Padilla-Moseley Janice, Sivakumar Bridve, Flexner Nadia, Grajeda Ruben, Gamble Brenda, Blanco-Metzler Adriana, Arcand JoAnne
Faculty of Health Sciences, Ontario Tech University, Oshawa ON, Canada.
Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, Ontario, Canada.
Curr Dev Nutr. 2023 Apr 1;7(5):100073. doi: 10.1016/j.cdnut.2023.100073. eCollection 2023 May.
Diets high in sodium are a risk factor for cardiovascular disease (CVD). Latin American countries (LAC) consume more than double the recommended sodium levels. Research uptake in dietary sodium reduction policies has been inconsistent in LAC, and the factors impacting research uptake are largely unknown. This study aimed to describe the barriers and facilitators to the uptake of research into sodium reduction policies from a funded research consortium with 5 LAC (Argentina, Brazil, Costa Rica, Paraguay, and Peru).
A qualitative case study included 5 researchers and 4 Ministry of Health officers from the funded consortium. Dimensions from Trostle's framework of actors, content, context, and process and relative advantages from the Diffusion of Innovation informed the semi-structured interview guide and analysis. One-on-one interviews were completed from November 2019 to January 2020. The participants validated transcripts, coded, and analyzed using NVivo software.
Key barriers to policy advancements included ) conflicts of interest from the food industry and some government actors; ) government turnover resulting in policy and personnel changes; ) a lack of human and financial resources; and ) and communication gaps among key actors. Key facilitators to policy advancement included: ) the content and quality of health economic, food supply, and qualitative data; ) support, technical assistance, and alliances with the government, non-governmental organizations, and international experts; and ) researchers enhanced skillsets facilitated with communication and dissemination with policymakers.
Researchers and policymakers are faced with several barriers and facilitators on research uptake in policies and programs in LAC; these factors should be addressed and leveraged to advance sodium reduction policy development. Future LAC studies can draw from the insights and lessons learned from this case study and apply the results to future efforts on policy nutrition to promote healthy eating and reduce CVD risk.
高钠饮食是心血管疾病（CVD）的一个风险因素。拉丁美洲国家（LAC）的钠摄入量超过推荐水平的两倍多。拉丁美洲在饮食钠减少政策方面的研究应用一直不一致，影响研究应用的因素在很大程度上尚不清楚。本研究旨在描述一个由五个拉丁美洲国家（阿根廷、巴西、哥斯达黎加、巴拉圭和秘鲁）组成的资助研究联盟在钠减少政策研究应用方面的障碍和促进因素。
一项定性案例研究包括来自该资助联盟的5名研究人员和4名卫生部官员。特罗斯特尔的行动者、内容、背景和过程框架中的维度以及创新扩散中的相对优势为半结构化访谈指南和分析提供了依据。2019年11月至2020年1月完成了一对一访谈。参与者对转录本进行了验证、编码，并使用NVivo软件进行了分析。
政策推进的主要障碍包括：（1）食品行业和一些政府行为者的利益冲突；（2）政府更替导致政策和人员变动；（3）缺乏人力和财力资源；（4）关键行为者之间的沟通差距。政策推进的主要促进因素包括：（1）健康经济、食品供应和定性数据的内容和质量；（2）与政府、非政府组织和国际专家的支持、技术援助和联盟；（3）研究人员通过与政策制定者的沟通和传播提高了技能。
研究人员和政策制定者在拉丁美洲国家的政策和项目研究应用方面面临着若干障碍和促进因素；应解决和利用这些因素来推进钠减少政策的制定。未来拉丁美洲国家的研究可以借鉴本案例研究的见解和经验教训，并将结果应用于未来的政策营养努力，以促进健康饮食和降低心血管疾病风险。
