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This study was performed to evaluate the differences in blood pressure, sodium intake and dietary behavior changes according to the extent of session attendance on sodium reduction education program for pre-hypertensive adults in a public health center. Sodium reduction education program consisted of 8 sessions for 8 weeks. Fifty three patients who completed the pre and post nutritional assessments were classified into 2 groups according to the session attendance rate. Nineteen participants who attended the education program 3 times or less (≤ 3) were categorized into the less attendance (LA) group and 34 participants attended 4 times or more (≥ 4) into the more attendance (MA) group. Blood pressure, anthropometric measurements, serum lipid profile, nutrient intakes including sodium, nutrition knowledge and dietary behavior score were assessed before and after the nutrition education program. Mean sodium intakes (p < 0.001), systolic/diastolic blood pressure (p < 0.001), and weight (p < 0.001) were significantly decreased in the MA group after sodium reduction education program. Compared to the MA group, mean sodium intakes, systolic/ diastolic blood pressure were not significantly changed after the education program even with significantly increased nutrition knowledge (p < 0.05) and dietary behavior score (p < 0.01) in the LA group. It appears that pre-hypertensive adults need to attend the sodium reduction education program for at least 4 times or more to gain beneficial effects from the intervention. Positive feedback of healthcare team or offering more cooking classes may be needed to raise the attendance rate in the sodium reduction education program. (Korean J Community Nutr 18(6) : 626~643, 2013)

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Objectives: This study was performed to evaluate the consumer education program for reducing sodium intake based on social cognitive theory (SCT) and investigate consumer perceptions of environmental, cognitive and behavioral factors. Methods: Consumers (n=4,439) were recruited nationwide in Korea to participate in a nutrition education program for reducing sodium intake which was targeted on senior housewives (SH), parents (P), and office workers (OW). Questions regarding main factors of SCT were asked both before and after the education program. Results: SH and P recognized external social efforts and information to reduce sodium including nutrition labeling more than OW. The main barriers to practice reducing sodium intake were limited choice of low sodium food and menu, interference with social relationship when dining with others, and limited information, knowledge and skills. SH had lower barriers to practice reducing sodium intake and OW perceived 'preference to soup or stew' and 'preference to Kimchi, salted fish and fermented sauces' as barriers more than other groups at the baseline. Less than 50% of participants knew the relationship between sodium and salt, sodium in nutrition labeling, and recommended sodium intake. In addition, OW had little knowledge for capability to reduce sodium intake and lower self-efficacy to practice compared with SH and P. After education, positive outcome expectations such as lowering blood pressure, prevention of cardiovascular disease and osteoporosis were increased and barriers to practice reducing sodium intake were decreased in all groups (p < 0.05). The knowledge for behavioral capability and self-efficacy to reduce sodium intake were also improved but OW had still lower scores compared with other groups. Conclusions: These results suggested that nutrition education programs could be an effective tool to impact general population by facilitating awareness and increased capability to reduce sodium intake.

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