Tailoring Sodium Reduction Messages to African Americans: Findings from a Corner Store Pilot Project in Kansas City

Background:  Obesity, cardiovascular disease and diabetes burden many Missourians with multiple related illnesses and premature death. Moreover, in Missouri, some groups suffer greater health disparities than others. African Americans living in Kansas City, Mo., have experienced a higher number of deaths due to essential hypertension than other groups in other areas of the state (MO DHSS MICA).  While sodium reduction is a key part of decreasing the burden of cardiovascular disease in America (IOM, 2010), many of the messages directed to these audiences are general and not tailored to audiences’ lives and culture.

Program background:  To understand African Americans’ level of awareness on the health risks related to sodium and to increase access to more fruits and vegetables, the Health Communication Research Center (HCRC) worked with local community partners to develop a health communication campaign, including a pilot intervention with two corner stores. The campaign included data collection and analysis, review of existing campaigns and messages, message development and testing and implementation of the campaign through mass media channels and corner stores in midtown Kansas City.

Evaluation Methods and Results:  Using a mixed method approach, the HCRC assessed the knowledge, attitudes, and behaviors among African Americans in midtown Kansas City around sodium’s impact on health. Methods included a telephone survey (n=602), community meetings, storeowner interviews (n=5), focus groups (n=12) and consumer intercept interviews (n=42). The HCRC worked with local partners to review tools, assess findings, and develop the health communication campaign featuring corner stores.  Data showed a high awareness of salt in packaged foods, but less certainty about the high salt content of items such as bread, ketchup and chicken. Along with the corner store intervention, this campaign included development of a sodium reduction brand (SKIP), a full bus wrap, place-based bus audio ads, billboards, newspaper ads, radio ads, corner store events and public relations. 

Conclusions:  Health communication campaigns can benefit from tailoring their materials to communities. National data can help inform messages for a sodium reduction campaign, but may need reframing based on audiences’ food preferences.  Emphasis on the Top Seven Salty Foods that African Americans in Kansas City preferred was more effective in this campaign than using the Top Ten for general Americans that included items such as soup and underemphasized the role of chicken. Present-centered messages, such as sodium reduction can help reduce swelling, rather than future-oriented messaging about living longer, are preferred. Campaigns also benefit when incorporating positive, nudge-behavior messaging, depicting people who look and sound like the target population. A community partnership can inform any campaign, particularly when funding limits data collection.

Implications for research and/or practice:  From our data collection, many African Americans living in midtown Kansas City are aware of the link between salt consumption and high blood pressure. However, there is a gap in translating this knowledge when health communications feature messages written for general audiences. When designing campaigns, health communicators should examine local data, appeal to people’s lives and experiences, and tailor messages to their audiences’ habits and preferences.