The implementation and evaluation of a community-based salt reduction strategy in Australia

Abstract

OBJECTIVE: Salt reduction is a public health priority but there are few studies testing the efficacy of plausible salt reduction programs. METHODS: A multi-faceted, community-based salt reduction program using the Communication for Behavioral Impact framework was implemented in Lithgow, Australia. Single 24hr urinary samples were obtained from a total of 991 individuals, as well as, information about knowledge and behaviours relating to salt. FINDINGS: Mean salt intake fell from 8.8 g/day (SD=3.6g/day) in 2011 to 8.0(3.6) g/day in 2014 (-0.80, 95% confidence interval –1.2 to -0.3;p<0.001). There were significant increases in the proportion of participants that knew the recommended upper limit of salt intake (18% vs. 29%; p<0.001), the importance of salt reduction (64% vs. 78%; p<0.001), reported changing their behaviors to reduce their salt intake by using spices (5% vs. 28%; p<0.001) and avoiding eating out (21% vs. 34%; p<0.001). However, the proportions that checked food labels (30% vs. 25%; p=0.02) fell, as did the numbers avoiding processed foods (44% vs. 35%; p=0.006). CONCLUSION: Implementation of this multi-faceted program was associated with a ~10% reduction in salt consumption. These findings highlight the potential of well-designed health promotion programs to compliment other population-based strategies to bring about much-needed reductions in salt consumption