ABSTRACT
BACKGROUND: Currently, Australian children and adults are eating too much salt, increasing their risk of cardiovascular-related conditions. Web-based programs provide an avenue to engage the parents of primary schoolchildren in salt-specific messages, which may positively impact their own salt-related knowledge, attitudes, and behaviors (KABs). OBJECTIVE: This pilot study aimed to determine whether parents' salt-related KABs improved following participation in the Digital Education to LImit Salt in the Home (DELISH) Web-based education program. METHODS: The DELISH program was a 5-week, home-delivered, Web-based intervention, with a pre- and posttest design, targeting schoolchildren aged 7 to 10 years and their parents. Parents received weekly Web-based educational newsletters and text messages and completed online pre- and postprogram surveys assessing salt-related KABs. Upon completion of the program, all parents were also invited to complete an online evaluation survey. Changes in KABs outcomes were assessed using McNemar tests and paired t tests. RESULTS: Of the 80 parents that commenced the program, 73 parents (mean age 41.0, SD 7.0 years; 86% (63/73) females) completed both pre- and postsurveys. Overall, mean score for salt-related knowledge improved (+3.6 [standard error (SE) 0.41] points), and mean behavior score also improved (+4.5 [SE 0.61] points), indicating a higher frequency of engaging in behaviors to reduce salt in the diet, and mean attitude score decreased (-0.7 [SE 0.19] points), representing lower importance of using salt to enhance the taste of food (all P<.001). Following participation, the proportion of parents aware of the daily salt intake recommendation increased from 40% (29/73) to 74% (54/73) (P<.001), and awareness of bread as the main source of salt increased from 58% (42/73) to 95% (69/73) (P<.001). The proportion of parents who agreed that salt should be used in cooking to enhance the flavor of food decreased from 30% (22/73) to 11% (8/73) (P=.002) and the proportion who agreed that sodium information displayed on food labels was difficult to understand decreased from 52% (38/73) to 32% (23/73) (P=.009). There was a reduction in the proportion of parents who reported adding salt during cooking (55% [40/73] vs 41% [30/73]; P=.03) and at the table (32% [23/73] vs 18% [13/73]; P=.002). Of the 16 parents who completed the evaluation survey, 75% (12/16) enjoyed the program, and all parents found the newsletters to be useful. Almost all parents (15/16, 94%) agreed that the DELISH program would be useful to other parents. CONCLUSIONS: The improvement in salt-related KABs in the DELISH program indicates the potential for online technology, to disseminate simple salt reduction education messages to families with primary school-aged children. Future work should seek to improve the quality of data collected by including a larger sample size and a control group to integrate the program within the school setting to enable wider dissemination.
Subject(s)
Diet/methods , Health Education/methods , Parents/psychology , Sodium Chloride, Dietary/metabolism , Adult , Attitude , Child , Female , Humans , Male , Pilot ProjectsABSTRACT
OBJECTIVE: To determine the efficacy of a Web-based salt reduction program on children's salt-related knowledge, attitudes, and behaviors (KABs), self-efficacy, and intake of dietary salt. DESIGN: Pretest and posttest. An online survey determined KABs and self-efficacy and a 24-hour urine collection revealed salt intake. SETTING: Victoria, Australia. PARTICIPANTS: Child-parent dyads (n = 102) recruited from 5 government schools. INTERVENTION: A 5-week behavior-based education program delivered via weekly online interactive education sessions. MAIN OUTCOME MEASURES: Change in KABs, self-efficacy, and daily salt intake. ANALYSIS: Changes in outcomes were assessed using McNemar test, paired t test, and Cohen's δ (CD). RESULTS: A total of 83 children participated (mean age, 9.2 years [SD, 0.8 years]; 59% girls); 35% to 76% of children viewed weekly education session. Children with complete survey data (n = 75) had improved scores for salt-related knowledge (+3.6 ± 0.4 points; P < .001; CD: 1.16), behaviors (+1.3 ± 0.1 points; P < .001; CD: 1.08), and self-efficacy (+0.9 ± 0.2 points; P < .001; CD: 0.64), but not attitude. Children with valid urine collections (n = 51) showed no change in salt intake. CONCLUSIONS AND IMPLICATIONS: Participation resulted in improvement of salt related knowledge, self-efficacy and behavior. Further research is required to confirm these results using a more robust study design which includes a control group. In addition, the long term impact on children's salt intakes of comparable education programs needs to be assessed.
Subject(s)
Child Behavior/psychology , Child Nutrition Sciences/education , Diet, Healthy/methods , Health Knowledge, Attitudes, Practice , Self Efficacy , Sodium Chloride, Dietary , Child , Female , Health Behavior , Health Education/methods , Humans , Internet , Male , Program Evaluation , Sodium Chloride, Dietary/urine , Surveys and Questionnaires , VictoriaABSTRACT
Salt intake in adults and children exceeds recommended levels. Salt-related knowledge, attitudes, and behaviours (KABs) may influence the amount of salt consumed. The aims of this study were to assess salt-related KABs among parents, and investigate whether salt-related knowledge and attitudes are associated with salt-specific behaviours. Parents with children.
Subject(s)
Feeding Behavior , Health Behavior , Health Knowledge, Attitudes, Practice , Parents/psychology , Sodium Chloride, Dietary/administration & dosage , Adolescent , Adolescent Behavior , Adolescent Nutritional Physiological Phenomena , Adult , Chi-Square Distribution , Child , Child Behavior , Child Nutritional Physiological Phenomena , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Logistic Models , Male , Middle Aged , Odds Ratio , Recommended Dietary Allowances , Risk Factors , Sodium Chloride, Dietary/adverse effects , VictoriaABSTRACT
OBJECTIVE: We compared the effect on mood of a moderate sodium Dietary Approaches to Stop Hypertension-type diet, which included lean red meat (vitality diet [VD]), with a healthy diet (HD; decreased fat and increased wholegrain breads and cereal). METHODS: In a randomized, parallel intervention study, postmenopausal women were assigned to the VD or HD for 14 wk. Mood was measured every 2 wk by the Profile of Mood States. Dietary adherence was assessed using 24-h urine collections. Data were analyzed using one-way between-groups multivariate analysis of variance and correlations. RESULTS: Forty-six subjects completed the VD and 49 completed the HD. The two groups showed an improvement in anger, confusion, depression, fatigue, tension, vigor, and the Profile of Mood States global score over the length of the intervention (P < 0.01 for time), but there was a significant diet group by time effect for anger (P < 0.05), such that anger improved more in the VD compared with the HD group. For the two groups combined, urinary sodium excretion was associated with the Profile of Mood States global score, such that a low sodium intake was associated with a better mood (r = 0.267, P < 0.05). In addition, red meat consumption (a component of the VD) was associated with a decrease in depression (r = -0.21, P < 0.05) and an increase in fruit consumption was associated with a decrease in confusion (r = -0.26, P < 0.05). CONCLUSION: In addition to the health benefits of a moderate-sodium Dietary Approaches to Stop Hypertension diet on blood pressure and bone health, this diet had a positive effect on improving mood in postmenopausal women.
