Dr. Mahmooda Khaliq Pasha and team use social marketing to reduce salt intake in Latin America

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February is Heart Health Month

 A New England Journal of Medicine article indicates that 1.7 million deaths globally can be blamed on consuming too much salt. Many of those deaths can be attributed to the hypertension—and the subsequent stroke and heart disease—excess salt causes.

“Too much dietary salt is a major cause of high blood pressure, which is a leading risk for disability worldwide,” said Mahmooda Khaliq Pasha, MHS, PhD, assistant professor of community and family health and at the USF College of Public Health.

Pasha is the principal investigator for the International Development Research Centre (IDRC) funded project evaluating the use of social marketing to reduce salt intake in four Latin American countries–Brazil, Peru, Costa Rica and Paraguay.

USF is partnering with the American Heart Foundation, the Pan American Health Organization (PAHO) and the Costa Rican Institute of Research and Teaching in Health and Nutrition to carry out the research.

“High blood pressure accounts for two-thirds of all strokes and one half of all heart disease. Latin America has some of the highest rates of hypertension, and the prevalence will only increase as people live longer,” Pasha said.

In an effort to curb salt intake in these countries, Dr. Pasha and her colleagues have been providing training and technical assistance in social marketing to core research teams in these four countries. The teams consist of representatives from the ministries of health, as well as those from the nonprofit sector and academic institutions.

The teams met in Costa Rica last June to summarize what they had discovered and to develop a salt-reducing social marketing strategy.

At last June’s gathering, left to right, Dr. Claudia Parvanta, COPH professor and director of the Florida Prevention Research Center, Dr. Ruben Grajeda, senior advisor Pan American Health Organization, and Adriana Blanco, project leader for Costa Rica, conduct a workshop to define a research strategy and target audience. (Photo courtesy of Dr. Mahmooda Khaliq Pasha)

“Basically these core research teams used the training we provided to identify specific behaviors that contribute to excess salt in the diet and then went on to identify the target population most amenable to making dietary changes,” said Pasha, who is also a COPH alumna and training lead for Florida Prevention Research Center (FPRC), a Centers for Disease Control and Prevention (CDC) funded center of excellence and associate director of the USF World Health Organization Collaborating Center on Social Marketing and Social Change.

Existing research done by the groups found that most salt was coming from ready-made, prepared foods and the target audience most receptive to change was young mothers of grade school children.

Paraguay team working on developing their research strategy. (Photo courtesy of Pasha)

“Young mothers want to do what’s best for their children, and they are also the ones most apt to learn about new things and introduce them into the home,” Pasha said. “If we can get information to them via a successful social marketing intervention, then we are setting the stage for long-term impact. If we can get the moms to change the behaviors in the household, then, in turn, that affects the taste profile of the household. If you have young children learning to tolerate less salt in their food, then the prevalence of hypertension can be reduced.”

“To be successful,” adds Adriana Blanca Metzler, Pasha’s Costa Rican counterpart, “it’s fundamental to segment and prioritize the population.”

Social marketing interventions that may be implemented could use promotional channels such as Facebook groups for young moms sharing low-salt recipes, a photo novella, a cookbook and meal preparation demonstrations at grocery stores.

Representatives from Brazil, Peru, Paraguay, Costa Rica, PAHO and USF working on the salt-reduction project. (Photo courtesy of Pasha)

Right now, Pasha said, the teams are conducting interviews and focus groups with these young moms and key stakeholders to see which interventions may work best.

“By the end of this grant, we will have a social marketing campaign. We’ll do a pilot in one of the countries and see what happens and then use that opportunity to leverage more funds so that the same interventions can be rolled out to many more countries.”

Story by Donna Campisano, USF College of Public Health