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Parents' Perceptions about Salt Consumption in Urban Areas of Peru: Formative Research for a Social Marketing Strategy.

ABSTRACT: BACKGROUND:Salt intakes in Latin America currently double the World Health Organization's recommendation of 5 g/day. Various strategies to reduce the population's salt consumption, such as raising awareness using social marketing, have been recommended. This study identified parents' perceptions of salt consumption to inform a social marketing strategy focused on urban areas in Peru. METHODS:Using a sequential exploratory methods design, parents of pre-school children, of high and low socioeconomic status, provided qualitative data in the form of interviews and focus groups. Following this, quantitative data was obtained via questionnaires, which were sent to all parents. The information was analyzed jointly. RESULTS:296 people (mean age 35.4, 82% women) participated, 64 in the qualitative and 232 in the quantitative phase of the study. Qualitative data from the first phase revealed that the majority of mothers were in charge of cooking, and female participants expressed that cooking was "their duty" as housewives. The qualitative phase also revealed that despite the majority of the participants considered their salt intake as adequate, half of them mentioned that they have tried to reduce salt consumption, and the change in the flavor of the food was stated as the most difficult challenge to continue with such practice. Quantitative data showed that 67% of participants would be willing to reduce their salt intake, and 79.7% recognized that high salt intake causes hypertension. In total, 84% of participants reaffirmed that mothers were in charge of cooking. There were no salient differences in terms of responses provided by participants from high versus low socioeconomic groups. CONCLUSIONS:The results point towards the identification of women as a potential target-audience of a social marketing strategy to promote reductions in salt intake in their families and, therefore, a gender-responsive social marketing intervention is recommended.

SUBMITTER: Ponce-Lucero V

PROVIDER: S-EPMC7019816 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Parents' Perceptions about Salt Consumption in Urban Areas of Peru: Formative Research for a Social Marketing Strategy.

Ponce-Lucero Vilarmina V Saavedra-Garcia Lorena L Cateriano-Arévalo Erik E Perez-Leon Silvana S Villarreal-Zegarra David D Horna-Alva Diego D Miranda J Jaime JJ

Nutrients 20200108 1

<h4>Background</h4>Salt intakes in Latin America currently double the World Health Organization's recommendation of 5 g/day. Various strategies to reduce the population's salt consumption, such as raising awareness using social marketing, have been recommended. This study identified parents' perceptions of salt consumption to inform a social marketing strategy focused on urban areas in Peru.<h4>Methods</h4>Using a sequential exploratory methods design, parents of pre-school children, of high and ...[more]

PMID: 31936312

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Project description:Humans have shaped carnivore behavior since at least the Middle Paleolithic period, about 42,000 years ago. In more recent times, spotted hyenas (Crocuta crocuta) in Ethiopia have adapted to living in urban areas, while humans have adapted to living with hyenas. Yet, relationships between coexisting humans and carnivores are rarely addressed beyond mitigating conflicts. We provided a case study for how to broadly think about coexistence and how to study it when measuring if humans and carnivores affect one another. We collected data in four Ethiopian cities: Mekelle, Harar, Addis Ababa, and Arba Minch. We held focus groups and key informant interviews that incorporated feedback from 163 people, representing a wide array of religious, economic, and educational backgrounds. We also determined how many hyenas resided in these cities, hyena behavioral responses to humans using a flight initiation test, and problem-solving abilities via puzzle box trials. We found that in three of the cities, hyenas and humans coexist at high densities and frequently encounter each other. While all participants recognized the importance of hyenas as scavengers to maintain a clean environment, there was pronounced variation in cultural perspectives across cities. For example, while the people of Harar revere hyenas in spiritual terms, in Arba Minch hyenas were regarded as nuisance animals. Hyenas were universally respected as a formidable predator across cities but reports of attacks on livestock and humans were few. Flight initiation tests revealed hyenas fled at significantly closer distances in Harar and Addis Ababa than in Mekelle. Hyenas succeeded at solving a puzzle box in Harar but not in Mekelle. These variable behavior in hyenas correlated to different human perceptions. Our case study results suggest that the hyena-human dynamic is highly variable across these locations. We conclude by exploring the implications of these findings for how humans and hyenas can shape one another's behavior. Developing studies to link human perceptions and animal behavior could advance wildlife conservation, especially in urban areas.

Project description:BackgroundHome-based interventions have potential for improving early child development (ECD) in low-resource settings. The design of locally acceptable strategies requires an in-depth understanding of the household context. In this formative research study, we aimed to characterize the home play and learning environments of children 6-23 months of age from low-income households in peri-urban Lima, Peru.MethodsDrawing on the developmental niche framework, we used quantitative and qualitative methods to understand children's physical and social settings, childcare practices, and caregiver perspectives. We conducted interviews, unstructured video-recorded observations, and spot-checks with 30 randomly selected caregiver-child dyads, 10 from each child age group of 6-11, 12-17, and 18-23 months of age, as well as key informant interviews with 12 daycare instructors. We analyzed the data for key trends and themes using Stata and ATLAS.ti and employed an adapted version of the Indicator of Parent-Child Interaction to evaluate the observations.ResultsChildren's social settings were characterized by multi-generational homes and the presence of siblings and cousins as play partners. Access to books and complex hand-eye coordination toys (e.g., puzzles, building blocks) in the home was limited (30.0 and 40.0%, respectively). Caregivers generally demonstrated low or inconsistent levels of interaction with their children; they rarely communicated using descriptive language or introduced novel, stimulating activities during play. Reading and telling stories to children were uncommon, yet 93.3% of caregivers reported singing to children daily. On average, caregivers ascribed a high learning value to reading books and playing with electronic toys (rated 9.7 and 9.1 out of 10, respectively), and perceived playing with everyday objects in the home as less beneficial (rated 6.8/10). Daycare instructors reinforced the problems posed by limited caregiver-child interaction and supported the use of songs for promoting ECD.ConclusionsThe features of the home learning environments highlighted here indicate several opportunities for intervention development to improve ECD. These include encouraging caregivers to communicate with children using full sentences and enhancing the use of everyday objects as toys. There is also great potential for leveraging song and music to encourage responsive caregiver-child interactions within the home setting.

Project description:ObjectiveThis study aimed to conduct a process evaluation of a salt substitute trial conducted in Peru.MethodsThrough semi-structured interviews of intervention participants, we documented and analyzed process evaluation variables as defined by the Medical Research Council Framework. This study was a stepped wedge trial conducted in Tumbes, Peru in 2014. The intervention was a community-wide replacement of regular salt (100% sodium) with "Salt Liz" (75% sodium and 25% potassium) using social marketing strategies to promote the adoption and continued use of the salt substitute in daily life. The components of the social marketing campaign included entertainment educational activities and local product promoters ("Amigas de Liz"). Another component of the intervention was the Salt Liz spoon to help guide the amount of salt that families should consume. The process evaluation variables measured were the context, mechanism of action, and implementation outcomes (acceptability, fidelity and adoption, perceptions, and feedback).ResultsIn total, 60 women were interviewed, 20 with hypertension and 40 without hypertension. Regarding context, common characteristics across the four villages included residents who primarily ate their meals at home and women who were responsible for household food preparation. As the mechanism of action, most participants did not notice a difference in the flavor between regular salt and Salt Liz; those that did notice a difference took around 2 weeks to become accustomed to the taste of the salt substitute. In terms of implementation outcomes, the Salt Liz was accepted by villagers and factors explaining this acceptability included that it was perceived as a "high quality" salt and as having a positive effect on one's health. Participants recognized that the Salt Liz is healthier than regular salt and that it can help prevent or control hypertension. However, most participants could not accurately recall how the compositions of the Salt Liz and regular salt differed and the role they play in hypertension. Although the use of the Salt Liz was far-reaching at the community level, the use of the Salt Liz spoon was poor. Educational entertainment activities were well-received, and most participants enjoyed them despite not always being active participants but rather sideline observers.ConclusionThis process evaluation identifies key intervention components that enabled a successful trial. Seeking and incorporating feedback from the target population helps deepen the understanding of contextual factors that influence an intervention's success. Furthermore, feedback received can aid the development of the intervention product. Some factors that can be improved for future interventions are acknowledged.Clinical trial registrationNCT01960972.

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Project description:BackgroundScientific evidence indicates that high dietary salt intake has detrimental effects on blood pressure and associated cardiovascular disease (CVD). However, limited information is available on how to implement salt reduction in low and middle-income countries (LMICs) such as India, where the burden of hypertension and CVD is increasing rapidly. As part of a large study to create the evidence base required to develop a salt reduction strategy for India, we assessed the perspectives of various stakeholders regarding developing an India specific salt reduction strategy.MethodsA qualitative research design was deployed to elicit various stakeholder's (government and policy-related stakeholders, industry, civil Society, consumers) perspectives on a salt reduction strategy for India, using in-depth interviews (IDIs) and focus group discussions (FGDs). We used an inductive approach for data analysis. Data were analyzed using thematic content analysis method.ResultsForty-two IDIs and eight FGDs were conducted with various stakeholders of interest and relevance. Analysis indicated three major themes: 1. Barriers for salt reduction 2. Facilitators for salt reduction; 3. Strategies for salt reduction. Most of the stakeholders were in alignment with the need for a salt reduction programme in India to prevent and control hypertension and related CVD. Major barriers indicated by the stakeholders for salt reduction in India were social and cultural beliefs, a large unorganized food retail sector, and the lack of proper implementation of even existing food policies. Stakeholders from the food industry reported that there might be decreased sales due to salt reduction. Major facilitators included the fact that: salt reduction is currently a part of the National Multi-Sectoral Action Plan for the prevention and control of NCDs, salt reduction and salt iodine programme are compatible, and that few of the multinational food companies have already started working in the direction of initiating efforts for salt reduction. Based on the barriers and facilitators, few of the recommendations are to generate awareness among consumers, promote salt reduction by processed food industry, and implement consumer friendly food labelling.ConclusionsIn this study of multiple key influential stakeholders in India, most of the stakeholders were in alignment with the need for a salt reduction programme in India to prevent and control hypertension and related CVD. The development and adoption of the National Multi-sectoral Action Plan to reduce premature non-communicable diseases (NCDs) in India, provides a potential platform that can be leveraged to drive, implement and monitor salt reduction efforts.

Dataset Information

Parents' Perceptions about Salt Consumption in Urban Areas of Peru: Formative Research for a Social Marketing Strategy.

Publications

Parents' Perceptions about Salt Consumption in Urban Areas of Peru: Formative Research for a Social Marketing Strategy.

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