Objective: To employ qualitative research methods to evaluate the sustainability of the Shandong-Ministry of Health Action on Salt and Hypertension (SMASH) interventions and their influencing factors. Method: In September 2023, interviewees meeting the inclusion criteria were recruited through purposive sampling in Jinan, Shandong Province. A semi-structured interview guide was designed based on the CFIR and RE-AIM frameworks. Personal in-depth interviews and focus group discussions were conducted to gather insights on the feasibility, effectiveness, and sustainability of the project interventions from various stakeholders, including representatives from the government, food manufacturers, restaurants, academia, and residents. Results: A total of 15 individuals participated in in-depth interviews, involving six representatives from food manufacturers, four from restaurants, three from the government, and two from academia. There were four focus group discussions with 30 residents. The study found that at the individual resident level, health awareness and the availability of sodium reduction tools in the market could affect their salt reduction practices. For food manufacturers and restaurants, consumers' preferences, technical challenges in reformulation, and government support were key factors determining the smooth progress of their salt reduction efforts. At the governmental level, multi-sectional coordination, chronic disease management demonstration areas, and the impact of the pandemic were the main factors influencing the implementation of sodium reduction interventions. Conclusion: Future endeavours should strengthen long-term management and optimise the complex influencing factors associated with intervention measures. This will be essential in sustaining and expanding the positive health outcomes achieved through the Shandong population sodium reduction strategy.
目的: 运用定性研究方法,评估山东省部联合减盐项目(SMASH)干预措施的可持续性及其影响因素。 方法: 于2023年9月,在山东省济南市通过目的性抽样招募符合纳入条件的访谈对象。基于CFIR和RE-AIM框架设计的半结构化访谈提纲,通过个人深度访谈和焦点小组讨论,探讨了不同利益相关者(包括政府部门、食品生产企业、餐饮单位、专家学者及居民)对项目干预措施的可行性、有效性、可持续性的看法。 结果: 个人深度访谈15名,其中食品生产企业代表6名,餐饮单位代表4名,政府部门代表3名,专家学者代表2名;小组讨论4组,共30名。研究发现,在居民个人层面,健康意识水平和健康产品市场的发展影响了他们的减盐实践;对于食品生产企业和餐饮单位而言,居民的消费习惯、技术挑战,以及政府支持与指导是决定其减盐工作能否顺利推进的关键因素;在政府层面,跨部门的协调合作、慢病示范区的建立,以及疫情带来的影响,是减盐干预落实的主要影响因素。 结论: 未来的工作应加强干预措施背后复杂影响因素的长效管理和优化,以确保减盐措施能在更广泛和深入的层面上持续产生积极影响。.