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Volume 17
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10.3390/nu17111845
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Sustained Effects of a Scaled-Up mHealth and School-Based Intervention for Salt Reduction (EduSaltS) in Schoolchildren and Their Families: 1-Year Follow-Up of a Cluster Randomized Controlled Trial

by
Naibo Wang
1,2,
Puhong Zhang
3,4,*,
Yinghua Li
5,
Chen Wang
1,
Feng J. He
6,
Li Li
5,
Yuan Li
3,
Rong Luo
3,
Yuanan Lu
7,
Dezhi Wan
8,
Tian Lu
2,
Lewei Xu
2,
Chaochao Zhu
1 and
Lei Wu
1,*
1
School of Public Health, Jiangxi Provincial Key Laboratory of Disease Prevention and Public Health, Jiangxi Medical College, Nanchang University, Nanchang 330006, China
2
Jiangxi Provincial Center for Patriotic Health and Health Promotion, Nanchang 330003, China
3
The George Institute for Global Health, Beijing 100060, China
4
Beijing Physical Examination Center, Xicheng District, Beijing 100050, China
5
Chinese Center for Health Education, Beijing 100011, China
6
Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK
7
Environmental Health Laboratory, Department of Public Health Sciences, Thompson School of Social Work and Public Health, University of Hawaii at Manoa, Honolulu, HI 96822, USA
8
Jiangxi Association for Health Education and Tobacco Control, Nanchang 330003, China
*
Authors to whom correspondence should be addressed.
Nutrients 2025, 17(11), 1845; https://doi.org/10.3390/nu17111845
Submission received: 6 April 2025 / Revised: 16 May 2025 / Accepted: 26 May 2025 / Published: 28 May 2025
(This article belongs to the Section Nutritional Epidemiology)
Versions Notes

Abstract

Background:While the mHealth and school-based scale-up intervention for salt reduction (EduSaltS) effectively reduced salt intake and blood pressure among adults living with participating schoolchildren, the sustainability of these effects remains uncertain. This study aimed to evaluate whether these effects persisted one year post intervention. Methods: A one-year follow-up of a cluster randomized controlled trial was conducted, involving 524 children and their 524 adult family members from 20 primary schools. At 24 months, 509 children (97.1%) and 486 adults (92.7%) completed the assessment. Mixed linear models were used to analyze the difference in changes in salt intake between the intervention and control groups at 24 months, compared to baseline and 12 months, as measured by consecutive 24 h urinary sodium excretions. Secondary outcomes included the differences in changes in blood pressure and salt-related knowledge, attitudes, and practices (KAP) scores. Results: The adjusted mean difference in changes in salt intake between groups was −0.34 g/24 h (95% CI: −0.94 to 0.26, p = 0.265) for children and −0.72 g/24 h (95% CI: −1.48 to 0.05, p = 0.065) for adults at 24 months versus baseline. The corresponding differences from 12 to 24 months were −0.09 g/24 h (95% CI: −0.69 to 0.51, p = 0.775) for children and 0.29 g/24 h (95% CI: −0.50 to 1.08, p = 0.468) for adults. The adjusted difference in changes in adult blood pressure showed a slight, nonsignificant rebound at 24 months. The intervention group maintained significantly higher KAP scores than the control group at both 12 and 24 months. Conclusions: The effects of EduSaltS on reducing salt intake and blood pressure in adults diminished slightly one year after the intervention ended. However, sustained improvements in salt-related KAP were observed in both children and adults. Ongoing support is vital to sustain long-term salt-reduction behaviors.
Keywords: school-based health education; mobile health; reducing salt intake; urinary sodium excretion; blood pressure; sustained effect school-based health education; mobile health; reducing salt intake; urinary sodium excretion; blood pressure; sustained effect

Share and Cite

MDPI and ACS Style

Wang, N.; Zhang, P.; Li, Y.; Wang, C.; He, F.J.; Li, L.; Li, Y.; Luo, R.; Lu, Y.; Wan, D.; et al. Sustained Effects of a Scaled-Up mHealth and School-Based Intervention for Salt Reduction (EduSaltS) in Schoolchildren and Their Families: 1-Year Follow-Up of a Cluster Randomized Controlled Trial. Nutrients 2025, 17, 1845. https://doi.org/10.3390/nu17111845

AMA Style

Wang N, Zhang P, Li Y, Wang C, He FJ, Li L, Li Y, Luo R, Lu Y, Wan D, et al. Sustained Effects of a Scaled-Up mHealth and School-Based Intervention for Salt Reduction (EduSaltS) in Schoolchildren and Their Families: 1-Year Follow-Up of a Cluster Randomized Controlled Trial. Nutrients. 2025; 17(11):1845. https://doi.org/10.3390/nu17111845

Chicago/Turabian Style

Wang, Naibo, Puhong Zhang, Yinghua Li, Chen Wang, Feng J. He, Li Li, Yuan Li, Rong Luo, Yuanan Lu, Dezhi Wan, and et al. 2025. "Sustained Effects of a Scaled-Up mHealth and School-Based Intervention for Salt Reduction (EduSaltS) in Schoolchildren and Their Families: 1-Year Follow-Up of a Cluster Randomized Controlled Trial" Nutrients 17, no. 11: 1845. https://doi.org/10.3390/nu17111845

APA Style

Wang, N., Zhang, P., Li, Y., Wang, C., He, F. J., Li, L., Li, Y., Luo, R., Lu, Y., Wan, D., Lu, T., Xu, L., Zhu, C., & Wu, L. (2025). Sustained Effects of a Scaled-Up mHealth and School-Based Intervention for Salt Reduction (EduSaltS) in Schoolchildren and Their Families: 1-Year Follow-Up of a Cluster Randomized Controlled Trial. Nutrients, 17(11), 1845. https://doi.org/10.3390/nu17111845

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