Purpose and ObjectivesThe Centers for Disease Control and Prevention’s Sodium Reduction in Communities Program (SRCP) aims to reduce dietary sodium intake through policy, systems, and environmental approaches. The objective of this study was to evaluate and document the progress of the first year of a 5-year SRCP project in northwest Arkansas.Intervention ApproachIn collaboration with 30 partner schools and 5 partner community meals programs, we sought to reduce dietary sodium intake through increased implementation of 1) food service guidelines, 2) procurement practices, 3) food preparation practices, and 4) environmental strategies.Evaluation MethodsWe collected daily menus, information on nutritional content of meals, and procurement records and counted the number of people served in partnering schools and community meals programs. We used a pretest–posttest quantitative evaluation design to analyze changes in the sodium content of meals from baseline to Year 1 follow-up.ResultsFrom baseline to Year 1 follow-up, participating schools lowered the mean sodium content served per lunch diner from 1,103 mg to 980 mg (−11.2%). The schools also reduced the mean sodium content of entrées offered (ie, entrées listed on the menu) from 674 mg to 625 mg (−7.3%) and entrées served from 615 mg to 589 mg (−4.2%). From baseline to follow-up, participating community meals programs reduced the mean sodium content of meals offered (ie, meals listed on the menu) from 1,710 mg to 1,053 mg (−38.4%). The community meals programs reduced the mean sodium content of meals served from 1,509 mg to 1,258 mg (−16.6%).Implications for Public HealthIn both venues, our evaluation findings showed reductions in sodium served during the 1-year evaluation period. These results highlight the potential effectiveness of sodium reduction interventions focused on food service guidelines, procurement practices, food preparation practices, and environmental strategies for schools and community meals programs.
Background:Pacific Islander populations, including Marshallese, face a disproportionately high burden of health disparities relative to the general population.Objectives:A community-based participatory research (CBPR) approach was utilized to engage Marshallese participants in a comparative effectiveness trial testing 2 Diabetes Prevention Program (DPP) interventions designed to reduce participant's weight, lower HbA1c, encourage healthy eating, and increase physical activity.Design:To compare the effectiveness of the faith-based (WORD) DPP to the culturally adapted (Pacific Culturally Adapted Diabetes Prevention Program [PILI]) DPP, a clustered randomized controlled trial (RCT) with 384 Marshallese participants will be implemented in 32 churches located in Arkansas, Kansas, Missouri, and Oklahoma. Churches will be randomly assigned to WORD DPP arm or to PILI DPP arm.Methods:WORD DPP focuses on connecting faith and health to attain a healthy weight, eat healthy, and be more physically active. In contrast, PILI DPP is a family and community focused DPP curriculum specifically adapted for implementation in Pacific Islander communities. PILI focuses on engaging social support networks to maintain a healthy weight, eat healthy, and be more physically active. All participants are assessed at baseline, immediate post intervention, and 12 months post intervention.Summary:Both interventions aim to cause weight loss through improving physical activity and healthy eating, with the goal of preventing the development of T2D. The clustered RCT will determine which intervention is most effective with the Marshallese population. The utilization of a CBPR approach that involves local stakeholders and engages faith-based institutions in Marshallese communities will increase the potential for success and sustainability. This study is registered at clinicaltrials.gov (NCT03270436).
What is known on this topic?High sodium intake is associated with hypertension and increased risk for cardiovascular disease, a leading cause of death for men and women in the United States. What does this report add?We evaluated a sodium-reduction intervention in community meals programs in northwest Arkansas and found substantial reductions in sodium served to diners after 3 years.What are the implications for public health practice? Sodium-reduction interventions in community meals programs, whose diners experience food insecurity, have low incomes, and are at high risk for hypertension, are effective and sustainable.
Purpose and Objectives The Centers for Disease Control and Prevention’s Sodium Reduction in Communities Program aims to reduce dietary sodium intake through policy, systems, and environmental approaches. The objective of our study was to evaluate changes in sodium levels over 5 years (2016–2021) in food served in school lunches as an outcome of a Sodium Reduction in Communities program in Arkansas’s largest school district. Intervention Approach We collaborated with Springdale Public Schools (SPS) to reduce dietary sodium intake in school lunches through increased implementation of 1) food service guidelines, 2) procurement practices, 3) food preparation practices, and 4) environmental strategies. These activities were maintained from year 1 through year 5. Implementation priorities were informed each year by evaluation findings from the preceding year. Evaluation Methods We collected lunch service records and information on nutritional content of menu items for the 30 schools under the direction of SPS’s Child Nutrition Department. We used a pretest–posttest quantitative evaluation design to analyze annual changes in the sodium content of meals, from baseline through year 5. Results From baseline through year 1, SPS reduced sodium served per diner, per entrée offered, and per entrée served. These reductions were maintained from baseline through 5 years of follow-up. Mean sodium per 1,000 kcal per diner served was 1,740 mg at baseline and was lower in each of the 5 follow-up years: 1,488 mg (14% decrease) in year 1; 1,495 mg (14% decrease) in year 2; 1,612 mg (7% decrease) in year 3; 1,560 mg (10% decrease) in year 4; and 1,532 mg (12% decrease) in year 5. Energy served per diner remained stable. Implications for Public Health Our study provides evidence for sustained sodium reduction strategies in a large ethnically and socioeconomically diverse school district, pointing to the potential benefit of implementing similar strategies in other school districts. The study also shows how program evaluation can be used to support sustainability.
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