Cost-effectiveness of reducing salt intake in the Pacific Islands: protocol for a before and after intervention study.
BACKGROUND
There is broad consensus that diets high in salt are bad for health and that reducing salt intake is a cost-effective strategy for preventing chronic diseases. The World Health Organization has been supporting the development of salt reduction strategies in the Pacific Islands where salt intakes are thought to be high. However, there are no accurate measures of salt intake in these countries. The aims of this project are to establish baseline levels of salt intake in two Pacific Island countries, implement multi-pronged, cross-sectoral salt reduction programs in both, and determine the effects and cost-effectiveness of the intervention strategies.


METHODS
Intervention effectiveness will be assessed from cross-sectional surveys before and after population-based salt reduction interventions in Fiji and Samoa. Baseline surveys began in July 2012 and follow-up surveys will be completed by July 2015 after a 2-year intervention period.A three-stage stratified cluster random sampling strategy will be used for the population surveys, building on existing government surveys in each country. Data on salt intake, salt levels in foods and sources of dietary salt measured at baseline will be combined with an in-depth qualitative analysis of stakeholder views to develop and implement targeted interventions to reduce salt intake.


CONCLUSIONS
Salt reduction is a global priority and all Member States of the World Health Organization have agreed on a target to reduce salt intake by 30% by 2025, as part of the global action plan to reduce the burden of non-communicable diseases. The study described by this protocol will be the first to provide a robust assessment of salt intake and the impact of salt reduction interventions in the Pacific Islands. As such, it will inform the development of strategies for other Pacific Island countries and comparable low and middle-income settings around the world.
George Institute for Global Health, (affiliated with the University of Sydney), Level 10, King George V Building, Royal Prince Alfred Hospital, Camperdown, Sydney, New South Wales 2050, Australia. jwebster@georgeinstitute.org.au.
Jacqui
J
Webster
Wendy
W
Snowdon
Marj
M
Moodie
Satu
S
Viali
Jimaima
J
Schultz
Colin
C
Bell
Mary-Anne
MA
Land
Shauna
S
Downs
Anthea
A
Christoforou
Elizabeth
E
Dunford
Federica
F
Barzi
Mark
M
Woodward
Bruce
B
Neal
D055812:Community-Based Participatory Research; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D005367:Fiji; D005504:Food Analysis; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D008297:Male; D010139:Pacific Islands; D018947:Samoa; D012964:Sodium / Q000652:urine; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage* / Q000032:analysis
D017673:Sodium Chloride, Dietary; D012964:Sodium