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Hypertension Research Programme - HT10

Cost effectiveness of salt reduction interventions in Pacific Islands

Project locations: Fiji and Samoa

Project duration: 2012 - 2015

Funding organisation

HT10 project video

Primary research aim

The aim of the project is to evaluate the impact and cost-effectiveness of multi-faceted intervention strategies to reduce salt in the Pacific Islands.

Research objectives and methodology

The primary objective is to measure the impact of sodium reduction interventions on the salt intake of the populations of Fiji and Samoa. This is achieved by obtaining reliable baseline data on salt intake, salt levels in foods and sources of salt combined with qualitative analysis of stakeholder views to develop and implement targeted interventions to reduce salt. Post-intervention monitoring of the measurements will be undertaken to enable an assessment of the intervention's impact and cost.

Current status

Baseline assessments have been completed and the parallel projects in Fiji and Samoa are currently in the intervention phase. In Fiji, several meetings with food business operators have been held to raise awareness and encourage local and multinational manufacturers to lower the salt levels in foods towards the targets. In addition, the Fiji team is raising awareness through television advertisements, newspaper articles, showing an educational DVD and providing pamphlets of information, particularly to relevant stakeholders such as heads of schools and canteen managers. 75 educators have been trained and will be educating the community on how to reduce their salt intake.

In Samoa, the team has been raising awareness through presenting and distributing information at charity events, religious group meetings, government meetings, and through advertisements in newspaper articles, radio and television. Also the team have met with three restaurants to raise awareness and encourage low-salt practices.

In both countries, plans for the repeat monitoring in 2015 are currently being made. A joint meeting to bring together collaborators from both projects will be held early next year to exchange experiences on the project to date, plan logistics and training for the follow up monitoring and identify lessons that can be used to inform other countries that are considering similar work. It is expected that, by the end of 2015, as well as demonstrating progress on reducing salt, the projects will have led to a range of tools and resources that it will be possible for other countries to utilise. It is hoped they will be disseminated through the World Health Organization Collaborating Centre on Population Salt Intake at the George Institute in line with its remit to support Member States towards achieving the global target of reducing average population salt intake by 30% by 2025.

Project contact: Jacqui Webster - jwebster@georgeinstitute.org.au

Investigators

Publications

  1. Webster, J., Su'a, S. A. F., Ieremia, M., Bompoint, S., Johnson, C., Faeamani, G., . . . Woodward, M. (2016). Salt Intakes, Knowledge, and Behavior in Samoa: Monitoring Saltā€Consumption Patterns Through the World Health Organization's Surveillance of Noncommunicable Disease Risk Factors (STEPS). Journal of Clinical Hypertension (Greenwich, Conn.), 18(9), 884-891. doi:10.1111/jch.12778
  2. Land MA, Webster J, Ma G, Li M, Asi Faletoese S, et al. (2015) Salt Intake and Iodine Status of Women in Samoa. Asia Pacific Journal of Clinical Nutrition Asia Pac J Clin Nutr 2016;25(1):142-149 . [IF 1.699]
  3. GACD Hypertension Research Programme WG, Peiris D, Thompson SR, Beratarrechea A, Cardenas MK, Diez-Canseco F, Webster J, et al. Behaviour change strategies for reducing blood pressure-related disease burden: findings from a global implementation research programme. Implement Sci. 2015;10(1):158. doi: 10.1186/s13012-015-0331-0. PubMed PMID: 26553092. [IF 4.122]
  4. Downs SM, Christoforou A, Snowdon W, Dunford E, Hoejskov P, Webster J. (2015) Setting targets for salt levels in foods: A five-step approach for low- and middle-income countries (based on lessons from the Pacific Islands). Food Policy 55: 101-108.
  5. Christoforou A, Snowdon W, Laesango N, Vatucawaqa S, Lamar D, Alam L, Lippwe K, Havea I, Tairea K, Hoejskov P, Waqanivalu T, Webster J. Progress on Salt Reduction in the Pacific Islands: From Strategies to Action. Heart, Lung and Circulation, 2014 DOI: 10.1016/j.hlc.2014.11.023 [Impact Factor 1.172]
  6. Webster J, Snowdon W, Moodie M, Viali S, Schultz J, Bell C, et al. Cost-effectiveness of reducing salt intake in the Pacific Islands: protocol for a before and after intervention study. BMC Public Health. 2014; 14: 107