Understanding dietary salt consumption among school personnel in Eastern India: Insights from a mixed-methods study
Sudip Bhattacharya, Deepanshi Saxena, Akash Dasgupta, Soumik Ghosh, Alok Singh, Siddharth Singh, Sunil Panigrahi, Boratne Abhijit Vinodrao, Vinayagamoorthy Venugopal, Manuj Kumar Sarkar, Smarak Ranjan Rout
A
BSTRACT
Background:
Excess dietary salt intake is a major modifiable risk factor for hypertension and cardiovascular diseases. Despite strong evidence supporting salt reduction, unhealthy dietary practices remain common due to behavioural, cultural, and environmental influences. School teachers and staff are influential role models; however, evidence regarding their knowledge, attitudes, and practices (KAP) related to dietary salt intake is limited in India. This study assessed salt-related KAP and explored the contextual factors influencing these behaviours.
Methods:
An explanatory sequential mixed-methods study was conducted among 191 teachers and nonteaching staff from government and private schools in Deoghar, Jharkhand. The quantitative phase comprised a cross-sectional survey using a validated KAP questionnaire, followed by four focus group discussions and ten in-depth interviews with purposively selected participants. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data underwent thematic analysis. Findings from both phases were integrated during interpretation.
Results:
More than 90% of participants recognised the harmful effects of excess salt intake and its association with hypertension; however, awareness of its relationship with cardiovascular disease, chronic kidney disease, and stroke was limited. Despite satisfactory knowledge, favourable practices, including food label reading and reduced discretionary salt use, remained suboptimal, with no significant association between knowledge and practices. Qualitative findings identified taste preferences, cultural norms, misconceptions regarding alternative salts, poor nutritional literacy, and absence of institutional policies as major barriers to behaviour change.
Conclusion:
High awareness alone was insufficient to improve salt-related practices. School-based interventions are needed to strengthen hypertension prevention.