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

doi:10.3390/nu13093225

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

Preventive Medicine

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

Abstract

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 language	English (US)
Article number	3225
Journal	Nutrients
Volume	13
Issue number	9
DOIs	https://doi.org/10.3390/nu13093225
State	Published - Sep 2021

Funding

Funding: This research received no external funding. X.Y. is supported by University of New South Wales Scientia PhD scholarships. J.W. is supported by a National Heart Foundation Future Leader II Fellowship (APP102039) and receives funding for work on salt reduction from the National Health and Medical Research Council, The World Health Organization, and the Victorian Health Promotion Foundation. K.T. was supported by an Early Career Fellowship (APP1161597) from the National Health and Medical Research Council of Australia (NHMRC) and a Postdoctoral Fellowship (Award ID: 102140) from the National Heart Foundation of Australia. J.H.Y.W. is supported by a University of New South Wales Scientia Fellowship. H.L. is supported by a NHMRC program grant fellowship. B.N. is supported by a National Health and Medical Research Council of Australia (NHMRC) and Principal Research Fellowship.

Keywords

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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3390/nu13093225

Cite this

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abstract = "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.",

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

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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