title: Effects of a community-based salt reduction program in a regional Australian population.
abstract: Salt reduction is a public health priority but there are few studies testing the efficacy of plausible salt reduction programs.
  
  
  
  A multi-faceted, community-based salt reduction program using the Communication for Behavioral Impact framework was implemented in Lithgow, Australia. Single 24-h urine samples were obtained from 419 individuals at baseline (2011) and from 572 at follow-up (2014). Information about knowledge and behaviors relating to salt was also collected.
  
  
  
  Survey participants were on average 56 years old and 58 % female. Mean salt intake estimated from 24-h urine samples fell from 8.8 g/day (SD = 3.6 g/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), knew the importance of salt reduction (64 % vs. 78 %; p < 0.001) and 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). Twenty-six percent reported using salt substitute at the end of the intervention period and 90 % had heard about the program. Findings were robust to multivariable adjustment.
  
  
  
  Implementation of this multi-faceted community-based program was associated with a ~10 % reduction in salt consumption in an Australian regional town. 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.
  
  
  
  NCT02105727 .
authors.affiliation: The George Institute for Global Health, PO BOX M201, Missenden Road, Camperdown, NSW, 2050, Australia. maland@georgeinstitute.org.au.|The University of Sydney, Sydney, Australia. maland@georgeinstitute.org.au.
authors.forename: Mary-Anne
authors.initials: MA
authors.lastname: Land
authors.affiliation: The George Institute for Global Health, PO BOX M201, Missenden Road, Camperdown, NSW, 2050, Australia.|The University of Sydney, Sydney, Australia.
authors.forename: Jason H Y
authors.initials: JH
authors.lastname: Wu
authors.affiliation: The George Institute for Global Health, PO BOX M201, Missenden Road, Camperdown, NSW, 2050, Australia.|The University of Sydney, Sydney, Australia.
authors.forename: Adriana
authors.initials: A
authors.lastname: Selwyn
authors.affiliation: The George Institute for Global Health, PO BOX M201, Missenden Road, Camperdown, NSW, 2050, Australia.|The University of Sydney, Sydney, Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Crino
authors.affiliation: The George Institute for Global Health, PO BOX M201, Missenden Road, Camperdown, NSW, 2050, Australia.|The University of Sydney, Sydney, Australia.|Department of Epidemiology, Johns Hopkins University, Baltimore, USA.|The George Institute for Global Health, University of Oxford, Oxford, UK.|Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Woodward
authors.affiliation: The George Institute for Global Health, PO BOX M201, Missenden Road, Camperdown, NSW, 2050, Australia.|The University of Sydney, Sydney, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Chalmers
authors.affiliation: The George Institute for Global Health, PO BOX M201, Missenden Road, Camperdown, NSW, 2050, Australia.|The University of Sydney, Sydney, Australia.
authors.forename: Jacqui
authors.initials: J
authors.lastname: Webster
authors.affiliation: Deakin University, Melbourne, Australia.
authors.forename: Caryl
authors.initials: C
authors.lastname: Nowson
authors.affiliation: New South Wales Health, Sydney, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Jeffery
authors.affiliation: Faculty of Health Sciences The Sydney University of Sydney, Sydney, Australia.
authors.forename: Wayne
authors.initials: W
authors.lastname: Smith
authors.affiliation: Faculty of Health Sciences The Sydney University of Sydney, Sydney, Australia.|St Vincent's Hospital, Sydney, Australia.
authors.forename: Victoria
authors.initials: V
authors.lastname: Flood
authors.affiliation: The George Institute for Global Health, PO BOX M201, Missenden Road, Camperdown, NSW, 2050, Australia.|The University of Sydney, Sydney, Australia.|Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Bruce
authors.initials: B
authors.lastname: Neal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003153:Community Health Services / Q000379:methods*; D004039:Diet, Sodium-Restricted / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D005515:Food Labeling; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017673:Sodium Chloride, Dietary / Q000652:urine*; D055815:Young Adult
chemical_list: D017673:Sodium Chloride, Dietary
keywords: 24-hour urine; Cardiovascular disease prevention; Salt; Sodium