Caracterizacao do consumo de sal entre hipertensos segundo fatores sociodemograficos e clinicos

OBJECTIVE: to evaluate the relationship between the behaviors of salt consumption and socio-demographic and clinical variables. METHOD: sodium consumption was evaluated using the methods: self-reporting (considering 3 different behaviors related to salt consumption), 24- hr dietary recall, discretionary salt, food frequency questionnaire, estimation of total sodium intake and 24-hr urinary excretion of sodium (n=108). RESULTS: elevated salt intake according to the different measurements of consumption of the nutrient was associated with the variables: male sex, low level of schooling and monthly income, being Caucasian, and being professionally inactive; and with the clinical variables: elevated Body Mass Index, tensional levels, ventricular hypertrophy and the number of medications used. CONCLUSION: the data obtained shows a heterogenous association between the different behaviors related to salt consumption and the socio-demographic and clinical variables. This data can be used to optimize the directing of educational activities with a view to reducing salt consumption among hypertensives.OBJETIVO: evaluar la relación entre los comportamientos de consumo de sal y variables sociodemográficas y clínicas. MÉTODO: el consumo de sodio fue evaluado según los métodos: de autorrelato (objetivando 3 diferentes comportamientos relacionados al consumo de sal), recordatorio de 24h, sal per cápita, cuestionario de frecuencia alimentaria, estimativa de consumo total de sodio y excreción urinaria de sodio (n=108). RESULTADOS: el consumo elevado de sal según las diferentes medidas de consumo del nutriente fue asociado a las variables: sexo masculino, bajo nivel de escolaridad y de renta mensual, color blanco, inactividad profesional y a las variables clínicas: Índice de Masa Corporal elevada, niveles de tensión, indicadores de hipertrofia ventricular y número de medicaciones utilizadas. CONCLUSIÓN: los datos obtenidos muestran una asociación heterogénea entre los diferentes comportamientos relacionados al consumo de sal y a las variables sociodemográficas y clínicas. Estos datos pueden ser utilizados para optimizar la orientación de las actividades educativas objetivando la reducción del consumo de sal entre hipertensos.OBJETIVO: avaliar a relação entre os comportamentos de consumo de sal e variáveis sociodemográficas e clínicas. MÉTODO: o consumo de sódio foi avaliado segundo os métodos: de autorrelato (visando 3 diferentes comportamentos relacionados ao consumo de sal), recordatório de 24h, sal per capita, questionário de frequência alimentar, estimativa de consumo total de sódio e excreção urinária de sódio (n=108). RESULTADOS: o consumo elevado de sal, segundo as diferentes medidas de consumo do nutriente foi associado às variáveis: sexo masculino, baixo nível de escolaridade e de renda mensal, cor branca, inatividade profissional e às variáveis clínicas: índice de massa corpórea elevada, níveis tensionais, indicadores de hipertrofia ventricular e número de medicações utilizadas. CONCLUSÃO: os dados obtidos mostram uma associação heterogênea entre os diferentes comportamentos relacionados ao consumo de sal e às variáveis sociodemográficas e clínicas. Esses dados podem ser utilizados para otimizar o direcionamento das atividades educativas, visando a redução do consumo de sal entre hipertensos

Impact of an intervention for strenthening the motivation to reduce salt intake among women with hypertension

Orientadores: Maria Cecília Bueno Jayme Gallani, Roberta Cunha Matheus RodriguesTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: A redução do consumo de sal constitui importante intervenção não farmacológica para a prevenção e controle da hipertensão arterial. Entretanto, estudo prévio realizado junto a hipertensos constatou consumo elevado de sal, principalmente do sal adicionado no preparo dos alimentos por mulheres hipertensas. O presente estudo teve como objetivo verificar o efeito de intervenção motivacional baseada em teoria (Programa SALdável) para redução do consumo de sal (uso de 4 gramas ou menos de sal no preparo das refeições) entre mulheres portadoras de hipertensão arterial, especificamente voltada para aumentar a percepção de auto-eficácia e modificar o hábito. Tratou-se de um estudo experimental, longitudinal com seis etapas em seguimento de três meses. Em T0 foram coletadas as variáveis sociodemográficas e clínicas, mensuradas as variáveis psicossociais (intenção, auto-eficácia e hábito) e o comportamento (medida subjetiva do comportamento, consumo de sal per capita e consumo de temperos prontos e excreção urinária de sódio de 24h), e realizada a randomização dos sujeitos em dois grupos: Intervenção (GI, n=43) e Controle (GC, n=49). Um (T1) e dois (T3) meses após T0, foram implementadas a primeira e segunda etapa da intervenção para o GI, respectivamente. Quinze dias após T1 (T2) e T3 (T4), foram realizados reforços das intervenções por contato telefônico. O GC foi submetido aos cuidados usuais do serviço de saúde. Três meses após T0 (T5), foram mensuradas as variáveis psicossociais e o comportamento em ambos os grupos. Os dados foram avaliados por meio de análise descritiva e de comparação. Análises de regressão linear foram realizadas para avaliar o efeito da intervenção sobre as medidas do comportamento e das variáveis psicossociais e para identificar os mediadores do efeito da intervenção. Por fim, foi calculado o tamanho do efeito da intervenção (effect size). Os resultados mostraram redução significativa do consumo de sal no GI e que a intervenção explicou a variabilidade de todas as medidas do comportamento de consumo de sal, exceto a excreção urinária de sódio de 24h. A intervenção ainda explicou 42,5% da variabilidade da intenção, 20,7% da variabilidade da auto-eficácia e 33,0% da variabilidade do hábito. Hábito foi identificado como mediador do efeito da intervenção sobre a medida subjetiva do comportamento de consumo de sal e auto-eficácia como mediadora do efeito da intervenção sobre a intenção. A intervenção baseada em teoria visando o aumento da percepção de auto-eficácia e modificação do hábito mostrou ser útil e efetiva para motivar as mulheres hipertensas a reduzirem o consumo de sal por meio da redução da adição de sal no preparo dos alimentosAbstract: Salt intake reduction is the most important non-pharmacological intervention to prevent and control high blood pressure. However, previous study among individuals with hypertension evidenced elevated salt consumption, mainly the salt addition during cooking. The aim of this study was to verify the effect of a theory-based motivational intervention (SALdável Program) to reduce salt intake (use of less than 4g of salt/day during cooking meals) among women with hypertension, with particular focus on improving self-efficacy perception and changing the habit. It was an experimental study with six steps in three-month follow-up. At baseline (T0), demographic, clinical, psychosocial (intention, self-efficacy and habit) and salt intake behavioral variables (behavioral question, discretionary salt, consumption of seasoned salt/bouillons and 24-h urinary sodium excretion) were measured, and women were randomized to the intervention (IG, n=43) or the control group (CG, n=49). Intervention sessions were performed one (T1) and two (T3) months after the baseline, for IG. Fifteen days after T1 (T2) and T3 (T4) participants received reinforcement phone calls. Three months after baseline (T5), psychosocial and behavioral variables were measured in both groups. Data were assessed by means of descriptive and comparison analyses. Regression analyses were conducted to verify the effect of the intervention and to identify the mediators of intervention. Finally, effect size was calculated. Results demonstrated that salt intake decreased significantly in IG and that the intervention explained the variance of all salt intake variables, except for 24-h urinary sodium. Intervention also explained the variance of intention (42.5%), self-efficacy (20.7%) and habit (33.0%). Multiple mediation analyses demonstrated that habit remained the only significant mediator of the relation between intervention and the behavioral question of salt intake whereas self-efficacy mediated the effect of the intervention on intention. The theory-based intervention aimed at improving self-efficacy perception and changing habit is feasible and effective to motivate women to reduce salt intake by means of reducing salt addition during cookingDoutoradoDoutor em Enfermage

Salt consumption among hypertensive subjects : study of behavioral individual determinants

Orientador: Maria Cecilia Bueno Jayme GallaniGaston GodinDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias MedicasResumo: Este estudo teve como objetivo identificar os fatores individuais associados ao comportamento do consumo de uma dieta com baixo teor de sal entre sujeitos portadores de hipertensão arterial, com emprego de uma extensão da Teoria do Comportamento Planejado (TPB). O consumo de sal foi avaliado por meio de três comportamentos distintos: Comportamento I - uso de no máximo 4 gramas de sal/dia no preparo dos alimentos; Comportamento II - evitar a adição de sal nos alimentos já preparados; Comportamento III - evitar o consumo de alimentos com alto teor de sal. Foi conduzido estudo longitudinal, com coleta de dados em T0 e T1 - 2 meses após a abordagem inicial. A amostra foi composta por 108 sujeitos em T0 e em T1 retornaram 95 sujeitos. Em T0 foi realizada a caracterização sociodemográfica e clínica e a medida das variáveis psicossociais oriundas da TPB (Intenção, Atitude, Norma Subjetiva, Controle Comportamental Percebido) e adicionais (Auto-eficácia, Hábito, Comportamento Passado, Preferências Alimentares, Determinantes Hedônicos, Auto-avaliação da Qualidade da Dieta e Ambiente). O comportamento foi mensurado em T0 (Comportamento passado) e em T1 (Comportamento atual), por meio de uma questão subjetiva, auto-avaliativa, sobre do consumo de sódio específico para cada um dos comportamentos estudados e por meio das medidas objetivas: recordatório de 24h; consumo de sal per capita, Questionário de Freqüência Alimentar de Sódio (QFASó) e sódio urinário. Os dados foram analisados inicialmente de forma descritiva e, em seguida, submetidos às análises inferenciais: de correlação (coeficiente de Spearman) - para verificar a relação entre as variáveis psicossociais oriundas da TPB / variáveis adicionais e a motivação para agir (Intenção), bem como entre Intenção e Comportamento; análise de regressão linear univariada seguida de regressão multivariada - para testar a capacidade das variáveis oriundas da TPB e adicionais em predizer a Intenção e da Intenção em predizer o Comportamento. Os principais achados apontaram que Auto-eficácia e Hábito explicaram 62% da variabilidade da Intenção relacionada ao Comportamento I, o Controle Comportamental Percebido 19% da variabilidade da Intenção relacionada ao Comportamento II, e as variáveis Auto-eficácia, Controle Comportamental Percebido e Norma Subjetiva 63% da variabilidade da Intenção relacionada ao Comportamento III. A Intenção foi preditora do Comportamento I, explicando 22% de sua variabilidade e preditora limítrofe estatisticamente do Comportamento III, explicando 4% de sua variabilidade. Assim, os dados obtidos fornecem subsídios para as atividades educativas posteriores, baseadas nos fatores determinantes da Intenção e dos Comportamentos I e III.Abstract: The aim of this study was to identify the individual factors associated to the behavior of low salt consumption among hypertensive subjects, based on an extension of the Theory of Planned Behavior (TPB). The salt consumption was evaluated by 3 distinct behaviors: Behavior I - the use of less than 4g of salt (corresponding to 1 "flat" teaspoon of salt) when you cook one of your usual recipes for any meal; Behavior II - to avoid adding salt/using table salt to the prepared food; Behavior III - to avoid the consumption of food with high salt content. The study was conducted over a 2-month period, with data collection at T0 (baseline) and T1 - 2 months after the first approach. A total of 95 (95/108; 87.9%) participants completed the study for the Behaviors II and III and 45 for the Behavior I (45/53; 84.9%). Questionnaire at baseline included demographic and clinical data, TPB variables (Intention, Attitude, Subjective Norm and Perceived Behavioral Control) and additional variables (Self-efficacy, Habit, Past Behavior, Food Preferences, Hedonic Determinants, Diet Quality and Environment). The Behavior was measured at T0 (Past Behavior) and at T1 (Actual Behavior), using an self-reported item about salt consumption specific for each behavior and through the objective measures: 24h-recall, per capita salt, food-frequency questionnaire for sodium intake(FFQ-Na) and 24-h urinary sodium. Data were initially submitted to a descriptive analysis and afterwards to the inferential analyses: Spearman's correlation coefficient, to investigate the relation between the TPB/additional variables and the motivation (Intention), as well as the relation between the Intention and the Behavior; and finally, linear regression analysis, to determine the ability of the Intention in predicting each one of the 3 Behaviors at the follow-up. The main findings pointed the Self-efficacy and Habit explained 62% in Intention variance related to Behavior I; for Behavior II, Intention was mainly predicted by Perceived Behavioral Control, that explained 19% of its variance; and Self-efficacy, Perceived Behavioral Control and Subjective Norm explained 63% of the Intention variance regarding Behavior III. Intention was a predictor of the Behavior I, explaining 22% of its variance, and statistically bordering predictor of the Behavior III, explaining 4% of its variability. The results provide subsidies to the development of educational interventions based on the Intention and the Behavior (I and III) determinants.MestradoEnfermagem e TrabalhoMestre em Enfermage

Effect of implementation intention on walking in people with diabetes: an experimental approach

OBJECTIVE: To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS: We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS: After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS: Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM

Characterization of salt consumption among hypertensives according to socio-demographic and clinical factors

OBJECTIVE: to evaluate the relationship between the behaviors of salt consumption and socio-demographic and clinical variables. METHOD: sodium consumption was evaluated using the methods: self-reporting (considering 3 different behaviors related to salt consumption), 24- hr dietary recall, discretionary salt, food frequency questionnaire, estimation of total sodium intake and 24-hr urinary excretion of sodium (n=108). RESULTS: elevated salt intake according to the different measurements of consumption of the nutrient was associated with the variables: male sex, low level of schooling and monthly income, being Caucasian, and being professionally inactive; and with the clinical variables: elevated Body Mass Index, tensional levels, ventricular hypertrophy and the number of medications used. CONCLUSION: the data obtained shows a heterogenous association between the different behaviors related to salt consumption and the socio-demographic and clinical variables. This data can be used to optimize the directing of educational activities with a view to reducing salt consumption among hypertensives

Caracterizacion del consumo de sal entre hipertensos segun factores sociodemograficos y clinicos

OBJECTIVE:to evaluate the relationship between the behaviors of salt consumption and socio-demographic and clinical variables.METHOD:sodium consumption was evaluated using the methods: self-reporting (considering 3 different behaviors related to salt consumption), 24- hr dietary recall, discretionary salt, food frequency questionnaire, estimation of total sodium intake and 24-hr urinary excretion of sodium (n=108).RESULTS:elevated salt intake according to the different measurements of consumption of the nutrient was associated with the variables: male sex, low level of schooling and monthly income, being Caucasian, and being professionally inactive; and with the clinical variables: elevated Body Mass Index, tensional levels, ventricular hypertrophy and the number of medications used.CONCLUSION:the data obtained shows a heterogenous association between the different behaviors related to salt consumption and the socio-demographic and clinical variables. This data can be used to optimize the directing of educational activities with a view to reducing salt consumption among hypertensives.OBJETIVO:avaliar a relação entre os comportamentos de consumo de sal e variáveis sociodemográficas e clínicas.MÉTODO:o consumo de sódio foi avaliado segundo os métodos: de autorrelato (visando 3 diferentes comportamentos relacionados ao consumo de sal), recordatório de 24h, sal per capita, questionário de frequência alimentar, estimativa de consumo total de sódio e excreção urinária de sódio (n=108).RESULTADOS:o consumo elevado de sal, segundo as diferentes medidas de consumo do nutriente foi associado às variáveis: sexo masculino, baixo nível de escolaridade e de renda mensal, cor branca, inatividade profissional e às variáveis clínicas: índice de massa corpórea elevada, níveis tensionais, indicadores de hipertrofia ventricular e número de medicações utilizadas.CONCLUSÃO:os dados obtidos mostram uma associação heterogênea entre os diferentes comportamentos relacionados ao consumo de sal e às variáveis sociodemográficas e clínicas. Esses dados podem ser utilizados para otimizar o direcionamento das atividades educativas, visando a redução do consumo de sal entre hipertensos.OBJETIVO:evaluar la relación entre los comportamientos de consumo de sal y variables sociodemográficas y clínicas.MÉTODO:el consumo de sodio fue evaluado según los métodos: de autorrelato (objetivando 3 diferentes comportamientos relacionados al consumo de sal), recordatorio de 24h, sal per cápita, cuestionario de frecuencia alimentaria, estimativa de consumo total de sodio y excreción urinaria de sodio (n=108).RESULTADOS:el consumo elevado de sal según las diferentes medidas de consumo del nutriente fue asociado a las variables: sexo masculino, bajo nivel de escolaridad y de renta mensual, color blanco, inactividad profesional y a las variables clínicas: Índice de Masa Corporal elevada, niveles de tensión, indicadores de hipertrofia ventricular y número de medicaciones utilizadas.CONCLUSIÓN:los datos obtenidos muestran una asociación heterogénea entre los diferentes comportamientos relacionados al consumo de sal y a las variables sociodemográficas y clínicas. Estos datos pueden ser utilizados para optimizar la orientación de las actividades educativas objetivando la reducción del consumo de sal entre hipertensos.1013102

Dietary sources of salt intake in adults and older people : a population-based study in a brazilian town

To assess salt intake and its dietary sources using biochemical and self-report methods and to characterize salt intake according to sociodemographic and disease-related variables in a sample of the Brazilian population. Population-based cross-sectional survey. Salt intake was assessed by biochemical (24 h urinary Na excretion) and self-report methods (sodium FFQ, 24 h dietary recall, seasoned-salt questionnaire, discretionary-salt questionnaire and total reported salt intake). Adults and older people (n 517) aged 20-80 years, living in Artur Nogueira, Sao Paulo, Brazil. Mean salt intake based on 24 h urinary Na excretion and total reported salt intake was 10 center dot 5 and 11 center dot 0 g/d, respectively; both measures were significantly correlated. Discretionary salt and seasoned salt were the most important sources of salt intake (68 center dot 2 %). Men in the study consumed more salt than women as estimated by 24 h urinary Na excretion (11 center dot 7 v. 9 center dot 6 g salt/d; P<0 center dot 0001). Participants known to be hypertensive added more salt to their meals but consumed less salty ultra-processed foods. Waist circumference in both sexes and BMI were positively correlated with salt intake estimated by 24 h urinary Na excretion. In addition, regression analysis revealed that being a young male or having a high waist circumference was a predictor of higher salt intake. Salt intake in this population was well above the recommended amount. The main source of salt intake came from salt added during cooking. Salt intake varied according to sex and waist circumference2281388139

Attitudes towards vaccines and intention to vaccinate against COVID-19: a cross-sectional analysis - implications for public health communications in Australia

Objective To examine SARS-CoV-2 vaccine confidence, attitudes and intentions in Australian adults as part of the iCARE Study. Design and setting Cross-sectional online survey conducted when free COVID-19 vaccinations first became available in Australia in February 2021. Participants Total of 1166 Australians from general population aged 18-90 years (mean 52, SD of 19). Main outcome measures Primary outcome: responses to question € If a vaccine for COVID-19 were available today, what is the likelihood that you would get vaccinated?'. Secondary outcome: analyses of putative drivers of uptake, including vaccine confidence, socioeconomic status and sources of trust, derived from multiple survey questions. Results Seventy-eight per cent reported being likely to receive a SARS-CoV-2 vaccine. Higher SARS-CoV-2 vaccine intentions were associated with: increasing age (OR: 2.01 (95% CI 1.77 to 2.77)), being male (1.37 (95% CI 1.08 to 1.72)), residing in least disadvantaged area quintile (2.27 (95% CI 1.53 to 3.37)) and a self-perceived high risk of getting COVID-19 (1.52 (95% CI 1.08 to 2.14)). However, 72% did not believe they were at a high risk of getting COVID-19. Findings regarding vaccines in general were similar except there were no sex differences. For both the SARS-CoV-2 vaccine and vaccines in general, there were no differences in intentions to vaccinate as a function of education level, perceived income level and rurality. Knowing that the vaccine is safe and effective and that getting vaccinated will protect others, trusting the company that made it and vaccination recommended by a doctor were reported to influence a large proportion of the study cohort to uptake the SARS-CoV-2 vaccine. Seventy-eight per cent reported the intent to continue engaging in virus-protecting behaviours (mask wearing, social distancing, etc) postvaccine. Conclusions Most Australians are likely to receive a SARS-CoV-2 vaccine. Key influencing factors identified (eg, knowing vaccine is safe and effective, and doctor's recommendation to get vaccinated) can inform public health messaging to enhance vaccination rates

How well do covariates perform when adjusting for sampling bias in online COVID-19 research? Insights from multiverse analyses

: COVID-19 research has relied heavily on convenience-based samples, which-though often necessary-are susceptible to important sampling biases. We begin with a theoretical overview and introduction to the dynamics that underlie sampling bias. We then empirically examine sampling bias in online COVID-19 surveys and evaluate the degree to which common statistical adjustments for demographic covariates successfully attenuate such bias. This registered study analysed responses to identical questions from three convenience and three largely representative samples (total N = 13,731) collected online in Canada within the International COVID-19 Awareness and Responses Evaluation Study ( www.icarestudy.com ). We compared samples on 11 behavioural and psychological outcomes (e.g., adherence to COVID-19 prevention measures, vaccine intentions) across three time points and employed multiverse-style analyses to examine how 512 combinations of demographic covariates (e.g., sex, age, education, income, ethnicity) impacted sampling discrepancies on these outcomes. Significant discrepancies emerged between samples on 73% of outcomes. Participants in the convenience samples held more positive thoughts towards and engaged in more COVID-19 prevention behaviours. Covariates attenuated sampling differences in only 55% of cases and increased differences in 45%. No covariate performed reliably well. Our results suggest that online convenience samples may display more positive dispositions towards COVID-19 prevention behaviours being studied than would samples drawn using more representative means. Adjusting results for demographic covariates frequently increased rather than decreased bias, suggesting that researchers should be cautious when interpreting adjusted findings. Using multiverse-style analyses as extended sensitivity analyses is recommended.COVID-19 research has relied heavily on convenience-based samples, which-though often necessary-are susceptible to important sampling biases. We begin with a theoretical overview and introduction to the dynamics that underlie sampling bias. We then empirically examine sampling bias in online COVID-19 surveys and evaluate the degree to which common statistical adjustments for demographic covariates successfully attenuate such bias. This registered study analysed responses to identical questions from three convenience and three largely representative samples (total N = 13,731) collected online in Canada within the International COVID-19 Awareness and Responses Evaluation Study (www.icarestudy.com). We compared samples on 11 behavioural and psychological outcomes (e.g., adherence to COVID-19 prevention measures, vaccine intentions) across three time points and employed multiverse-style analyses to examine how 512 combinations of demographic covariates (e.g., sex, age, education, income, ethnicity) impacted sampling discrepancies on these outcomes. Significant discrepancies emerged between samples on 73% of outcomes. Participants in the convenience samples held more positive thoughts towards and engaged in more COVID-19 prevention behaviours. Covariates attenuated sampling differences in only 55% of cases and increased differences in 45%. No covariate performed reliably well. Our results suggest that online convenience samples may display more positive dispositions towards COVID-19 prevention behaviours being studied than would samples drawn using more representative means. Adjusting results for demographic covariates frequently increased rather than decreased bias, suggesting that researchers should be cautious when interpreting adjusted findings. Using multiverse-style analyses as extended sensitivity analyses is recommended