Purpose: We developed and validated two dietary sodium screening tools: Sodium Calculator (SC) and Sodium Calculator Plus (SCP). The purpose of this abstract is to report the results of iterative user testing during the development phase, and content and face validity by experts and users.
Methods: The SC and SCP are web-based food-frequency questionnaires developed from national survey on foods contributing the most sodium to the Canadian diet. The SCP asks standard portion sizes consumed. To allow for rapid calculations, the SC does not ask about portion size but includes average portion sizes consumed by Canadians in its algorithm. To calculate the amount and sources of sodium in the user’s diet, the sodium content of foods and beverages available in the Food Label Information Program 2013/2017 and the Canadian Nutrient File 2010/2015 were used. Nutrition experts conducted face and content validity. University students provided feedback on the SC and SCP in an open-ended survey as part of the iterative testing process.
Results: The SC contains 26 questions on intake frequency and took 5 minutes to complete. The more detailed SCP contains 72 questions and took 10-15 minutes to complete. Nutrition experts made several suggestions about wording, foods included and report formats. They suggested the use of graphs/visual displays to illustrate sodium intake and the inclusion of risk estimates for health impacts of sodium intake. Users (n=118) liked the reported grouping of foods, options for frequency of consumption, concise instructions, and personalized feedback on sodium intakes and felt that SC and SCP both increased awareness of sodium consumption and reading of food labels. However, users indicated some improvements such as clarification of portion sizes, food form (e.g. canned/dry), use of color and larger font and additional examples related to culturally-based diet. These data were used to modify the web-based calculators, as part of the iterative development process.
Conclusion: The SC and SCP provide rapid, detailed, personalized information on dietary sodium. The SC is a rapid screener that is useful in a busy clinical setting. The SCP can provide more detailed assessments and track longitudinal dietary changes. Both tools may be integrated into e-health platforms to support behaviour change and improved health outcomes.