Community organization in a school health education program to reduce sodium consumption.

This paper describes the important role of community organization in providing the enabling and reinforcing factors necessary for students to adopt dietary behavior changes recommended in a school health education program for cardiovascular health. The "Hold the Salt!" program was designed to teach sixth grade students and their families about the link between high sodium diets early in life and increased risk for cardiovascular disease, and to significantly reduce pupils' intake of high-sodium snacks. The program consists of four educational components: a classroom cafeteria curriculum unit built around a board game; parent outreach; health provider reinforcement; and community support. The program was tested in an experimental group (n = 55) of urban, black, sixth grade students, whose knowledge and behavior changes were compared to a control group (n = 23) with similar demographic statistics. Data collected before and after the school program showed a 20% increase in knowledge about sodium and health (p less than .01) and a 33% decrease in reported high-sodium snack consumption (p less than .05) in the experimental group compared to no significant knowledge or reported behavior changes in the control group. The program was piloted for two years in Baltimore City elementary schools, then adopted by the Maryland State Dept. of Education for dissemination as part of the Home Economics curriculum in all of the state's middle schools.