Logic model and action plan for reducing salt intake

Abstract

Objective: To create a logic model and organize measures using a ladder of intervention aimed at reducing salt intake among other nutrition and dietary goals, and to present an example action plan.

Methods: The logic model was set up using the PRECEDE-PROCEED model with intermediate outcome factors. Measures for which there were existing cases and papers were organized using a ladder of interventions. Action plans were developed based on measures for which evidence had been reported in Japan.

Results: The logic model was designed with a final outcome of reduced salt intake. Intermediate outcomes were reduced salt intake at home, for take-away/restaurant food, and for meal services; participation in nutrition education; and attitudes, knowledge, and skills such as interest and confidence in reducing salt intake. Existing measures were mostly level 6 to 8 on a ladder of interventions, while a few were level 5 or 4. The action plans included reducing salt in company cafeteria food and delivered lunches as well as providing nutrition education in the workplace. Measures in the workplace included regional/workplace cooperation projects implemented by local governments such as the health and productivity management, as well as guidance for meal service facilities, and there is evidence of their effectiveness. The key to implementation is to increase choice and promote the purchase of low-salt foods by introducing a system of collaboration between the health management department and the meal service department, and to provide incentives for a ladder of interventions.

Conclusion: When local governments create action plans, it is important to create a logic model based on an understanding of the actual situation, and to combine promotion campaigns and incentives to encourage the purchase of low-salt food products in addition to reducing the amount of salt in the food environment.