Contextual factors and implementation strategies for a multi-level community-based sodium reduction intervention in Chicago’s South Side: A qualitative study
Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Background
Excessive sodium intake exacerbates rates of hypertension. African American adults have higher rates of hypertension in part due to a higher-sodium diet. The multi-level Communication for Behavioral Impact for Sodium Reduction (COMBI-SR) community-based intervention effectively reduces sodium intake in international settings, but it has not yet been implemented and tested in the U.S. This study explored the contextual factors (barriers/facilitators) and implementation strategies for COMBI-SR in Chicago’s South Side neighborhood–an area with high rates of hypertension.
Methods
Data were gathered between May and November 2023, through qualitative interviews and focus groups with 40 local participants, including community members, faith-based leaders, and healthcare professionals. The Consolidated Framework for Implementation Research (CFIR) 2.0 guided the development of semi-structured interview guides. Thematic analysis was performed with coding based on CFIR 2.0 constructs (contextual factors) and the Expert Recommendations for Implementing Change (ERIC) compilation of implementation strategies.
Results
Key barriers included a lack of awareness of sodium content in foods, socioeconomic disparities limiting access to healthy options, and cultural dietary traditions. Facilitators included strong community partnerships, engaged faith-based organizations, and openness to integrating technology, such as a mobile app, to help monitor and reduce sodium intake. Specific strategies to support sodium reduction involved simplifying public health messages, offering low sodium cooking demonstrations, promoting healthier food options through community outreach, and providing personalized education on reading nutrition labels and managing sodium intake.
Conclusion
Successful implementation of COMBI-SR in Chicago’s South Side requires addressing financial, educational, and cultural barriers while leveraging trusted community structures to promote sustainable sodium reduction. These findings will guide future efforts to implement COMBI-SR in the U.S. and improve cardiovascular health.
