title: Evaluation of Online and In-Person Nutrition Education Related to Salt Knowledge and Behaviors among Special Supplemental Nutrition Program for Women, Infants, and Children Participants.
abstract: BACKGROUND
  The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) differs from other federal nutrition programs in that nutrition education is a required component. WIC programs traditionally provide in-person education, but recently some WIC sites have started offering online education. Education focused on reducing salt intake is an important topic for WIC participants because a high-sodium diet has been associated with high blood pressure, and low-income populations are at increased risk.
  
  
  OBJECTIVE
  Our aim was to examine the impacts of traditional in-person and online nutrition education on changes in knowledge, self-efficacy, and behaviors related to reducing salt intake in low-income women enrolled in WIC.
  
  
  METHODS
  Although a comparison of groups was not the primary focus, a randomized trial examining the impact of online and in-person nutrition education on participant knowledge, self-efficacy, and behaviors related to salt intake was conducted.
  
  
  METHODS
  Five hundred fourteen WIC participants from three Los Angeles, CA, WIC clinics received either in-person (n=257) or online (n=257) education. Questionnaires assessing salt-related knowledge, self-efficacy, and behaviors were administered at baseline and 2 to 4 months and 9 months later from November 2014 through October 2015.
  
  
  RESULTS
  Positive changes in knowledge and self-efficacy were retained 2 to 4 months and 9 months later for both groups (P<0.05). Both groups reported significant changes in behaviors related to using less salt in cooking (P<0.0001) and eating fewer foods with salt added at the table or during cooking (P<0.001) at 2 to 4 months and 9 months.
  
  
  CONCLUSIONS
  Both online and in-person education resulted in improvements during a 9-month period in knowledge, self-efficacy, and reported behaviors associated with reducing salt intake in a low-income population. Offering an online education option for WIC participants could broaden the reach of nutrition education and lead to long-term positive dietary changes.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Au
authors.forename: Shannon E
authors.initials: SE
authors.lastname: Whaley
authors.forename: Klara
authors.initials: K
authors.lastname: Gurzo
authors.forename: Martha
authors.initials: M
authors.lastname: Meza
authors.forename: Nila J
authors.initials: NJ
authors.lastname: Rosen
authors.forename: Lorrene D
authors.initials: LD
authors.lastname: Ritchie
mesh_terms: D000328:Adult; D003376:Counseling / Q000379:methods*; D004032:Diet / Q000523:psychology*; D005260:Female; D063105:Food Assistance; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D015141:Los Angeles; D011203:Poverty / Q000523:psychology*; D015397:Program Evaluation; D017673:Sodium Chloride, Dietary; D011795:Surveys and Questionnaires
chemical_list: D017673:Sodium Chloride, Dietary
keywords: Behavior; Education; Online; Salt; Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)