A town level comprehensive intervention study to reduce salt intake in China: protocol for a cluster randomised controlled trial

Introduction Salt intake in China (≈12 g/day) is more than twice the upper limit recommended by the WHO (5 g/day). To reduce salt intake, Action on Salt China (ASC) was launched in 2017. As one of four randomised controlled trials (RCTs) in the ASC programme, a comprehensive intervention study was d...

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Main Authors: Jing Wu, Yuan Li, Xue Zhou, Jun He, Jixin Sun, Feng J He, Graham A MacGregor, Donghui Jin, Puhong Zhang, Zhihua Xu, Jianwei Xu, Biwei Tang, Yamin Bai, Wei Yan
Format: Article
Language:English
Published: BMJ Publishing Group 2020-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/1/e032976.full
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author Jing Wu
Yuan Li
Xue Zhou
Jun He
Jixin Sun
Feng J He
Graham A MacGregor
Donghui Jin
Puhong Zhang
Zhihua Xu
Jianwei Xu
Biwei Tang
Yamin Bai
Wei Yan
author_facet Jing Wu
Yuan Li
Xue Zhou
Jun He
Jixin Sun
Feng J He
Graham A MacGregor
Donghui Jin
Puhong Zhang
Zhihua Xu
Jianwei Xu
Biwei Tang
Yamin Bai
Wei Yan
author_sort Jing Wu
collection DOAJ
description Introduction Salt intake in China (≈12 g/day) is more than twice the upper limit recommended by the WHO (5 g/day). To reduce salt intake, Action on Salt China (ASC) was launched in 2017. As one of four randomised controlled trials (RCTs) in the ASC programme, a comprehensive intervention study was designed to test whether all the components of the interventions adopted by other RCTs are acceptable, scalable and effective when provided to a region in the real world.Methods and analysis Using a cluster RCT design, 2688 participants were selected from 48 towns (clusters) in 12 counties in 6 provinces and assigned to the intervention group or the control group. Randomisation was performed after the baseline survey was completed. Information on salt-related knowledge, attitude and practice (KAP), blood pressure and 24-hour urinary sodium were collected. The intervention includes government engagement, health education and other intervention components targeting restaurants, home cooks and primary school students and their families that have been used in other RCTs. The control group will not receive the intervention. The project will be followed up for 2 years, with the intervention being carried out for the first year only. The primary outcome is salt intake measured by 24-hour urinary sodium excretion after 1 year. The secondary outcomes are the long-lasting effectiveness on salt intake and blood pressure measured by the same method, as well as salt-related KAP and blood pressure at the 1-year and 2-year follow-ups. Process evaluation and health economics analysis will be conducted as well.Ethics and dissemination The study was reviewed and approved by the Institutional Review Board of the National Center for Chronic and Noncommunicable Disease Control and Prevention, the Chinese Center for Disease Control and Prevention, and Queen Mary Research Ethics Committee. Results will be disseminated through presentations, publications and social media.Trial registration number ChiCTR1800018119
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spelling doaj-art-b8a993ea632a4bbf938d434ab4c83ddb2024-12-04T06:25:14ZengBMJ Publishing GroupBMJ Open2044-60552020-01-0110110.1136/bmjopen-2019-032976A town level comprehensive intervention study to reduce salt intake in China: protocol for a cluster randomised controlled trialJing Wu0Yuan Li1Xue Zhou2Jun He3Jixin Sun4Feng J He5Graham A MacGregor6Donghui Jin7Puhong Zhang8Zhihua Xu9Jianwei Xu10Biwei Tang11Yamin Bai12Wei Yan131 Department of Infectious Disease, The People`s Hospital of Dazu Chongqing, Chongqing, ChinaThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, AustraliaHeilongjiang Provincial Center for Disease Control and Prevention, Harbin, ChinaDepartment of Neurosurgery, People`s Hospital of Yubei District of Chongqing City, Chongqing, ChinaDepartment of Non-communicable Disease Prevention and Control, Center for Disease Control of Hebei Province, Shijiazhuang, ChinaWolfson Institute of Preventive Medicine, Queen Mary University of London, London, UKWolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK7 Hunan Provincial Center for Disease Control and Prevention, Changsha, China4 The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia5 Qinghai Provincial Center for Disease Control and Prevention, Xining, China1 National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China1 National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China1 National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, ChinaDepartment of Obstetrics and Gynecology, National Clinical Research Center for Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaIntroduction Salt intake in China (≈12 g/day) is more than twice the upper limit recommended by the WHO (5 g/day). To reduce salt intake, Action on Salt China (ASC) was launched in 2017. As one of four randomised controlled trials (RCTs) in the ASC programme, a comprehensive intervention study was designed to test whether all the components of the interventions adopted by other RCTs are acceptable, scalable and effective when provided to a region in the real world.Methods and analysis Using a cluster RCT design, 2688 participants were selected from 48 towns (clusters) in 12 counties in 6 provinces and assigned to the intervention group or the control group. Randomisation was performed after the baseline survey was completed. Information on salt-related knowledge, attitude and practice (KAP), blood pressure and 24-hour urinary sodium were collected. The intervention includes government engagement, health education and other intervention components targeting restaurants, home cooks and primary school students and their families that have been used in other RCTs. The control group will not receive the intervention. The project will be followed up for 2 years, with the intervention being carried out for the first year only. The primary outcome is salt intake measured by 24-hour urinary sodium excretion after 1 year. The secondary outcomes are the long-lasting effectiveness on salt intake and blood pressure measured by the same method, as well as salt-related KAP and blood pressure at the 1-year and 2-year follow-ups. Process evaluation and health economics analysis will be conducted as well.Ethics and dissemination The study was reviewed and approved by the Institutional Review Board of the National Center for Chronic and Noncommunicable Disease Control and Prevention, the Chinese Center for Disease Control and Prevention, and Queen Mary Research Ethics Committee. Results will be disseminated through presentations, publications and social media.Trial registration number ChiCTR1800018119https://bmjopen.bmj.com/content/10/1/e032976.full
spellingShingle Jing Wu
Yuan Li
Xue Zhou
Jun He
Jixin Sun
Feng J He
Graham A MacGregor
Donghui Jin
Puhong Zhang
Zhihua Xu
Jianwei Xu
Biwei Tang
Yamin Bai
Wei Yan
A town level comprehensive intervention study to reduce salt intake in China: protocol for a cluster randomised controlled trial
BMJ Open
title A town level comprehensive intervention study to reduce salt intake in China: protocol for a cluster randomised controlled trial
title_full A town level comprehensive intervention study to reduce salt intake in China: protocol for a cluster randomised controlled trial
title_fullStr A town level comprehensive intervention study to reduce salt intake in China: protocol for a cluster randomised controlled trial
title_full_unstemmed A town level comprehensive intervention study to reduce salt intake in China: protocol for a cluster randomised controlled trial
title_short A town level comprehensive intervention study to reduce salt intake in China: protocol for a cluster randomised controlled trial
title_sort town level comprehensive intervention study to reduce salt intake in china protocol for a cluster randomised controlled trial
url https://bmjopen.bmj.com/content/10/1/e032976.full
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