ObjectiveTo assess salt intake and its dietary sources using biochemical and self-report methods and to characterize salt intake according to sociodemographic and disease-related variables in a sample of the Brazilian population.DesignPopulation-based cross-sectional survey.SettingSalt intake was assessed by biochemical (24 h urinary Na excretion) and self-report methods (sodium FFQ, 24 h dietary recall, seasoned-salt questionnaire, discretionary-salt questionnaire and total reported salt intake).ParticipantsAdults and older people (n 517) aged 20–80 years, living in Artur Nogueira, São Paulo, Brazil.ResultsMean salt intake based on 24 h urinary Na excretion and total reported salt intake was 10·5 and 11·0 g/d, respectively; both measures were significantly correlated. Discretionary salt and seasoned salt were the most important sources of salt intake (68·2 %). Men in the study consumed more salt than women as estimated by 24 h urinary Na excretion (11·7 v. 9·6 g salt/d; P<0·0001). Participants known to be hypertensive added more salt to their meals but consumed less salty ultra-processed foods. Waist circumference in both sexes and BMI were positively correlated with salt intake estimated by 24 h urinary Na excretion. In addition, regression analysis revealed that being a young male or having a high waist circumference was a predictor of higher salt intake.ConclusionsSalt intake in this population was well above the recommended amount. The main source of salt intake came from salt added during cooking. Salt intake varied according to sex and waist circumference.

Background There is little information about the functions and behavior change techniques (BCTs) needed to implement shared decision making (SDM) in clinical practice. To guide future implementation initiatives, we sought to develop a BCT taxonomy for SDM implementation interventions. Methods This study is a secondary analysis of a 2018 Cochrane review on interventions for increasing the use of shared decision making by healthcare professionals. We examined all 87 studies included in the review. We extracted relevant information on each study intervention into a spreadsheet. Coders had undergone a training workshop on intervention functions and online training on BCT Taxonomy version 1 (BCTTv1). We performed functions and BCTs coding trials, and identified coding rules. We used Michie’s guide for designing behavior change interventions to code the functions and BCTs used in the interventions. Coders met to compare coding and discrepancies were discussed until consensus was reached. Data was analyzed using simple descriptive statistics. Results Overall, 7 functions, 24 combinations of functions and 32 BCTs were used in the 87 SDM implementation interventions. The mean of functions per intervention was 2.5 and the mean of BCTs per intervention was 3.7. The functions Coercion and Restriction were not found. The most common function was Education (73 studies). Three combinations of functions were most common (e.g: Education + Persuasion, used in 10 studies). The functions associated with more effective SDM implementation interventions were Modeling and Training. The most effective combination of functions was Education + Training + Modeling + Enablement. The most commonly used BCT was Instruction on how to perform the behavior (43 studies). BCTs associated with more effective SDM implementation interventions were: Instruction on how to perform the behavior, Demonstration of the behavior, Feedback on behavior, Pharmacological support, Material reward, and Biofeedback. Twenty-five BCTs were associated with less effective SDM implementation interventions. Four new BCTs were identified: General information to support the behavior, Tailoring, Exercises to conceptually prepare for the behavior, and Experience sharing and learning. Conclusions We established a BCT taxonomy specific to the field of SDM to guide future SDM implementation interventions. Four new BCTs should be added to BCTTv1.

Objective: to evaluate the relationship between the behaviors of salt consumption and sociodemographic and clinical variables. Method: sodium consumption was evaluated using the methods: self-reporting (considering 3 different behaviors related to salt consumption), 24-hr dietary recall, discretionary salt, food frequency questionnaire, estimation of total sodium intake and 24-hr urinary excretion of sodium (n=108). Results: elevated salt intake according to the different measurements of consumption of the nutrient was associated with the variables: male sex, low level of schooling and monthly income, being Caucasian, and being professionally inactive; and with the clinical variables: elevated Body Mass Index, tensional levels, ventricular hypertrophy and the number of medications used. Conclusion: the data obtained shows a heterogenous association between the different behaviors related to salt consumption and the socio-demographic and clinical variables. This data can be used to optimize the directing of educational activities with a view to reducing salt consumption among hypertensives. (1) . Among the factors related to the development and progression of hypertension, the elevated consumption of salt has been directly associated with the increase in blood pressure levels and the occurrence of cardiovascular complications (2)(3)(4)(5)(6)(7) . Although there are international and Brazilian recommendations for the limiting of sodium consumption both for the population in general and for hypertensive individuals of 5g and 4g respectively (8)(9) , studies with different populations show a consumption of sodium which is higher than the recommended (9)(10)(11)(12)(13)(14) , with an average of up to 4600mg of sodium (11.5g of salt)/day (7) . An important study in the area, the INTERSALT

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Background There is sound evidence associating high salt intake and a greater risk of cardiovascular and noncardiovascular diseases. High salt intake has been observed in several populations worldwide. Therefore, promoting healthier salt consumption has been encouraged as a low-cost strategy to reduce this risk factor. However, these strategies need to be sound, built on theoretical and methodological bases, and consider the target population’s context. Objective This protocol aims to describe a mobile phone app intervention to promote healthy salt intake among adults. Methods This is an experimental and longitudinal study protocol conducted in three modules. Module 1 refers to the planning of the intervention based on the Behaviour Change Wheel framework. Module 2 is the development of the mobile phone app intervention based on the date of module 1. In module 3, the intervention will be evaluated using a randomized controlled study, with three steps of data collection in a 2-month follow-up in a sample of 86 adults (43 participants for each group: the control group and intervention group) recruited from the primary health care centers of a Brazilian town. The discretionary salt intake questionnaire will assess salt consumption, the app usability will be assessed using the System Usability Scale, and psychosocial variables (habit, intention, and self-efficacy) will also be measured. Results Recruitment began in October 2021, and the follow-up will end in August 2022. The results of this study are expected to be published in 2023. Conclusions Results from this study will help people to control salt intake when cooking at home, will stimulate self-care, will work as an alternative or supportive method in the relationship between health care professionals and patients, and will contribute to implementing the app intervention to promote healthy salt intake on a large scale. Trial Registration The Brazilian Clinical Trials Registry RBR-4s8qyyq; https://ensaiosclinicos.gov.br/rg/RBR-4s8qyyq International Registered Report Identifier (IRRID) DERR1-10.2196/37853

BACKGROUND Background: There are sound evidences associating high salt intake and greater risk of cardiovascular and non-cardiovascular diseases. A high salt intake has been observed in several populations worldwide, therefore the promotion of a healthier salt consumption has been encouraged as a low-cost strategy to reduce this risk factor. However, these strategies need to be sound, built on theoretical and methodological bases and considering context of the target population. OBJECTIVE Objective: To describe a protocol of a mobile phone App intervention to promote healthy salt intake among adults. METHODS Methods: This is an experimental and longitudinal study, conducted into three modules. Module 1 refers to the planning of the intervention based on the Behaviour Change Wheel framework. Module 2 is the development of the mobile phone App intervention based on the data of Module 1. In Module 3, the intervention will be evaluated by means of a randomized controlled study, with three steps of data collection in two-month follow-up, in a sample of 86 adults (43 participants for each group: control group and intervention group) recruited from Primary Health Care centers of a Brazilian town. Salt consumption will be assessed by the discretionary salt intake, the App usability by means of the System Usability Scale and psychosocial variables (Habit, Intention and Self-efficacy) will also be measured. RESULTS Results: Recruitment began in October 2021 and the follow-up will end in August 2022. The results of this study are expected to be published in 2023. CONCLUSIONS Conclusions: Results from this study will help people to control salt intake when cooking at home, will stimulate the self-care, will work as an alternative or supportive method in the relation between healthcare professionals and patient and, besides, will contribute to implement the App intervention to promote healthy salt intake in large scale. CLINICALTRIAL https://ensaiosclinicos.gov.br/rg/RBR-4s8qyyq. Registered on January 28th, 2022.

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