Abstract Body: Introduction
India has a high burden of uncontrolled hypertension (28%) with low control rates (<10%). Mean dietary sodium intake (4000mg/d) is also high, which warrants implementation of population-level sodium reduction interventions, such as using low-sodium iodized salt (LSIS). Given the low awareness about LSIS, we co-created and evaluated an intervention to promote its usage.
Objective
To estimate change from baseline to end line in proportion of households reporting LSIS use post implementation of a co-created (involving multiple stakeholders) intervention to provide education (education only arm) on LSIS and education along with subsidy to purchase LSIS (education+subsidy arm).
Methods
The study was implemented (8 months intervention) in rural and urban sites of north and south India. In the education only arm, trained health workers provided education on LSIS to community members using pamphlets, a short video and encouraged retailers to sell LSIS to consumers by displaying point of sale posters. In the education+subsidy arm, apart from aforementioned activities, subsidy of $ 0.24/kg (~50% of the price) to purchase LSIS was provided to the distributors, who passed this on to retailers and consumers.
Results
A total of 1,602 households and 3,108 participants were interviewed. The mean(SD) age of the participants was 46.9(14.2) years. Fifty two percent were females. At baseline, proportion of households reporting ever use of LSIS was 1.3% (95%CI: 0.9–2.1) and 2.3% (1.8–2.7) respectively, in the education and education+subsidy arms. At end line, this proportion increased to 22.6% (21.1–24.1) and 49.3% (47.5-51.2%) respectively. The odds of LSIS ever use was 2.6 (1.2-5.7) times higher in the education+subsidy arm compared to education only arm. The odds of reporting LSIS use was higher if the household had ≥ one patient with hypertension (1.7[1.3-2.3]), with graduate education (1.6[1.3-2.0]) or belonged to richest quintile (1.6[1.3-2.0]). There was no significant change in mean systolic and diastolic blood pressure, urinary sodium, and potassium between the two arms from baseline to end line.
Conclusion
We demonstrated the possibility of increasing LSIS usage through a co-created intervention providing either education only or education+subsidy to buy LSIS with a substantially higher response for the latter. This underscores the need to make LSIS accessible, available, and affordable for regular use to reduce dietary sodium intake and control hypertension.