
Barbara Corso ◽  
Nadia Minicuci ◽  
Ilaria Rocco ◽  
Joanna Russell ◽  
...  
Keyword(s):  
Salt Intake ◽  
Population Based ◽  
Dietary Sodium ◽  
World Health ◽  
Adult Health ◽  
Salt Reduction ◽  
Hypertension Prevalence ◽  
Salt Consumption ◽  
Consumption Data

Abstract Though Ghana has high hypertension prevalence, the country lacks current national salt consumption data required to build and enhance advocacy for salt reduction. We explored the characteristics of a randomly selected sub sample that had valid urine collection, along with matched survey, anthropometric and BP data (n = 839, mean age = 60y), from the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE), Ghana Wave 3, n = 3053). We also investigated the relationship between salt intake and blood pressure (BP) among the cohort. BP was measured in triplicate and 24 h urine was collected for the determination of urinary sodium (Na), potassium (K), creatinine (Cr) and iodine levels. Hypertension prevalence was 44.3%. Median salt intake was 8.3 g/day, higher in women compared to men (8.6, interquartile range (IQR) 7.5 g/day vs 7.5, IQR 7.4 g/day, p <  0.01), younger participants (18–49 y) compared to older ones (50+ y) (9.7, IQR 7.9 g/day vs 8.1, IQR 7.1 g/day, p <  0.01) and those with higher Body Mass Index (BMI) (> 30 kg/m2) compared to a healthy BMI (18.5–24.9 kg/m2) (10.04, IQR 5.1 g/day vs 6.2, IQR 5.6 g/day, p <  0.01). More than three quarters (77%, n = 647) of participants had salt intakes above the WHO maximum recommendation of 5 g/d, and nearly two thirds (65%, n = 548) had daily K intakes below the recommended level of 90 mmol. Dietary sodium to potassium (Na: K) ratios above 2 mmol/mmol were positively associated with increasing BP with age. Population-based interventions to reduce salt intake and increase K consumption are needed.

scholarly journals Effects of salt reduction on cardiovascular risk factors. The STRIVE-study

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
U Toft ◽  
N L Riis ◽  
A D Lassen ◽  
E Trolle ◽  
K S Bjørnsbo
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Adverse Effects ◽  
Cardiovascular Risk Factors ◽  
Salt Intake ◽  
Plasma Cholesterol ◽  
Plasma Triglyceride ◽  
Salt Reduction ◽  
Reduced Salt

Abstract Potential adverse effects of reducing salt intake in the general population are discussed. This study aims to explore the effect of gradually reducing salt intake in a real-life setting. The study was a 4-month cluster RCT with families randomly assigned to either A) salt reduced bread, B) salt reduced bread and dietary counselling or C) standard bread (control) Participants in intervention A received bread gradually reduced in salt content from 1.2 g salt/100g (regular) to 0.6 g salt/100g in ryebread and 0.4 g salt/100g in wheat bread. Participants in intervention B received the same bread as intervention A but in addition, they received dietary advise on how to further reduce their salt intake and promote potassium. The control group received regular bread (blinded). Changes in outcomes were assessed using linear mixed models. Results A total of 89 Danish families (155 adults; 156 children) participated in the study. A total of 291 (94%) participants completed the intervention. Results are preliminary. Intention to treat analyses showed no significant effects of the salt reduction intervention on changes in systolic and diastolic blood pressure, plasma triglyceride. A small, but significant (-0.26 mmol/l; P = 0.02) decrease in total plasma cholesterol was shown in intervention group A. Per protocol analyses, including only participants in the intervention groups that decreased their salt intake by at least 20% from baseline to 4-month follow-up, showed a significant decrease in diastolic (-3.5 mmHg; P &lt; 0.0001) and systolic (-6.3 mmHg; P &lt; 0.0001) blood pressure, total cholesterol (-0.25 mmol/l; P = 0.0009), LDL cholesterol (log. transformed) (-6%; P = 0.03) and plasma triglyceride (log. transformed) (-17%; P = 0.04). No significant effects were found for HDL plasma cholesterol, aldosterone, renin, plasma glucose and HbA1c. Conclusions Reduced salt intake were associated with beneficial changes in cardiovascular risk factors. No adverse effects were observed. Key messages Reduced salt intake were associated with benificial changes in cardiovascular risk factors. No adverse effects were observed.

scholarly journals Stakeholder perspectives on the effectiveness of the Victorian Salt Reduction Partnership: a qualitative study

BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Emalie Rosewarne ◽  
Wai-Kwan Chislett ◽  
Briar McKenzie ◽  
Jenny Reimers ◽  
Kellie-Ann Jolly ◽  
...  
Keyword(s):  
Capacity Building ◽  
Communication Networks ◽  
Food Industry ◽  
Salt Intake ◽  
Cost Effective ◽  
Structured Interviews ◽  
Salt Reduction ◽  
Implementation Team ◽  
Collaborative Action ◽  
Stakeholder Perspectives

Abstract Background Interventions to reduce population salt intake are feasible and cost-effective. The Victorian Salt Reduction Partnership implemented a complex, multi-faceted salt reduction intervention between 2014 and 2020 in the Australian state of Victoria. This study aimed to understand stakeholder perspectives on the effectiveness of the Victorian Salt Reduction Partnership. Methods Semi-structured interviews were conducted with Partnership and food industry stakeholders. The Consolidated Framework for Implementation Research was adapted for the Partnership intervention and used to guide the qualitative analysis. Results Fourteen Partnership and seven food industry stakeholders were interviewed. The Partnership was viewed as essential for intervention planning and decision-making and an enabler for intervention delivery. The goals of capacity building and collaborative action were perceived to have been achieved. The implementation team executed intended intervention activities and outputs, with some adaptations to strategy. Barriers and enablers to implementation were identified by interviewees, such as compatibility of individual, organisational and Partnership values and building positive relationships between the Partnership and food industry, respectively. Legal, political, social, environmental, technological and economic factors affecting intervention design, delivery and outcomes were identified. Conclusions Establishing a Partnership with diverse skills and experience facilitated collaborative action, capacity building and execution of the intervention. Monitoring and evaluating implementation informed strategy adaptations, which allowed optimisation of Partnership strategy. The importance of developing strong communication networks between strategic and implementation-levels was a key lesson.

scholarly journals Stakeholder Perspectives on the Effectiveness of the Victorian Salt Reduction Partnership

2020 ◽  
Author(s):  
Emalie Rosewarne ◽  
Wai-Kwan Chislett ◽  
Briar McKenzie ◽  
Jenny Reimers ◽  
Kellie-Ann Jolly ◽  
...  
Keyword(s):  
Capacity Building ◽  
Communication Networks ◽  
Food Industry ◽  
Salt Intake ◽  
Cost Effective ◽  
Structured Interviews ◽  
Salt Reduction ◽  
Implementation Team ◽  
Collaborative Action ◽  
Stakeholder Perspectives

Abstract Background: Interventions to reduce population salt intake are feasible and cost-effective. The Victorian Salt Reduction Partnership implemented a complex, multi-faceted salt reduction intervention between 2014 and 2020 in the Australian state of Victoria. This study aimed to understand stakeholder perspectives on the effectiveness of the Victorian Salt Reduction Partnership. Methods: Semi-structured interviews were conducted with Partnership and food industry stakeholders. The Consolidated Framework for Implementation Research was adapted for the Partnership intervention and used to guide the qualitative analysis.Results: Fourteen Partnership and seven food industry stakeholders were interviewed. The Partnership was viewed as essential for intervention planning and decision-making and an enabler for intervention delivery. The goals of capacity building and collaborative action were perceived to have been achieved. The implementation team executed intended intervention activities and outputs, with some adaptations to strategy. Barriers and enablers to implementation were identified by interviewees, such as compatibility of individual, organisational and Partnership values and building positive relationships between the Partnership and food industry, respectively. Legal, political, social, environmental, technological and economic factors affecting intervention design, delivery and outcomes were identified. Conclusions: Establishing a Partnership with diverse skills and experience facilitated collaborative action, capacity building and execution of the intervention. Monitoring and evaluating implementation informed strategy adaptations, which allowed optimisation of Partnership strategy. The importance of developing strong communication networks between strategic and implementation-levels was a key lesson.

scholarly journals Screening tool for identifying adults with excessive salt intake among community-dwelling adults: a population-based cohort study

2020 ◽  
Vol 111 (4) ◽  
pp. 814-820
Author(s):  
Sho Sasaki ◽  
Toshihiko Takada ◽  
Shingo Fukuma ◽  
Miyuki Imamoto ◽  
Takeshi Hasegawa ◽  
...  
Keyword(s):  
Screening Tool ◽  
Salt Intake ◽  
Characteristic Curve ◽  
External Validation ◽  
Population Based ◽  
Community Dwelling ◽  
Clinical Expertise ◽  
Scoring Method ◽  
Salt Reduction ◽  
Validation Set

ABSTRACT Background Excessive salt intake is widely known to be a cause of hypertension, cardiovascular events, and so on. However, simple tools for screening excessive salt intake are lacking. Objective We aimed to develop a simple screening tool to identify community-dwelling adults with excessive salt intake. Methods The present study involved participants who received health check-ups in Fukushima, Japan, in 2016 and 2017. We defined data from the 2016 check-up as the derivation set, and data from those who received check-ups in 2017 but not 2016 as the validation set. The outcome measure was excessive salt intake, defined as the estimated daily salt intake of 1 SD or more. Candidate predictors associated with the outcome were extracted using the Delphi method by an expert panel and narrowed down with clinical expertise and stepwise backward selection. The screening tool was developed using a coefficient-based multivariable scoring method and externally validated. Results A total of 1101 participants were included in the derivation set and 249 in the validation set. At the conclusion of the deviation process, 8 predictors were selected and scored. The areas under the receiver operating characteristic curve for derivation and external validation were 0.70 (95% CI: 0.67, 0.74) and 0.71 (95% CI: 0.62, 0.80), respectively. The calibration slope and intercept for external validation were 1.16 and −0.03, respectively. Conclusion We developed a screening tool to identify adults with excessive salt intake. By extracting groups with excessive salt intake, target populations needing intervention for salt reduction can be highlighted efficiently.

scholarly journals A Brief Study of Dietary Salt Intake in an Urban Population

2021 ◽  
Author(s):  
Tahere Soltani ◽  
Seyed Saeed Mazloomy Mahmoodabad ◽  
Azadeh Nadjarzadeh ◽  
Ali Akbar Vaezi ◽  
Seyedeh Mahdieh Namayandeh ◽  
...  
Keyword(s):  
Salt Intake ◽  
Sodium Intake ◽  
Salt Content ◽  
Population Based ◽  
Time Interval ◽  
Dietary Salt ◽  
Related Factors ◽  
Salt Reduction ◽  
Dietary Salt Intake ◽  
The People

Background: The purpose of this study is to investigate the amount of salt consumed by the people living in Yazd, Iran and its related factors based on previous investigations. materials and methods: A general search was performed on electronic databases of Daneshgostar Barakat system, Magiran, SID and English databases such as Scopus, PubMed, Web of sciences, Science direct, and Google scholar search engines using following keywords: "salt intake" OR "sodium intake" OR "salt reduction" OR "salt content" OR "sodium reduction" OR "Diet, Reducing"  regardless of the time interval. A total of 273 articles were obtained from the mentioned website. Papers published up to September 30, 2019 were retrieved. A total of 15 related articles were analyzed, and studies on the amount of salt consumed were evaluated. Results: The amount of salt received by the people of Yazd is higher than the standard of the World Organization and has an increasing trend. Conclusion: A population-based approach for salt intake reduction can lower blood pressure levels and presumably significantly reduce mortality. Therefore, the implementation of a comprehensive plan and intervention for salt consumption is necessary for this population.

scholarly journals Stakeholder Perspectives on the Effectiveness of the Victorian Salt Reduction Partnership: A Qualitative Study

2020 ◽  
Author(s):  
Emalie Rosewarne ◽  
Wai-Kwan Chislett ◽  
Briar McKenzie ◽  
Jenny Reimers ◽  
Kellie-Ann Jolly ◽  
...  
Keyword(s):  
Capacity Building ◽  
Communication Networks ◽  
Food Industry ◽  
Salt Intake ◽  
Cost Effective ◽  
Structured Interviews ◽  
Salt Reduction ◽  
Implementation Team ◽  
Collaborative Action ◽  
Stakeholder Perspectives

Abstract Background: Interventions to reduce population salt intake are feasible and cost-effective. The Victorian Salt Reduction Partnership implemented a complex, multi-faceted salt reduction intervention between 2014 and 2020 in the Australian state of Victoria. This study aimed to understand stakeholder perspectives on the effectiveness of the Victorian Salt Reduction Partnership. Methods: Semi-structured interviews were conducted with Partnership and food industry stakeholders. The Consolidated Framework for Implementation Research was adapted for the Partnership intervention and used to guide the qualitative analysis.Results: Fourteen Partnership and seven food industry stakeholders were interviewed. The Partnership was viewed as essential for intervention planning and decision-making and an enabler for intervention delivery. The goals of capacity building and collaborative action were perceived to have been achieved. The implementation team executed intended intervention activities and outputs, with some adaptations to strategy. Barriers and enablers to implementation were identified by interviewees, such as compatibility of individual, organisational and Partnership values and building positive relationships between the Partnership and food industry, respectively. Legal, political, social, environmental, technological and economic factors affecting intervention design, delivery and outcomes were identified. Conclusions: Establishing a Partnership with diverse skills and experience facilitated collaborative action, capacity building and execution of the intervention. Monitoring and evaluating implementation informed strategy adaptations, which allowed optimisation of Partnership strategy. The importance of developing strong communication networks between strategic and implementation-levels was a key lesson.

scholarly journals The psychosocial response to a terrorist attack at Manchester Arena, 2017: a process evaluation

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Daniel Hind ◽  
Kate Allsopp ◽  
Prathiba Chitsabesan ◽  
Paul French
Keyword(s):  
Young People ◽  
Process Evaluation ◽  
Terrorist Attack ◽  
Health Sector ◽  
Routine Data ◽  
Recovery Phase ◽  
Normalisation Process Theory ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Response Phase

Abstract Background A 2017 terrorist attack in Manchester, UK, affected large numbers of adults and young people. During the response phase (first seven weeks), a multi-sector collaborative co-ordinated a decentralised response. In the subsequent recovery phase they implemented a centralised assertive outreach programme, ‘The Resilience Hub’, to screen and refer those affected. We present a process evaluation conducted after 1 year. Methods Case study, involving a logic modelling approach, aggregate routine data, and semi-structured interviews topic guides based on the Inter-Agency Collaboration Framework and May’s Normalisation Process Theory. Leaders from health, education and voluntary sectors (n = 21) and frontline Resilience Hub workers (n = 6) were sampled for maximum variation or theoretically, then consented and interviewed. Framework analysis of transcripts was undertaken by two researchers. Results Devolved government, a collaborative culture, and existing clinical networks meant that, in the response phase, a collaboration was quickly established between health and education. All but one leader evaluated the response positively, although they were not involved in pre-disaster statutory planning. However, despite overwhelming positive feedback there were clear difficulties. (1) Some voluntary sector colleagues felt that it took some time for them to be involved. (2) Other VCSE organisations were accused of inappropriate, harmful use of early intervention. (3) The health sector were accused of overlooking those below the threshold for clinical treatment. (4) There was a perception that there were barriers to information sharing across organisations, which was particularly evident in relation to attempts to outreach to first responders and other professionals who may have been affected by the incident. (5) Hub workers encountered barriers to referring people who live outside of Greater Manchester. After 1 year of the recovery phase, 877 children and young people and 2375 adults had completed screening via the Resilience Hub, 79% of whom lived outside Greater Manchester. Conclusions The psychosocial response to terrorist attacks and other contingencies should be planned and practiced before the event, including reviews of communications, protocols, data sharing procedures and workforce capacity. Further research is needed to understand how the health and voluntary sectors can best collaborate in the wake of future incidents.

scholarly journals Salt Intake in Nigeria: a nationwide population survey

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.N Odili ◽  
B.S Chori ◽  
B Danladi ◽  
P.C Nwakile ◽  
J.O Ogedengbe ◽  
...  
Keyword(s):  
Salt Intake ◽  
Sodium Intake ◽  
Population Analysis ◽  
Cost Effective ◽  
Rural Site ◽  
Urban Site ◽  
Funding Source ◽  
Salt Reduction ◽  
High Salt Intake ◽  
The Impact

Abstract Background Population wide salt reduction programmes are cost effective strategies for control of cardiovascular diseases (CVDs). Obtaining a nationwide salt consumption data in a multi-cultural setting as Nigeria's is key for proper implementation and monitoring of such strategy. Methods We measured sodium in 24-hour urine of free-living adult Nigerians selected from an urban and a rural site each from the 6 geopolitical zones of Nigeria to evaluate patterns of salt intake and its associations with blood pressures (BP). Results Across the 12 sites, sodium intake ranged from 97.9 in the rural South-South to 210 mmol/day in the urban site of the same zone. Overall, the median (IQR) daily sodium intake was 143.5 (97.8) mmol; with higher (p=0.0028) levels among the urban 149.7 (113.8) compared to the rural 133.1 (105.2) dwellers. Overall, 20% of the subjects consumed less than the recommended 2g (86mmol) of sodium daily. After adjustment for age, sex and BMI; sodium intake and BP (systolic and diastolic) were positively associated in 8 out of the 12 sites; significantly so in 2 (p&lt;0.05) for systolic. Within population analysis; which included 973 individuals, increasing sodium intake tended (not significantly) to increase SBP but decrease DBP. However, among subjects whose sodium intake was in excess of 257mmol/day, a 100 mmol/day increase in sodium intake was significantly (p=0.04) associated with a 3.3 mmHg increase in SBP. Conclusion Salt intake among Nigerians is higher than the recommended. The impact of sodium intake on BP appears to be evident only among individuals with high salt intake. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Wellcome Trust

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