Multilevel evaluation of 'China Healthy Lifestyles for All', a nationwide initiative to promote lower intakes of salt and edible oil

Objective: To evaluate the impact of 'China Healthy Lifestyle for All' on levels of knowledge, taste and intentions to modify future consumption of salt and edible oil. Methods: Between May and August 2012, a face-to-face survey carried out in all 31 provinces, autonomous regions, and municipalities in mainland China, achieved a 98.1% response. Intention-To-Treat analysis via multilevel logistic regression was used to examine differences in outcomes between 31,396 non-institutionalised individuals aged >18. years from 31 'intervention' (i.e. participating) and 26 'control' (i.e. non-participating) counties respectively. Results: Adjusting for socioeconomic confounders, participants in 'intervention' counties were more likely to know the limit of salt (Odds Ratio 3.14, 95% Confidence Interval (95% CI) 1.98, 4.96) and oil consumption (3.67, 95% CI 2.31, 5.82), and were more intent to modify their consumption (salt 1.98, 95% CI 1.41, 2.76; oil OR 1.99, 95% CI 1.41, 2.81) and to report a change in taste (salt 1.90, 95% CI 1.31, 2.75; oil 2.07, 95% CI 1.38, 3.10). 'Intervention' effects were consistent regardless of income or education, but women and older participants benefited disproportionately. Outcomes were 2.8 and 4.7 times more likely among those with better recall. Conclusion: Place-based health promotion interventions have an important role to play in addressing non-communicable disease in China.