Everything with a pinch of salt: what knowledge have adult Barbadians gained from recent salt reduction messages and what impact have the messages had on their dietary choices?

OBJECTIVE: To ascertain whether adult Barbadians, 25-55 years, could identify and understand messages contained in phase one of the ‘Battling the Hidden Enemy” Salt Reduction Campaign, and to assess if these messages impacted dietary choices, particularly salt consumption. DESIGN AND METHODS: Purposeful sampling was used to recruit 22 Barbadians from a public and a private clinic to participate in five focus groups. Recorded group sessions were analysed using inductive and deductive reasoning and data was classified and organised according to key themes, concepts and emergent categories using framework analysis, aided by the software programme, Atlas.ti. RESULTS: Participants could identify and understood the public service announcement (PSA) messages but did not report an increase in skills and self-efficacy in selecting low salt food options as they were still unable to read labels and make better food choices. Mainly female participants stated an inability to limit their salt intake and pointed to barriers to changing their behaviours such as heavily advertised products, low-cost foods high in salt, addiction to tasty (salty) foods, inadequate labeling and a lack of nutritional information in food establishments. CONCLUSIONS: Education alone was ineffective in reducing the perceived salt consumption levels of focus group members, who judged the PSAs as educational but not effective. A multi-pronged approach should be used including a targeted, consistent campaign, supported by interventions that change the food environment in ways that encourage population-wide behaviour change.