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管理与控制局（NAFDAC）正在牵头实施 并与其他国家、州和国际机构一起扩大国家减钠计划 使用世卫组织的“百思买”SHAKE包（盐摄入量监测，监测工业，采用标准 标签和营销，知识赋予消费者，环境促进健康饮食）。 SHAKE为以下人群的钠减少干预提供了基于证据的建议： 高血压防治。我们的研究将支持和嵌入到这个计划的实施 并通过评估高血压防治后期实施研究的规模， 在何种程度上，该计划是使用第三类混合，混合方法研究设计，通过 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 在适应、规划和基线初步实施期间实施研究方法（第1年- 2，UG 3期）和随访（3-4年和5-6年，UH 3期）评估。急需的饮食 还将在基线和第5-6年随访时进行钠源研究，以达到目标/跟踪钠水平 根据当地情况和文化作出减少努力。研究期间的零售调查将收集 通过国际上关于包装、非包装和非正式餐馆/小贩食品的新数据， FoodSwitch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、实施和维持（EPIS）框架 在这两个阶段。形成研究期将包括探索和准备，届时我们将 对关键过程指标进行定量和定性测量，了解相关背景因素 由CFIR和相关的普罗克特实施结果、可接受性、可行性和适当性。作为 开始实施后，我们将使用范围、有效性、采用、实施和维护 （RE-AIM）框架，包括实施结果（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，并将扩大我们现有的实施研究培训 通过循证决策向利益攸关方提供知识转化方案， 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， 传播和部门之间的多层次政策一致性，包括粮食、卫生、贸易和法律， 他人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 来自阿布贾大学、西北大学和乔治全球研究所的团队成员 后者正在中国使用类似的方法进行一项由GACD资助的平行评估。

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.