Abstract
ObjectiveTo assess the effects of a novel mass media intervention in increasing media reports on salt and health by involving media reporters in a scientifically well designed salt reduction trial.MethodsWe recruited and trained 66 media reporters in Changzhi, Shanxi province, China to conduct a randomized controlled trial on blood pressure lowering effect of salt substitute in Dec, 2012 and Jan 2013 among their own relatives or friends (253 from 129 families in the salt substitute arm and 263 from 133 families in the control arm for two months). We shared trial results and other information on salt and health with the reporters within a month after the trial. We monitored all local newspapers for the number of relevant articles in 3 months before, 3 months during and 3 months after the intervention and at the 6th, 12th, 18th, 24th and 48th months after the intervention. Additionally, we conducted two independent surveys on knowledge, belief and behaviours of salt and health among local citizens before and after the intervention.ResultsAs expected, systolic blood pressure was reduced significantly more in the salt substitute than the control group (-4.7±11.0 mmHg vs -2.6±10.3 mmHg, p<0.001) in the randomized trial. The monthly mean number of relevant articles increased from 0.7 before to 1.7 during (p = 0.263), and further to 6.0 after the intervention (p<0.001), and varied from 2 (p = 0.170) to 4 (p = 0.008) from the 6th to 48th month; the awareness of knowledge on salt and health among local citizens improved significantly after the intervention.ConclusionsMedia reporters’ participation in a well-designed salt reduction trial significantly increased the number of relevant media reports, and the effect was sustained for a prolonged period. Future mass media public health education programs should consider this innovative strategy for better and sustained impacts.
Highlights
In China, the prevalence of hypertension has been increasing
Media reporters’ participation in a well-designed salt reduction trial significantly increased the number of relevant media reports, and the effect was sustained for a prolonged period
Many observational studies [5,6,7,8,9,10], animal studies [11,12] and randomized clinical trials [13,14] have confirmed that reducing salt intake can reduce blood pressure levels [14,15], thereby reducing the incidence of cardiovascular diseases [2,16,17,18,19,20]; recent observational studies showing a purported ‘U’ shape curve between salt intake and cardiovascular mortality [21,22] have been criticized on methodological grounds [23,24]
Summary
In China, the prevalence of hypertension has been increasing. The most recent official prevalence of hypertension in 2012–15 was reported to be 25.2% in adults, translating to over 200 million patients with high blood pressure, making China a country with the highest number of patients with hypertension in the world [1]. Population salt reduction has been identified by the World Health Organization (WHO) as one of the three ‘best buys’ for prevention and control of cardiovascular disease globally [4]. WHO and professional societies around the world have recommended lower salt intake for prevention and control of hypertension [25]. Salt reduction has become a global action in prevention and control of hypertension and cardiovascular disease. Per capita salt intake is 8–13 g per day in some European countries, such as 9.5 g per day in the UK, 12 g per day in China, all markedly higher than the WHO recommended 5 g per day [26]
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