An mHealth-based school health education system designed to scale up salt reduction in China (EduSaltS): A development and preliminary implementation study
BackgroundHigh-salt diet is an important risk factor for several non-communicable diseases. School-based health education has been found effective in reducing salt intake among children and their families in China. However, no such interventions have been scaled up in the real world. For this purpos...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2023.1161282/full |
| _version_ | 1797845633222049792 |
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| author | Puhong Zhang Jingwen Sun Yinghua Li Yuan Li Yuewen Sun Rong Luo Xueqiong Nie Li Li Yu Liu Feng J He |
| author_facet | Puhong Zhang Jingwen Sun Yinghua Li Yuan Li Yuewen Sun Rong Luo Xueqiong Nie Li Li Yu Liu Feng J He |
| author_sort | Puhong Zhang |
| collection | DOAJ |
| description | BackgroundHigh-salt diet is an important risk factor for several non-communicable diseases. School-based health education has been found effective in reducing salt intake among children and their families in China. However, no such interventions have been scaled up in the real world. For this purpose, a study was launched to support the development and scale-up of an mHealth-based system (EduSaltS) that integrated routine health education and salt reduction and was delivered through primary schools. This study aims to elaborate the framework, development process, features, and preliminary scaling-up of the EduSaltS system.MethodsThe EduSaltS system evolved from previously successfully tested interventions to reduce family salt intake by empowering schoolchildren through school health education. EduSaltS was designed by following the WHO’s conceptual framework for developing a scaling-up strategy which accounted for the nature of the innovation, the capacity of the implementing organizations, the characteristics of the environment, the resources available, and type of scaling up. The system was then developed step by step from determination of online platform architecture, definition of component interventions and activities, development of specific educational materials and tools, to the development of the online/offline hybridized system. The system was tested and refined by a pilot in two schools and a preliminary scale-up in two cities in China.ResultsEduSaltS was developed as an innovative health education system, including an online WeChat-based education platform, a set of offline activities, and an actual administrative website showing the progress and setting the system. The WeChat platform could be installed on users’ smartphones to automatically deliver 20 sessions of five-minute well-structured cartoon video classes, followed by other online interactive activities. It also helps support project implementation and real-time performance evaluation. As a first-stage roll-out, a one-year course has been successfully implemented among 54,538 children and their families from 209 schools in two cities, and the average course completion rate was 89.1%.ConclusionAs an innovative mHealth-based health education system, EduSaltS was developed based on successfully tested interventions and an appropriate framework for scaling up. The early-stage roll-out has shown its preliminary scalability, and further evaluation is ongoing. |
| first_indexed | 2024-04-09T17:42:07Z |
| format | Article |
| id | doaj.art-cbc9e60e991649c1bf747713b45a8f2c |
| institution | Directory Open Access Journal |
| issn | 2296-861X |
| language | English |
| last_indexed | 2024-04-09T17:42:07Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj.art-cbc9e60e991649c1bf747713b45a8f2c2023-04-17T04:50:09ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2023-04-011010.3389/fnut.2023.11612821161282An mHealth-based school health education system designed to scale up salt reduction in China (EduSaltS): A development and preliminary implementation studyPuhong Zhang0Jingwen Sun1Yinghua Li2Yuan Li3Yuewen Sun4Rong Luo5Xueqiong Nie6Li Li7Yu Liu8Feng J He9The George Institute for Global Health, Beijing, ChinaThe George Institute for Global Health, Beijing, ChinaChinese Center for Health Education, Beijing, ChinaThe George Institute for Global Health, Beijing, ChinaThe George Institute for Global Health, Beijing, ChinaThe George Institute for Global Health, Beijing, ChinaChinese Center for Health Education, Beijing, ChinaChinese Center for Health Education, Beijing, ChinaSchool of Computing Science and Engineering, Beihang University, Beijing, ChinaBarts and The London School of Medicine and Dentistry, Wolfson Institute of Population Health, Queen Mary University of London, London, United KingdomBackgroundHigh-salt diet is an important risk factor for several non-communicable diseases. School-based health education has been found effective in reducing salt intake among children and their families in China. However, no such interventions have been scaled up in the real world. For this purpose, a study was launched to support the development and scale-up of an mHealth-based system (EduSaltS) that integrated routine health education and salt reduction and was delivered through primary schools. This study aims to elaborate the framework, development process, features, and preliminary scaling-up of the EduSaltS system.MethodsThe EduSaltS system evolved from previously successfully tested interventions to reduce family salt intake by empowering schoolchildren through school health education. EduSaltS was designed by following the WHO’s conceptual framework for developing a scaling-up strategy which accounted for the nature of the innovation, the capacity of the implementing organizations, the characteristics of the environment, the resources available, and type of scaling up. The system was then developed step by step from determination of online platform architecture, definition of component interventions and activities, development of specific educational materials and tools, to the development of the online/offline hybridized system. The system was tested and refined by a pilot in two schools and a preliminary scale-up in two cities in China.ResultsEduSaltS was developed as an innovative health education system, including an online WeChat-based education platform, a set of offline activities, and an actual administrative website showing the progress and setting the system. The WeChat platform could be installed on users’ smartphones to automatically deliver 20 sessions of five-minute well-structured cartoon video classes, followed by other online interactive activities. It also helps support project implementation and real-time performance evaluation. As a first-stage roll-out, a one-year course has been successfully implemented among 54,538 children and their families from 209 schools in two cities, and the average course completion rate was 89.1%.ConclusionAs an innovative mHealth-based health education system, EduSaltS was developed based on successfully tested interventions and an appropriate framework for scaling up. The early-stage roll-out has shown its preliminary scalability, and further evaluation is ongoing.https://www.frontiersin.org/articles/10.3389/fnut.2023.1161282/fullschool-based health educationsalt reductionbehavior changeintervention platform developmentm-healthprevention |
| spellingShingle | Puhong Zhang Jingwen Sun Yinghua Li Yuan Li Yuewen Sun Rong Luo Xueqiong Nie Li Li Yu Liu Feng J He An mHealth-based school health education system designed to scale up salt reduction in China (EduSaltS): A development and preliminary implementation study Frontiers in Nutrition school-based health education salt reduction behavior change intervention platform development m-health prevention |
| title | An mHealth-based school health education system designed to scale up salt reduction in China (EduSaltS): A development and preliminary implementation study |
| title_full | An mHealth-based school health education system designed to scale up salt reduction in China (EduSaltS): A development and preliminary implementation study |
| title_fullStr | An mHealth-based school health education system designed to scale up salt reduction in China (EduSaltS): A development and preliminary implementation study |
| title_full_unstemmed | An mHealth-based school health education system designed to scale up salt reduction in China (EduSaltS): A development and preliminary implementation study |
| title_short | An mHealth-based school health education system designed to scale up salt reduction in China (EduSaltS): A development and preliminary implementation study |
| title_sort | mhealth based school health education system designed to scale up salt reduction in china edusalts a development and preliminary implementation study |
| topic | school-based health education salt reduction behavior change intervention platform development m-health prevention |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2023.1161282/full |
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