Barriers and facilitators to implementing reduced-sodium salts as a population-level intervention: A qualitative study

Xuejun Yin, Maoyi Tian*, Lingli Sun, Jacqui Webster, Kathy Trieu, Mark D. Huffman, J. Jaime Miranda, Matti Marklund, Jason H.Y. Wu, Laura K. Cobb, Hongling Chu, Sallie Anne Pearson, Bruce Neal, Hueiming Liu

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Widespread use of reduced-sodium salts can potentially lower excessive population-level dietary sodium intake. This study aimed to identify key barriers and facilitators to implementing reduced-sodium salt as a population level intervention. Semi-structured interviews were conducted with key informants from academia, the salt manufacturing industry, and government. We used the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework to inform our interview guides and data analysis. Eighteen key informants from nine countries across five World Health Organization regions participated in the study from January 2020 to July 2020. Participants were concerned about the lack of robust evidence on safety for specific populations such as those with renal impairment. Taste and price compared to regular salt and an understanding of the potential health benefits of reduced-sodium salt were identified as critical factors influencing the adoption of reduced-sodium salts. Higher production costs, low profit return, and reduced market demand for reduced-sodium salts were key barriers for industry in implementation. Participants provided recommendations as potential strategies to enhance the uptake. There are presently substantial barriers to the widespread use of reduced-sodium salt but there are also clear opportunities to take actions that would increase uptake.

Original languageEnglish (US)
Article number3225
Issue number9
StatePublished - Sep 2021


  • Key informant interview
  • Low-sodium salt
  • Potassium
  • Qualitative study
  • Reduced-sodium salt
  • Salt substitute
  • Sodium reduction

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics


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