Digital Education to Limit Salt in the Home (DELISH) Program Improves Knowledge, Self-Efficacy, and Behaviors Among Children

Abstract

Objective: To determine the efficacy of a Web-based salt reduction program on children's salt-related knowledge, attitudes, and behaviors (KABs), self-efficacy, and intake of dietary salt.

Design: Pretest and posttest. An online survey determined KABs and self-efficacy and a 24-hour urine collection revealed salt intake.

Setting: Victoria, Australia.

Participants: Child-parent dyads (n = 102) recruited from 5 government schools.

Intervention: A 5-week behavior-based education program delivered via weekly online interactive education sessions.

Main outcome measures: Change in KABs, self-efficacy, and daily salt intake.

Analysis: Changes in outcomes were assessed using McNemar test, paired t test, and Cohen's δ (CD).

Results: A total of 83 children participated (mean age, 9.2 years [SD, 0.8 years]; 59% girls); 35% to 76% of children viewed weekly education session. Children with complete survey data (n = 75) had improved scores for salt-related knowledge (+3.6 ± 0.4 points; P < .001; CD: 1.16), behaviors (+1.3 ± 0.1 points; P < .001; CD: 1.08), and self-efficacy (+0.9 ± 0.2 points; P < .001; CD: 0.64), but not attitude. Children with valid urine collections (n = 51) showed no change in salt intake.

Conclusions and implications: Participation resulted in improvement of salt related knowledge, self-efficacy and behavior. Further research is required to confirm these results using a more robust study design which includes a control group. In addition, the long term impact on children's salt intakes of comparable education programs needs to be assessed.

Keywords: Australia; behavior; child; dietary sodium; education.