Stages of Behavioral Change for Reducing Sodium Intake in Korean Consumers: Comparison of Characteristics Based on Social Cognitive Theory

Abstract

High sodium intake increases the risk of cardiovascular disease. Given the importance of behavioral changes to reducing sodium intake, this study aims to investigate the stages of change and the differences in cognitive and behavioral characteristics by stage in Korean consumers. Adult participants (N = 3892) completed a questionnaire on the stages of behavioral change, recognition of social efforts, outcome expectancy, barriers to practice, nutrition knowledge and dietary behaviors, and self-efficiency related to reduced sodium intake. The numbers of participants in each stage of behavioral change for reducing sodium intake was 29.5% in the maintenance stage, 19.5% in the action stage, and 51.0% in the preaction stage that included the precontemplation, contemplation, and preparation stages. Multiple logistic regression showed that the factors differentiating the three stages were recognizing a supportive social environment, perceived barriers to the practice of reducing sodium intake, and self-efficacy to be conscious of sodium content and to request less salt when eating out. Purchasing experience of sodium-reduced products for salty foods, knowledge of the recommended intake of salt and the difference between sodium and salt, and improving dietary habits of eating salted fish, processed food, and salty snacks were factors for being in the action stage versus the preaction stage. These findings suggest that tailored intervention according to the characteristics of each stage is helpful in reducing sodium intake.

Perceptions and Feasibility of Actions Related to Sodium Reduction among Restaurant Owners and Cooks in Seongnam, South Korea: Comparison According to Stages of Behavioral Change

“…The food industry successfully reformulated many processed foods to contain less sodium, and continuous nationwide campaigns created public awareness [16]. Our previous study showed that the percentages of Korean consumers in each stage of behavioral change for sodium reduction were 29.5% in the maintenance stage, 19.5% in the action stage, and 3.7% in the preparation stage [25]. Compared to consumers, a lower proportion of restaurant owners and cooks were classified in the maintenance and action stages (20.4%), but a higher proportion were classified in the preparation stage, indicating that it is not easy to find low-sodium foods in restaurants, despite half of consumers already practicing sodium reduction.…”

Restaurant interventions for salt reduction in China: protocol for a randomised controlled trial

“…Social cognitive theory proposes behaviour was influenced by the constant interaction of personal factors (ie, skills and knowledge) and environmental factors (ie, appropriate modelling for learning and available materials). 22 Therefore, we designed the intervention activities based on both the supply (restaurant) and demand (consumer) sides (figure 1). For the intervention group, the RIS intervention package included the following activities:…”

“…To achieve the goal, we developed a restaurant salt reduction package, the feasibility and effectiveness of which are being tested by RIS. The key interventions were based on social cognitive theory 22 and included: (1) building tailored restaurant environments that encourage consumers to order lowersalt or reduced-salt dishes; (2) lower salt or reduced-salt ordering reminders from the waiters; (3) training cooks in reduced-salt cooking; and (4) salt reduction campaigns. As a part of the ASC programme, this article reports on the design of the RIS intervention package and its implementation, evaluation and current status.…”

Development and Assessment of a Helicobacter pylori Medication Adherence and Stomach Cancer Prevention Curriculum for a Chinese American Immigrant Population

“…It comprises 3 primary constructs: self-efficacy (an individual s confidence to be in control of their health); outcome expectations (an individual s understanding of the consequences of a behavior); and socio-structural factors (the facilitators and challenges to behavior that may indirectly influence health behavior and goal setting, e.g., socio-cultural norms and environment) [16]. Social Cognitive Theory addresses the complex interactions between individual factors (such as skills, knowledge, self-efficacy, including goal setting, and outcome expectancy behaviors) and the environment (models for learning and available materials) [17] and was used to guide the development of behavioral strategies. Health communication theory informed curriculum messaging to foster positive outcome expectations, beliefs about the likelihood and value of the consequences of taking medication, as well as self-efficacy, to enhance the likelihood of a desired action (goal setting) [18].…”