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Nutrients 2018, 10(2), 155; doi:10.3390/nu10020155

Process Evaluation and Costing of a Multifaceted Population-Wide Intervention to Reduce Salt Consumption in Fiji

1
The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia
2
School of Public Health, the University of Sydney, Sydney, NSW 2006, Australia
3
Pacific Research Centre for the Prevention of Obesity and Noncommunicable Diseases (C-POND), Fiji National University, Nasinu, Fiji
4
Independent Nutrition Consultant, Suva, Fiji
5
Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Burwood, VIC 3125, Australia
6
Global Obesity Centre, Deakin University, Geelong, VIC 3216, Australia
*
Author to whom correspondence should be addressed.
Received: 20 December 2017 / Revised: 16 January 2018 / Accepted: 24 January 2018 / Published: 30 January 2018
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Abstract

This paper reports the process evaluation and costing of a national salt reduction intervention in Fiji. The population-wide intervention included engaging food industry to reduce salt in foods, strategic health communication and a hospital program. The evaluation showed a 1.4 g/day drop in salt intake from the 11.7 g/day at baseline; however, this was not statistically significant. To better understand intervention implementation, we collated data to assess intervention fidelity, reach, context and costs. Government and management changes affected intervention implementation, meaning fidelity was relatively low. There was no active mechanism for ensuring food companies adhered to the voluntary salt reduction targets. Communication activities had wide reach but most activities were one-off, meaning the overall dose was low and impact on behavior limited. Intervention costs were moderate (FJD $277,410 or $0.31 per person) but the strategy relied on multi-sector action which was not fully operationalised. The cyclone also delayed monitoring and likely impacted the results. However, 73% of people surveyed had heard about the campaign and salt reduction policies have been mainstreamed into government programs. Longer-term monitoring of salt intake is planned through future surveys and lessons from this process evaluation will be used to inform future strategies in the Pacific Islands and globally. View Full-Text
Keywords: evaluation; salt reduction; advocacy; public health policy; capacity building; costs; behavior change; food; nutrition; hypertension prevention evaluation; salt reduction; advocacy; public health policy; capacity building; costs; behavior change; food; nutrition; hypertension prevention
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Webster, J.; Pillay, A.; Suku, A.; Gohil, P.; Santos, J.A.; Schultz, J.; Wate, J.; Trieu, K.; Hope, S.; Snowdon, W.; Moodie, M.; Jan, S.; Bell, C. Process Evaluation and Costing of a Multifaceted Population-Wide Intervention to Reduce Salt Consumption in Fiji. Nutrients 2018, 10, 155.

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