Evaluating the Implementation and Scale-Up of Nigeria National Sodium Reduction Program

项目摘要 尼日利亚食品和药物监督管理局(NAFDAC)正在牵头实施 与其他国家、州和国际机构一起扩大国家降钠计划 使用世界卫生组织的“百思买”奶昔套餐(食盐摄入量监测，马具行业，采用标准 用于标签和营销、增强消费者能力的知识以及促进健康饮食的环境)。 Shake为全人群降钠干预提供循证建议 预防和控制高血压。我们的研究将支持并嵌入到该计划的实施中 并通过评估高血压防治的后期实施研究扩大规模 通过使用类型III混合、混合方法研究设计来实施该计划的程度 重复：1)利益相关者访谈，2)人口调查，3)零售调查。我们将使用 基线适应、规划和初步实施期间的实施研究方法(第1年- 2，UG3阶段)和后续评估(3-4年和5-6年，UH3阶段)。急需的饮食 还将对钠的来源进行基线研究，并对目标/跟踪钠进行5-6年的跟踪 根据当地情况和文化做出减少努力。研究期间的零售业调查将包括 关于包装、非包装和非正式餐馆/小贩食品的新数据，通过国际 FoodSwitch计划，该计划将面向消费者的工具与众包相结合，以更好地定义尼日利亚的 食物供应。我们将使用探索、准备、实施和持续(EPIS)框架 在这两个阶段。形成性研究阶段包括探索和准备，届时我们将 执行关键过程指标的定量和定性测量，了解相关背景因素 通过CFIR和相关的Proctor实施结果、可接受性、可行性和适当性。AS 实施开始后，我们将使用范围、有效性、采用率、实施和维护 (Re-AIM)框架，包括实施成果(可行性、保真度、采用率、可接受性和成本) 以及与实施和维持阶段相关的背景因素。我们将传播我们的 通过大众媒体宣传活动发现，并将延长我们现有的实施研究培训 通过循证决策向利益相关者提供知识转化计划，以优化 可持续发展。我们将主办多部门利益攸关方会议，以促进跨部门合作， 各部门之间的传播和多层次政策一致性包括粮食、卫生、贸易和法律，其中 其他。该提案建立在该团队现有的由NHLBI资助的大规模高血压控制计划的基础上 与来自阿布贾大学、西北大学和乔治全球研究所的团队成员 后者正在用类似的方法对中国进行一项平行的、由GACD资助的评估。

PROJECT ABSTRACT The Nigerian Agency for Food and Drug Administration and Control (NAFDAC) is leading implementation and scale-up of a national sodium reduction program with other national, state, and international agencies using the WHO’s “Best Buy” SHAKE package (Surveillance of salt intake, Harness industry, Adopt standards for labelling and marketing, Knowledge to empower consumers, and Environments to promote healthy eating). SHAKE provides evidence-based recommendations for population-wide sodium reduction interventions for hypertension prevention and control. Our research will support and embed in this program’s implementation and scale-up for late-stage implementation research for hypertension prevention and control by evaluating the extent to which the program is implemented using a type III hybrid, mixed methods study design through repeated: 1) stakeholder interviews, 2) populations surveys, and 3) retail surveys. We will use implementation research methods during adaptation, planning, and initial implementation for baseline (Years 1- 2, UG3 phase) and of follow-up (Years 3-4 and Years 5-6, UH3 phase) assessments. A much-needed dietary sources of sodium study will also be performed at baseline and Years 5-6 follow-up to target/track sodium reduction efforts according to local context and culture. The retails surveys over the study period will capture novel data on packaged, unpackaged, and informal restaurant/hawker food through the international FoodSwitch program, which combines a consumer facing tool with crowdsourcing to better define Nigeria’s food supply. We will use the Exploration, Preparation, Implementation and Sustainment (EPIS) framework throughout both phases. The formative research period will include Exploration and Preparation, when we will perform quantitative and qualitative measures of key process indicators, relevant contextual factors informed by CFIR, and relevant Proctor implementation outcomes, acceptability, feasibility and appropriateness. As implementation is started, we will use the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework, including implementation outcomes (feasibility, fidelity, adoption, acceptability, and cost) and contextual factors associated with the Implementation and Sustainment phases. We will disseminate our finding via mass media advocacy campaigns and will extend our existing implementation research training program to stakeholders for knowledge translation through evidence-informed policymaking to optimize sustainability. We will host multisectoral stakeholder meetings to facilitate cross-sectoral collaboration, dissemination, and multi-level policy coherence among sectors include food, health, trade, and law, among others. The proposal builds on the team’s existing NHLBI-funded large-scale hypertension control program with team members from University of Abuja, Northwestern University, and The George Institute for Global Health, the latter which is performing a parallel, GACD-funded assessment in China with similar methods.