Implementation Intention Strategy to Reduce Salt Intake among Heart Failure Patients: A Randomized Controlled Trial

Andressa Teoli Nunciaroni,Roberta Cunha Matheus Rodrigues,Rafaela Batista Dos Santos Pedrosa,Henrique Ceretta Oliveira,Maria Cecília Gallani,Rúbia De Freitas Agondi

doi:10.7202/1086400ar

Abstract

Introduction: An Implementation Intention strategy might be effective in transforming a positive intention to reduce salt intake into effective action among heart-failure patients. Objective: To assess the potential efficacy of an Implementation Intention intervention to reduce salt intake among heart-failure patients. Methods: Randomized controlled trial. The 60 heart-failure patients recruited were first randomized into 2 groups: an experimental group (EG) and a control group (CG). The study population was further broken down into 4 groups depending on whether the individuals prepared their own meals: 2 individual groups (EG-Individual and CG-Individual); and 2 collaborative groups, involving the patient and a social referent (EG-Collaborative and CG- Collaborative). The experimental groups developed action and coping plans based on the Implementation Intention. Total salt intake was calculated through discretionary salt, sodium-food frequency questionnaires, and 24-hour recall, obtained at the baseline (T0) and at the 2-month follow-up (T3). Results: 56 patients ended the follow-up. A reduction in the total salt intake was observed in the EGs (Individual and Collaborative) compared to baseline (5.04g/day vs. 12.21g/day for the EG-Individual (p≤0.001); 4.79g/day vs. 11.43g/day for the EG-Collaborative; p≤0.001). The multivariate analysis showed that the 2 EGs had lower salt intake at T3 than the 2 CGs (95% CI 4.19-9.29 for individual groups vs. 95% CI 4.84-10.22 for collaborative groups). There were no differences between the 2 EGs (95% CI –2.77 to 2.41). The total variance explained (R2) by these comparisons was 0.70. Discussion and conclusion: This study suggests that Implementation Intention might be effective in reducing salt intake among heart-failure patients, either individually or collaboratively. Further research testing mediator and moderator effects of the psychosocial variables are recommended.

Highlights

An Implementation Intention strategy might be effective in transforming a positive intention to reduce salt intake into effective action among heart-failure patients
A significant reduction in salt intake was observed in the experimental groups at the final follow-up (T3) when compared to the baseline, while the control groups maintained their salt intake at levels close to those observed at T0 (Table 2)
With regard the intention score, the patients included in experimental groups (EG-Individual and EGCollaborative) presented significant increases at T3, despite the high scores obtained in T0

Summary

Introduction

An Implementation Intention strategy might be effective in transforming a positive intention to reduce salt intake into effective action among heart-failure patients. Objective: To assess the potential efficacy of an Implementation Intention intervention to reduce salt intake among heart-failure patients. Discussion and conclusion: This study suggests that Implementation Intention might be effective in reducing salt intake among heart-failure patients, either individually or collaboratively. Discussion et conclusion : L’Activation de l’Intention peut être efficace pour réduire la consommation de sel chez les patients atteints d’IC, individuellement ou en collaboration avec un référent social. Important, is not enough to push patients to undertake selfcare, as it is not always translated into effective behaviour

Results

Discussion

Conclusion