Working towards less salt
Sue Harvey of Kent County Council Trading Standards talks about thier 'Working towards less salt' project which took place across workplaces in Kent and aimed to reduce salt intake in employees eating in work canteens.
Aims and Objectives
The aim of the project was to use a workplace intervention to enable employees in Kent to reduce their salt intake. The target audience was adult male employees.
Objectives
- To design an educative and interactive workplace display for employees to support salt intake
- To support workplace caterers reduce the salt content of foods offered in the employee restaurant
Partners
Kent County Council - Trading Standards & Kent Scientific Services
Food Standards Agency
Employees of 6 participating workplaces in Kent and catering staff of their employee restaurants/ canteens.
Methodology
As part of Phase 3 of the FSA’s national Salt Campaign grant funding was offered by the Agency to external agencies for projects aimed at changing consumer behaviour to reduce salt intake. In February 2008, a grant of was awarded to Kent Trading Standards (KTS) to design, implement and evaluate a workplace intervention to promote salt reduction amongst employees in the county. The project consisted of two elements:
An educational display
The display was developed to enable employees at the six participating workplaces to acquire the knowledge, skills and motivation to drive healthy salt behaviours. Four display boards each measuring 80cm by 214cm were developed to ‘tell a story’ i.e. show the health reasons for reducing salt, the maximum recommended salt intake, the traffic light labelling scheme and tips for reducing salt. An external company was engaged to develop two draft display board designs.
The draft displays were piloted through the Centre for Health Services Studies (CHSS) at the University of Kent to ensure content and presentation was effective with the target audience. The finalised display was positioned within each workplace restaurant area for between 4 and 5 days, manned at 2 advertised sessions by trading standards staff. It was based on active learning principles with a supporting information leaflet. Each workplace was encouraged to advertise the event through staff notice boards, email messages and staff meetings. To support this a flyer was produced for each workplace to display or circulate via email.
Environmental input
The second element of the intervention was designed to reduce salt levels in the most popular meals provided in the workplace restaurant. Initially meals were analysed for their salt content and the results shared with the caterers. Opportunities were identified with the catering team on how to reduce the salt content within the meals and food offered through the catering service.
Discussions centred on the amount of salt added during preparation and cooking, the ‘hidden’ sources of salt e.g. stock and the potential to use lower salt versions of products e.g. meat products. The provision of salt on the dining table and/or service counter was also raised.
Promotion
Local businesses known by Kent County Council TS to have canteens were approached directly.
Resources
The FSA Grant funded design and production of display boards and the evaluation of the project. Copies of the Agency’s salt leaflets were provided free. Analysis of meals was met through the Service Level Agreement with KSS. Staffing for sampling and display attendance was met by KTS.
Evaluation
The evaluation was divided into two parts reflecting the two elements of the project.
Employee attitudes & behaviour
The quantitative evaluation of employee knowledge and self reported behaviour was contracted to CHSS. Data was collated through a retrospective employee questionnaire. The data from self–reported behaviour, of a small sample has to be viewed with caution but suggests that the intervention changed behaviour, attitudes, knowledge, and opinions towards a high salt intake in the desired direction.
The intervention appeared to induce a significant restraint in the amount of salt taken with food compared to two weeks earlier and a significant reduction in the amount of salt added to food at the table. There was higher awareness about the risks of a diet high in salt, and a higher interest in finding out about the levels of salt in foods. As expected, the impact of the intervention was visibly stronger in inducing a change in attitudes than in behaviour.
The intervention increased significantly the accuracy of individuals’ knowledge about the recommended maximum daily salt intake, the meaning of front of pack signpost labelling for the salt content of prepared foods, and the average percentage of salt intake that comes from prepared foods. Further it changed respondents’ opinions about the reasons for people like themselves not to change their unhealthy salt intake habits.
Ignorance of the consequences of a diet high in salt was citied more as a reason by those in the intervention group rather than to assign responsibility to factors outside their control i.e. the amount of salt added to food by manufacturers or by the ‘cook’ in the household or to disagreements about the actual negative effects to health of a high salt intake. However, more research would be necessary to establish if its effects are long lasting.
Two thirds of the respondents who participated in the evaluation did not see or pay attention to the display. Reaching this large group of individuals may prove difficult, as the responses implied that they do not see it in their hands to solve the problem, attributing it to lack of control over the levels in salt food or disputing whether it is healthier to reduce salt intake.
Salt content of meals
The assessment of salt content in workplace catering was undertaken by KTS through the sampling of menu items and chemical analysis of foods conducted by KSS. It was difficult to draw any conclusions from the analysis of meals in the workplace as in only one workplace was it possible to make direct comparisons between meals pre and post intervention. There was a reduction in levels of salt when viewed across the range of results but this was accompanied by some increases in specific meals. The limited reductions in salt indicate that further support to caterers would be needed.
Whilst it was not been possible to draw strong conclusions the project provided useful experience and insight on which to build in future activity for workplace restaurants and other catering establishments.
Lessons Learned
- Workplace recruitment – obtaining commitment to participate proved difficult. Some employees expressed interest initially but were slow to make a commitment to participate. It was important to gain access to the person with authority within the workplace to make that commitment and for this commitment to be carried through to the intervention stage. Working on the ground in respect of the display with a motivated employee coupled with a professional interest e.g. occupational health practitioner proved beneficial. A sufficient lead in period is needed to fully plan and prepare for the process and to accommodate for employer preferences.
- Siting of display – the display was positioned in the restaurant area of each workplace. The pilot process for the display conducted by CHSS indicated that some of the target group, namely blue collar workers within that particular workplace were not frequent users of the workplace restaurant. Other sites for the display were explored but limitations in terms of size and access meant that it was not possible to re-position on Health and Safety grounds.
- Engaging employees – the use of pens was useful as an opening to engage employees in conversation and draw their attention to the display. It also provided a website reference for access to information on salt at the employee’s leisure.
- Display materials – additional display materials were identified as potentially offering increased efficiency and interaction. Participants were talked through a number of examples using food labels. An improvement could be to present these as A4 size worked examples, indicating how much each component of a compound meal contributes to the overall salt level of that meal. This could then be shown alongside a similar worked example using lower salt components. A competition or quiz element to estimate the amount of salt in a meal could be coupled with this to increase engagement and instantly test knowledge and understanding.
- Accommodating caterers/employers interests – the analysis of meals was intended to be limited to salt only. However it became clear that caterers and employers were also interested in fat and saturated fat levels. To facilitate working together analysis both pre and post display was extended to include these parameters and shared at the caterer interviews.
Future Developments
As highlighted under lessons learned -participants were talked through a number of examples using food labels. An improvement could be to present these as A4 size worked examples, indicating how much each component of a compound meal contributes to the overall salt level of that meal. This could then be shown alongside a similar worked example using lower salt components. A competition or quiz element to estimate the amount of salt in a meal could be coupled with this to increase engagement and instantly test knowledge and understanding.
The display is now being used within libraries at their Healthy Living themed events. The library also identifies supporting books e.g. low salt cookery books to display with the stand.
A copy of the full project report is available at www.kent.gov.uk and click on trading standards or visit the Food Standards Agency website at www.food.gov.uk/news/newsarchive/2008/jun/saltpart
Contact Details
Contact Name: Sue Harvey
Job Title: Lead Officer Food & Agriculture
Phone: 01622 221012
Email: susan.harvey@kent.gov.uk
Website: www.kent.gov.uk
Organisation: Kent County Council
Address: Kent County Council Trading Standards, Invicta House, Maidstone ME14 1XX