Evidence map›Paper›PMID 37647266›Full record

ArticlePLOS global public health2023

Development and piloting of a primary school-based salt reduction programme: Formative work and a process evaluation in rural and urban Malawi.

Nozgechi Phiri, Yvonne Cunningham, Stefan Witek-Mcmanus, McDonald Chabwera, Shekinah Munthali-Mkandawire, Jones Masiye, Albert Saka, Miryam Katundulu, Caroline Chiphinga Mwale, Dalitso Dembo Kang'ombe and 3 more

Open access · goldAbstract read
In one paragraph

Article in PLOS global public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 2 countries.

Nozgechi PhiriMalawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi.ORCID https://orcid.org/0000-0002-2866-1826
Yvonne CunninghamSchool of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.ORCID https://orcid.org/0000-0002-7533-8933
Stefan Witek-McmanusMalawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi.ORCID https://orcid.org/0000-0002-1445-3567
McDonald ChabweraMalawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi.
Shekinah Munthali-MkandawireMalawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi.ORCID https://orcid.org/0000-0003-2615-1790
Jones MasiyeMinistry of Health, Lilongwe, Malawi.
Albert SakaMinistry of Education, Lilongwe, Malawi.
Miryam KatunduluMalawi Institute of Education, Domasi, Zomba.
Caroline Chiphinga MwaleMinistry of Education, Lilongwe, Malawi.
Dalitso Dembo Kang'ombeMinistry of Health, Lilongwe, Malawi.
Joseph KimangilaComplete Health Foundation, Lilongwe, Malawi.
Amelia C CrampinMalawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi.
Frances S MairSchool of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.ORCID https://orcid.org/0000-0001-9780-1135
Malawi Epidemiology and Intervention Research Unit · MWLondon School of Hygiene & Tropical Medicine · GBMinistry of Health · MWUniversity of Glasgow · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Excess salt intake is a major modifiable risk factor for cardiovascular disease. Promoting salt reduction as part of routine school-health programming may be a pragmatic way to address this risk factor early in the life course but has not been tested in sub-Saharan Africa (SSA). Here we describe the formative work with stakeholders and process evaluation of pilot work to develop a school-based salt reduction programme for children aged 11-14 years, in preparation for a cluster-randomised trial in rural/urban Malawi. Collection of observational data and documentary evidence (meeting minutes/field notes) from the earliest key stakeholder engagement with Malawi Ministries of Health, Education, Local Government and Rural Development and Malawi Institute of Education, and non-governmental stakeholders; and a series of semi-structured interviews and focus groups (with head teachers (n = 2); teachers (n = 4); parents (n = 30); and learners (n = 40)). Data was analysed thematically and conceptualised through a Normalization Process Theory lens. Formative work illustrated a range of administrative, technical, and practical issues faced during development of the programme; including allocation of stakeholder roles and responsibilities, harmonisation with pre-existing strategies and competing priorities, resources required for programme development, and design of effective teaching materials. While participants were positive about the programme, the process evaluation identified features to be refined including perceived challenges to participation, recommended adaptations to the content and delivery of lessons, and concerns related to quantity/quality of learning resources provided. This study demonstrates the importance of comprehensive, sustained, and participatory stakeholder engagement in the development of a novel school health programme in SSA; and highlights the factors that were critical to successfully achieving this. We also demonstrate the value of detailed process evaluation in informing development of the programme to ensure that it was feasible and relevant to the context prior to evaluation through a cluster-randomised trial.

Identifiers

PMID37647266
PMCPMC10468067
OpenAlexW4386275838

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.