Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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Development and evaluation of a nutrition education program for housewives to reduce sodium intake: application of the social cognitive theory and a transtheoretical model

주부대상 나트륨 섭취 줄이기 영양교육 프로그램 개발 및 효과 평가: 사회인지론과 행동변화단계모델 적용

  • Ahn, Sohyun (Department of Food and Nutrition, Shingu College) ;
  • Kwon, Jong-Sook (Department of Food and Nutrition, Shingu College) ;
  • Kim, Kyungmin (Department of Food and Nutrition, Baewha Women's University) ;
  • Kim, Hye-Kyeong (Department of Food Science & Nutrition, The Catholic University of Korea)
  • Received : 2021.12.14
  • Accepted : 2022.01.07
  • Published : 2022.02.28
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Abstract

Purpose: This study was performed to evaluate an education program for housewives to reduce sodium intake based on the social cognitive theory. Methods: Housewives (n = 387) received 2 education sessions focused on food purchase and cooking, and completed a questionnaire on their perceptions of environmental, cognitive, and behavioral factors and the stages of behavioral change to reducing sodium intake both before and after the education program. Results: After the education program, the recognition of social efforts for sodium reduction and sodium labeling and experience with low-sodium products increased. Positive expectancies for the prevention of osteoporosis by the reduction of sodium were enhanced while the main barriers in practicing sodium reduction decreased, especially 'interrupting social relationships when dining with others', 'bad taste', 'preference for soup or stew', and 'limited knowledge and skills to practice'. In addition, cognition and nutrition knowledge related to reducing sodium intake were improved on all scores, but the effect on self-efficacy and dietary behavior was limited to only a few items. The percentage of participants in the pre-action stage (including pre-contemplation, contemplation, and preparation stages) for reducing sodium intake decreased from 43.2% before education to 21.5% after education, while that in the action stage increased from 19.6% before education to 43.5% after education (p < 0.001). The education program had the most significant impact on participants who were in the pre-action stage and showed improved scores in all sections. Conclusion: These results suggest that a customized education program for housewives could be an effective tool to reduce sodium intake by improving personal expectancies, cognition, and nutrition knowledge regarding sodium reduction and enabling a greater section of the population to move to the action stage of reducing sodium intake.

본 연구는 가정 내의 식품구매와 조리를 주로 담당하는 주부를 대상으로 나트륨 줄이기 영양교육프로그램을 개발하고 전국적인 교육을 실시한 후 설문지로 교육전·후환경적·인지적·행동적 요인의 변화와 행동변화 단계 분포를 조사하여 교육효과를 분석하였다. 교육에 참여하여 분석된 대상자는 387명으로 평균연령 54세, 고졸이상 학력이 87.6%였다. 교육 후 나트륨 줄이기와 관련된 사회적 노력과 영양표시에 대한 인지 비율이 증가하고 소금, 간장, 치즈, 스낵 및 칩 등의 저나트륨 제품 구매경험이 높아졌다. 나트륨 섭취 줄이기의 긍정적 결과로 골다공증 예방에 대한 기대가 높아졌고, 부정적 장애요인의 평균점수가 낮아졌는데 특히 '가족이나 친구와 함께 식사할 때 사회적 관계의 제한으로 혼자 저나트륨식을 실천하기 어려움', '저나트륨식은 맛이 없음', '나트륨 줄이기 실천을 위한 기술, 정보, 방법을 모름', '국, 찌개 등의 국물음식 선호' (p <0.05)의 항목들이 유의미하게 개선되었다. 나트륨 섭취 줄이기와 관련된 인식 및 영양지식은 모든 항목에서 향상되었으나 나트륨 섭취 줄이기 실행과 관련된 자아효능감은 '가공식품과 인스턴트 식품보다는 신선식품을 구매하겠음' 항목만 유의미한 점수향상을 보였다 (p < 0.05). 또한 교육 후 나트륨 섭취 줄이기와 관련된 식행동도 '국, 찌개나 국수류의 국물을 다 먹는 편이다' (p < 0.05)와 '식품구매나 외식할 때 영양표시의 나트륨 함량을 확인하는 편이다' (p < 0.001)의 항목만 개선되어 한계가 있었다. 나트륨 줄이기 행동변화 단계는 행동전단계가 교육 전 43.2%에서 교육 후 21.5%로 감소하고, 행동단계는 교육 전 19.6%에서 교육 후 43.5%로 증가되었다. 특히 교육 전 행동전단계인 대상자들은 교육 후 모든 부분의 점수가 향상되어 가장 뚜렷한 효과가 나타났다. 결론적으로 나트륨 섭취 줄이기를 위한 식품구매와 조리에 집중하여 주부 대상으로 개발된 본 영양교육 프로그램은 단기간임에도 나트륨 섭취 줄이기에 대한 결과기대와 인식, 영양지식을 향상시키고 나트륨 섭취 줄이기 실행단계를 개선시켜 집단의 행동변화 유도에 효과적이었으며, 식행동개선을 위한 후속 연구의 기초자료를 제공한 점에서 의의가 있다.

Keywords

Acknowledgement

This research was supported by a grant from Korea Food and Drug Administration (11162Sobiyeon165).

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