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Background: Excessive salt intake has been directly associated with cardiovascular diseases, especially hypertension, and non-cardiovascular diseases. Despite the current recommendations, salt intake remains high, indicating the need to develop theory-based interventions aimed at reducing this intake., Aim: The purpose of this study was to test the impact of a theory-based intervention - the SALdável Program - to promote the use of less than 4 g of salt/day during cooking., Methods: This was a two-arm parallel-group randomized study. A total of 92 hypertensive women were randomly assigned to an intervention or control group. The intervention was aimed at motivating participants to reduce salt addition by increasing self-efficacy and counteracting the negative influence of habit. Primary outcomes were the behavioral question of salt addition and total salt addition, secondary outcomes were overall salt intake, provided by 24-hour urinary sodium excretion, and psychosocial variables (intention, self-efficacy, and habit)., Results: At three-month follow-up, the intervention group improved significantly more than the control group regarding salt addition measures (p-values between 0.05 and 0.001) and psychosocial variables (all p-values ⩽0.001). The reduction in 24-hour urinary sodium excretion was not significant., Conclusion: The findings showed that this theory-based intervention was effective to motivate and change the behavior of hypertensive women regarding daily salt use in cooking meals. This was accomplished by means of improvements in intention and self-efficacy and reduction of the habit of using more than 4 g of salt/day during cooking., (© The European Society of Cardiology 2015.)

Background: Despite strong evidence for a relationship between high salt intake and hypertension, plus the widespread recommendations for dietary salt restriction among hypertensive subjects, there are no nursing studies describing effective theory-based interventions., Aim: To describe a systematic process for development of a theory-based nursing intervention that is aimed at reducing salt intake among hypertensive women, by applying the 'intervention mapping' protocol., Methods: We developed our intervention following the six steps of the 'intervention mapping' protocol: assessing needs, creating a matrix of change objectives, selecting theoretical methods and practical applications, defining the intervention programme, organizing the adoption and implementation plan, and defining the evaluation plan., Results: Addition of salt during cooking is identified as the main source for salt consumption, plus women are identified as the people responsible for cooking meals at home. In our study, the motivational predictors of this behaviour were self-efficacy and habit. Guided practice, verbal persuasion, coping barriers, consciousness-raising and counter-conditioning were the theoretical methods we selected for enhancing self-efficacy and promoting habit change, respectively. Brainstorming, role-playing, cookbook use, measuring spoon use, label reading, hands-on skill-building activities and reinforcement phone calls were the chosen practical applications. We designed our intervention programme, and then organized the adoption and implementation plans. Finally, we generated a plan to evaluate our intervention., Conclusions: 'Intervention mapping' was a feasible methodological framework to guide the development of a theory-based nursing intervention for dietary salt reduction among hypertensive women.