Analysis by Delphi Survey of a Performance Evaluation Index for a Salt Reduction Project

Hyun-Hee Kim; Eun-Kyung Shin; Hye-Jin Lee; Nan-Hee Lee; Byung-Yeol Chun; Moon-Young Ahn; Yeon-Kyung Lee

doi:10.4163/kjn.2009.42.5.486

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Kim, Shin, Lee, Lee, Chun, Ahn, and Lee: Analysis by Delphi Survey of a Performance Evaluation Index for a Salt Reduction Project

Original Article

Korean Journal of Nutrition

Korean Journal of Nutrition 2009; 42(5): 486-495.

Published online: 31 July 2009

DOI: https://doi.org/10.4163/kjn.2009.42.5.486

Analysis by Delphi Survey of a Performance Evaluation Index for a Salt Reduction Project

Hyun-Hee Kim¹, Eun-Kyung Shin¹, Hye-Jin Lee², Nan-Hee Lee³, Byung-Yeol Chun⁴, Moon-Young Ahn⁵, Yeon-Kyung Lee¹

¹Department of Food Science and Nutritio, Kyungpook National University, Daegu 702-701, Korea.

²Division of Chronic Disease Surveillance, Korea Centers for Disease Control & Prevention, Seoul 122-701, Korea.

³Department of Food Science and Nutrition, Catholic University of Daegu, Kyungsan 712-702, Korea.

⁴Health Promotion Research Center in Kyungpook National University, Daegu 702-701, Korea.

⁵Public Health and Hygiene Division, Daegu Metropolitan City, Daegu 700-714, Korea.

To whom correspondence should be addressed. (yklee@knu.ac.kr)

Received 19 March 2009 Revised 1 May 2009 Accepted 17 June 2009

Abstract

The purpose of this study was to analyze the performance evaluation index for a salt reduction project. Questionnaires were developed in order to investigate salt reduction programs nationwide. The evaluation index and programs were analyzed through the case study of a salt reduction program in public health centers. The validity of the salt reduction program's evaluation index was determined based on study of the Delphi survey and on discussion with nutrition and health care professionals. The Delphi survey showed that daily salt intake was the most valid nutritional evaluation index. Stroke mortality and stomach cancer mortality were good health care evaluation indexes. The method for measuring salt intake that had the greatest validity was a 24-hour urine collection. However, 24-hour urine collection had the lowest score for ease of performance. The combined scores of validity and ease of performance showed that the survey method for dietary attitude and dietary behavior, dietary frequency analysis (DFQ 15), and a salty taste assessment, in that order, were proper methods. The high reliability of the salty taste assessment indicated that the percentage of the population that exhibits proper salt intake (2,000 mg sodium or less daily) and the percentage of the population that consumes low-salt diets as nutritional evaluation indexes also will be helpful to evaluate performance of salt reduction programs.

Keywords: delphi survey, salt reduction project, evaluation index, validity, reliability

Figures and Tables

Fig. 1

Evaluation index for salt reduction programs using logic model.

Table 1

Summary of performance evaluation indexes for salt reduction projects

Table 2

Examples of using the measurement methods of the nutritional evaluation index

1)Salty taste assessment consists of 5-point rating of the intensity and preference, based on 5 levels of salinity

2)Salty taste assessment consists of the 5-point preference and the 10-point sensitivity of a salty taste, based on 1 level of salinity

3)Salty taste assessment consists of 3-point rating of the intensity, based on 7 levels of salinity

DFQ: Dietary Frequency Questionnaire, FFQ: Food Frequency Questionnaire

Table 3

Assessment of properness of performance evaluation indexes for the salt reduction project

1)Performance evaluation indexes are counted with 5-point rating

^**: p < 0.01, ^***: p < 0.001

abc: Values with the different small superscript are significantly different among different index by Duncan's multiple range test at p < 0.05

Table 4

Comparison of validity and performance of the measurement methods used for the nutritional evaluation index

^***: p < 0.001

abc: Values with the different small superscript are significantly different among different methods of measurement by Duncan's multiple range test at p < 0.05

Table 5

Comparison of the intensity and preference of a salty taste of between and within examiners

Unsalty: 1, slightly unsalty: 2, neither unsalty nor salty: 3, slightly salty: 4, salty: 5

^*: p < 0.05, ^**: p < 0.01

Table 6

Comparison of the salty taste assessment of between and within examiners

^**: p < 0.01

Notes

This research was supported by the National Health Promotion Fund.

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