Is it still possible to reduce population salt intake in the absence of adequate national policies and regulations? A social marketing intervention

Abstract

Purpose: High salt intake is one of the most important causes of some serious health problems. This study aims to evaluate the effects of a salt intake reduction intervention based on social marketing model in Ahwaz city, Iran. Design/methodology/approach: This was a before-after study with a control group using social marketing approach. Two similar residential complexes were chosen and randomly assigned into intervention or control groups. One hundred and thirty women were selected in each complex. Formative research was conducted, including focus group discussions (FGDs), a survey to identify cognitive factors of salt intake and a 24-h urine test to estimate salt intake value. Based on the results of the formative research, an intervention was planned and implemented for one month in the intervention group. The postintervention assessment was conducted repeating the cognitive survey and urine test. Statistical tests, including independent T-Test and paired T-Test, were used to compare the experimental and control groups. Findings: Before the intervention mean salt intake levels were 8,574.41 and 8,282.23 mg/day in the intervention and control groups, respectively. The total mean scores of cognitive and behavioral factors were 25.32 and 26.41 out of 59 in the intervention and control groups, respectively. After the intervention in the intervention group, daily salt intake decreased significantly by 1,558.83 mg/day and mean total scores of cognitive and behavioral factors increased significantly by 10.73. Research limitations/implications: Due to sodium excretion fluctuations in different days and/or different people, estimating sodium excretion based on one-day sample may have bias. Still, 24-h urine test is the most effective method to estimate population mean salt intake which is used in this study. Practical implications: The authors could not investigate urine sodium levels in other family members due to resource limitations. Knowing this could help us to see if similar results are achieved. Originality/value: Despite the lack of public policies to decrease population salt intake, interventions based on social marketing can significantly reduce salt intake. However, the long-term effect of such interventions will require further investigation.