Do knowledge about sodium, health status by self-report, and having hypertension predict sodium consumption behaviors among Southern California hospital employees?

Abstract

Little is known about factors that shape sodium consumption behaviors among hospital employees targeted by recent federally funded, sodium-related policy, systems, and environmental change interventions. To address this gap in health promotion practice, we assessed the influence of sodium-related knowledge and attitudes, and health status by self-report on the sodium consumption behaviors of hospital employees targeted by the Los Angeles County Sodium Reduction Initiative. Cross-sectional surveys were administered to 1,213 hospital employees at four Southern California hospitals between 2016 and 2018. Logistic regression models examined the associations between five key sodium consumption behaviors and independent variables of interest (i.e., knowledge and attitudes about sodium, self-reported general health status, and self-reported lifetime hypertension diagnosis), controlling for covariates (i.e., sociodemographic characteristics, body mass index, the type of hospital from which participants were recruited, and the median household income in the hospital’s zip code). 1,213 hospital employees completed the survey (completion rate = 50%). The belief that salt intake is harmful was associated with four of five sodium consumption behaviors, while adequate sodium intake knowledge and self-reported “good health” were associated with three of the behaviors. Hypertension diagnosis was associated with only one. Understanding sodium consumption behaviors among healthcare workers can help hospitals improve their employees’ health through the promotion of healthier food environments in the workplace and changes in institutional practices.

Lay Summary

A major problem in the United States is the overconsumption of high sodium foods. These foods often put people at higher risk of hypertension, heart disease, and stroke. Recent public health efforts have tackled this problem by making it easier to select/purchase healthier, lower sodium foods in different settings. Hospital employees are one such group that has been the focus of these interventions. Presently, little is known about what explains sodium-related dietary behaviors among hospital employees. To address this gap, we used data from a survey of hospital staff who were exposed to sodium reduction interventions in the workplace to examine how their knowledge, attitudes, and self-reported health status affected their sodium consumption. A key finding was being in “good health” and having the belief that salt intake matters for health predicted decreased sodium consumption among the survey participants. These and other study findings provide context and insights into ways in which further sodium reduction could be achieved among at-risk hospital employees.