Effectiveness of family-centered strength-based approach on salt intake among adolescents in rural households of central India: A Quasi-experimental study using the trial of improved practices (TIPs)

Introduction: High salt intake is a significant risk factor for noncommunicable diseases, such as cardiovascular diseases and stroke. This study aimed to evaluate the effectiveness of a family-centered strength-based approach using the trial of improved practices (TIPs) methodology to reduce salt intake among adolescents in rural households. Methodology: A community-based quasi-experimental mixed-method study was conducted over 12 months. From three purposively selected villages, 60 households with adolescents aged 10–19 years were randomly chosen from each wealth quintile for both the intervention and control arms across two primary health center areas. Data collection methods comprised of a modified STEPwise approach to NCD risk factor surveillance questionnaire, 24-h urine sodium estimations, and deviance inquiry. Data were analyzed utilizing difference-in-difference and thematic analysis. Results: The key salt-reduction practices adopted by households using TIPs were “not taking extra salt during meals” and “eliminating salt in dough.” The intervention group showed a significant reduction of 1.4 g/capita/day in salt intake. Health concerns, professional advice, and gradual habit changes were key motivators for reducing salt intake, while taste preferences and established habits were common barriers. Conclusion: Family-centered approaches worked due to the engagement of mothers and focus on simple, actionable, and sustainable practices. Healthcare access facilitated support, while higher socioeconomic status offered more resources for change. The TIP methodology highlights the need for simple, actionable dietary changes that are easily adoptable, with raising household awareness to limit high-salt traditional dietary practices. To ensure long-term adherence, policies should focus on continued engagement and tailored strategies for sustainable salt reduction through frontline health workers, such as Accredited Social Health Activist.