Persistent effect of salt reduction in schoolchildren and their families: 1-year follow-up after an application-based cluster randomized controlled trial.

IF 8.3 1区医学 Q1 MEDICINE, GENERAL & INTERNAL BMC Medicine Pub Date : 2025-01-27 DOI:10.1186/s12916-025-03868-8

Yuan Li, Puhong Zhang, Feng J He, Rong Luo, Jing Song, Changqiong Wang, Fengge Chen, Wei Zhao, Yuhong Zhao, Hang Chen, Tianyong Wu, Xiaoyan Wang, Hui Zhou, Zhi Han, Jie Zhang

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Abstract

Background: A 12-month cluster randomized controlled trial (RCT) demonstrated the effectiveness of an application-based education program in reducing the salt intake and systolic blood pressure (SBP) of schoolchildren's adult family members. This study aimed to assess whether the effect at 12 months persisted at 24 months.

Methods: Fifty-four schools were randomly assigned to either the intervention or control group. All participants (594 children in grade 3 and 1188 of their adult family members) who completed the baseline survey were contacted again 12 months after the trial. The primary outcome was the difference in salt intake change between the intervention and control groups at 24 months versus baseline and 12 months, measured by the mean two consecutive 24-h urinary sodium excretions. The secondary outcome was the difference in the change of blood pressure and salt-related Knowledge, Attitude, Practice (KAP) score.

Results: The difference in salt intake change in adults between the intervention and control groups after adjusting for confounding factors was - 0.38 g/day at 24 months versus baseline (95% CI - 0.81 to 0.05, p = 0.09), following the - 0.83 g/day (95% CI - 1.25 to - 0.41, p < 0.001) at 12 months. The adjusted difference in SBP change was - 2.19 mm Hg (95% CI - 3.63 to - 0.76, p = 0.003) at 24 months versus baseline, following the - 1.80 mm Hg (95% CI - 3.19 to - 0.40, p = 0.01) at 12 months. The intervention group had a higher KAP score than the control group both at 12 months and at 24 months versus baseline. No significant changes were found in children.

Conclusions: The effect of the education program on adults' salt intake faded, but the SBP lowering effect and the improvement of KAP score remained 12 months after the completion of the RCT. Continuous efforts are needed to maintain the salt reduction effects in real-world settings.

Trial registration: ChiCTR1800017553. Registered on August 3, 2018.

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学龄儿童及其家庭减盐的持续效果：以应用为基础的群组随机对照试验后的 1 年随访。

背景：一项为期12个月的集群随机对照试验（RCT）证明了基于应用的教育计划在降低学童成年家庭成员的盐摄入量和收缩压（SBP）方面的有效性。本研究旨在评估12个月时的效果是否持续到24个月。方法：将54所学校随机分为干预组和对照组。所有完成基线调查的参与者（594名三年级儿童和1188名成年家庭成员）在试验12个月后再次联系。主要结局是干预组和对照组在24个月与基线和12个月时盐摄入量变化的差异，通过平均连续两次24小时尿钠排泄量来测量。次要结局是血压变化和盐相关知识、态度、实践（KAP）评分的差异。结果:盐摄入量的变化成人之间的差异的干预和控制组织调整后的混杂因素——0.38克/天在24个月和基线(95% CI, 0.81 - 0.05, p = 0.09),在- 0.83克/天(95% CI, 1.25 - 0.41, p结论:在成人教育项目的影响降低盐摄入量消退,但SBP的效果和改善KAP得分仍个随机对照试验的完成后12个月。需要继续努力，在现实环境中保持减盐效果。试验注册：ChiCTR1800017553。2018年8月3日注册。

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来源期刊

BMC Medicine 医学-医学：内科

CiteScore

13.10

自引率

1.10%

发文量

435

审稿时长

4-8 weeks

期刊介绍： BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.