小学生及其家庭减盐的持续效果：基于应用程序的整群随机对照试验后的1年随访

Persistent effect of salt reduction in schoolchildren and their families: 1-year follow-up after an application-based cluster randomized controlled trial.

作者信息

Li Yuan, Zhang Puhong, He Feng J, Luo Rong, Song Jing, Wang Changqiong, Chen Fengge, Zhao Wei, Zhao Yuhong, Chen Hang, Wu Tianyong, Wang Xiaoyan, Zhou Hui, Han Zhi, Zhang Jie

机构信息

The George Institute for Global Health, Beijing, China.

The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.

出版信息

BMC Med. 2025 Jan 27;23(1):41. doi: 10.1186/s12916-025-03868-8.

DOI:10.1186/s12916-025-03868-8

PMID:39865267

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11771009/

Abstract

BACKGROUND

A 12-month cluster randomized controlled trial (RCT) demonstrated the effectiveness of an application-based education program in reducing the salt intake and systolic blood pressure (SBP) of schoolchildren's adult family members. This study aimed to assess whether the effect at 12 months persisted at 24 months.

METHODS

Fifty-four schools were randomly assigned to either the intervention or control group. All participants (594 children in grade 3 and 1188 of their adult family members) who completed the baseline survey were contacted again 12 months after the trial. The primary outcome was the difference in salt intake change between the intervention and control groups at 24 months versus baseline and 12 months, measured by the mean two consecutive 24-h urinary sodium excretions. The secondary outcome was the difference in the change of blood pressure and salt-related Knowledge, Attitude, Practice (KAP) score.

RESULTS

The difference in salt intake change in adults between the intervention and control groups after adjusting for confounding factors was - 0.38 g/day at 24 months versus baseline (95% CI - 0.81 to 0.05, p = 0.09), following the - 0.83 g/day (95% CI - 1.25 to - 0.41, p < 0.001) at 12 months. The adjusted difference in SBP change was - 2.19 mm Hg (95% CI - 3.63 to - 0.76, p = 0.003) at 24 months versus baseline, following the - 1.80 mm Hg (95% CI - 3.19 to - 0.40, p = 0.01) at 12 months. The intervention group had a higher KAP score than the control group both at 12 months and at 24 months versus baseline. No significant changes were found in children.

CONCLUSIONS

The effect of the education program on adults' salt intake faded, but the SBP lowering effect and the improvement of KAP score remained 12 months after the completion of the RCT. Continuous efforts are needed to maintain the salt reduction effects in real-world settings.

TRIAL REGISTRATION

ChiCTR1800017553. Registered on August 3, 2018.

摘要

背景

一项为期12个月的整群随机对照试验（RCT）证明了一项基于应用程序的教育计划在降低学童成年家庭成员的盐摄入量和收缩压（SBP）方面的有效性。本研究旨在评估12个月时的效果在24个月时是否持续存在。

方法

54所学校被随机分配到干预组或对照组。所有完成基线调查的参与者（594名三年级儿童及其1188名成年家庭成员）在试验结束12个月后再次被联系。主要结局是干预组和对照组在24个月时与基线和12个月时相比盐摄入量变化的差异，通过连续两次24小时尿钠排泄量的平均值来衡量。次要结局是血压变化以及与盐相关的知识、态度、行为（KAP）得分的差异。

结果

在调整混杂因素后，干预组和对照组在24个月时与基线相比成年人盐摄入量变化的差异为-0.38克/天（95%CI -0.81至0.05，p = 0.09），而在12个月时为-0.83克/天（95%CI -1.25至-0.41，p < 0.001）。在24个月时与基线相比收缩压变化的调整差异为-2.19毫米汞柱（95%CI -3.63至-0.76，p = 0.003），在12个月时为-1.80毫米汞柱（95%CI -3.19至-0.40，p = 0.01）。干预组在12个月和24个月时与基线相比的KAP得分均高于对照组。儿童未发现显著变化。