Salt reduction dietary intention and influencing factors in middle-aged and elderly hypertensive patients based on the theory of planned behavior

Salt reduction dietary intention and influencing factors in middle-aged and elderly hypertensive patients based on the theory of planned behavior | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Salt reduction dietary intention and influencing factors in middle-aged and elderly hypertensive patients based on the theory of planned behavior By Yaqi Wen, Xia Li, Ya Shi, Lei Luo, Du Zhang, Zumin Shi, Manoj Sharma, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7325252/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Objective This study aims to guide the development of behavioral interventions and promote salt reduction dietary practices. Using the Theory of Planned Behavior (TPB) as the theoretical framework and Structural Equation Modeling (SEM) as the methodological basis, we explored the current status of salt reduction dietary intention and its influencing factors in middle-aged and elderly hypertensive patients. Methods From March to November 2023, convenience sampling was employed to conduct face-to-face surveys by using the Likert scale among 590 middle-aged and elderly hypertensive patients across 38 districts and counties in Chongqing. Structural Equation Model (SEM) was used to analyze the relationship between salt reduction intention (INT) and attitude towards salt reduction (ATT), subjective norms of salt reduction (SN), and perceived behavioral control of salt reduction (PBC). We also evaluated the bivariate correlation among attitude towards salt reduction, subjective norms of salt reduction, and perceived behavioral control of salt reduction in middle-aged and elderly hypertensive patients aged 45 years and above. Result A sample size of 558 respondents was included in the analysis, of which 70.8% had the intention to reduce salt in their diets; 55.2% were female; 48% had junior high school education or higher; 73.5% were married; 44.1% were home cooks; households with home addresses in “Central City(CC),” “Main City New Area (MCNA),” “Northeast Chongqing Three Gorges Reservoir Town Cluster (NCTGRT),” and “Southeast Chongqing Wuling Mountains Town Cluster (SCWMT")” accounted for 29.4%, 27.6%, 29.6%, and 13.4%, respectively; 50.5% had no chronic diseases, except hypertension; and 61.3% were elderly, and 38.7% were middle-aged individuals. Salt-reducing diet attitudes (β = 0.22, P < 0.05) and perceived behavioral control (β = 0.70, P 0.05) had a non-significant effect on salt-reducing diet intentions. Conclusion This study highlights the central influence of salt-reducing dietary attitudes and perceived behavioral control in salt-reducing dietary intentions among middle-aged and elderly hypertensive patients. Future nutritional health education should prioritize exploring pragmatic ways of attitude-to-practice. Middle-age Elderly hypertension salt theory of planned behavior structural equation modeling influencing factors Figures Figure 1 Figure 2 1. Introduction In recent years, China has experienced a dramatic population aging and health transition ( 1 , 2 ) . As of 2020, 18.7% of China’s total population will be aged 60 and over ( 3 ) ; by 2040, 28% of China’s population will be aged 60 years and over ( 4 ) . This group is prone to a high incidence of chronic diseases; the most common of which is hypertension, which causes physical and psychological suffering to patients ( 5 , 6 ) . Hypertension is a common chronic non-communicable disease that increases mortality from stroke and the rates of disability, kidney disease, and cardiovascular disease; with more people dying each year from cardiovascular disease than from any other cause ( 7 , 8 ) . According to the Report on Nutrition and Chronic Disease Status of Chinese Residents (2020), the prevalence of hypertension among Chinese people over 60 years old is as high as 59.2%. The Global Hypertension Report (2023) shows that the number of adults aged 30–79 years with hypertension in China is about 256.7 million, with an overall age-standardized prevalence rate of 27% (9) , a hypertension diagnosis rate of 52%, a treatment rate of 39%, and an up-to-date treatment rate of only 16%. Data from another study based on a sample size of 23,308 drawn from 13 districts (counties) in Chongqing also showed that the prevalence of hypertension among community residents aged 30–79 years in Chongqing was 35.07% (10) , which was higher than the overall prevalence level of hypertension in China ( 11 , 12 ) . However, the cure and hypertension control rates were only 47.3% and 14.6%, respectively ( 13 ) . The economic benefit-to-cost ratio of improved hypertension treatment programs is estimated to be approximately 18:1 ( 9 ) , which has significant financial costs to patients and their families, the health system, and the population’s economy. According to the World Health Organization (WHO), the average global sodium intake of adults is 4310 mg/day (i.e., equivalent to 10.78 g/day of salt), which is more than twice the WHO recommended sodium intake of less than 2000 mg/day (5 g/day of salt). The China’s “Report on Nutrition and Chronic Disease Status of Chinese Residents (2020)” also shows that the average daily salt intake of Chinese residents is as high as 9.3 g ( 14 ) , which tends to be two times the revised recommendations for dietary nutrient sodium (sodium PI-NCD ≤ 2,000 mg) for Chinese residents in 2023 ( 15 ) , which shows that high salt diets are prevalent globally. A high-salt diet seriously affects human health by raising blood pressure and increasing the risk of cardiovascular diseases, such as cardiovascular disease, obesity, gastric cancer, kidney disease, and osteoporosis ( 16 ) . About 1.89 million deaths per year are related to high sodium intake ( 17 ) . A high salt diet has become a significant public health problem in China, and the salt intake of residents should be reduced ( 14 , 18 ) . A previous study was conducted on the knowledge, attitude, and behavioral survey on sodium salt reduction and control among some residents in six provinces of China; the results showed that the support rate of the attitude of salt reduction was 73.78%, but the high level of knowledge of salt reduction was only 29% (19) . This finding shows a long way to go in salt-reduction diet. Many animal experiments and epidemiological and population intervention studies have confirmed that a high-salt diet is a risk factor for hypertension ( 20 , 21 ) . The Global Hypertension Report mentions reducing dietary sodium intake as an essential step in preventing and controlling hypertension. A salt-reduced diet not only reduces blood pressure levels in middle-aged and elderly hypertensive patients but also has a vital role in improving the entire population's health and overall health literacy in the long run. However, salt-reduced diets are, in turn, affected by demographic factors, knowledge ( 19 , 22 ) , attitudes about salt-reduced diets ( 19 , 23 ) , dietary environments ( 24 ) , lifestyles of critical relational figures (25, 26) , health education ( 26 ) , and other factors. Most current studies consider individual attitudes and knowledge about salt-reduced diets but ignore factors such as individual behavioral control and environmental factors they are exposed to; how to bridge the gap among knowledge, attitude, and behavior is a significant challenge in public health ( 27 ) . Hypertension is the most common chronic disease, and a salt-reduced diet is a health-related behavior in accordance to the applicable scenarios of the Theory of Planned Behavior (TPB) ( 28 ) . This study used the TPB theoretical model to analyze factors influencing the intention to reduce salt diet in middle-aged and elderly hypertensive patients in Chongqing from the attitude toward salt-reducing diets, subjective norms of salt-reducing diets, and the control of salt-reducing diets in terms of perceptual behavior, that is, intention to reduce salt diet. We propose the following hypotheses based on the theoretical framework of TPB and the aim of this research (Fig. 1 ). Hypothesis 1 (H1): The more robust the attitude about salt reduction diet, the greater will be the intention to reduce salt diet among middle-aged and elderly hypertensive patients. Hypothesis 2 (H2): The more robust the subjective norms regarding salt reduction diet, the greater will be the intention to reduce salt diet among middle-aged and elderly hypertensive patients. Hypothesis 3 (H3): The more robust the perceived behavioral control regarding salt reduction diet, the greater will be the intention to reduce salt diet among middle-aged and elderly hypertensive patients. In addition, we studied the interrelationship among salt-reducing diet attitude, salt-reducing diet competent norms, and perceived behavioral control of salt-reducing diet. 2. Methods 2.1 Study Design and Sample Collection This cross-sectional study was conducted from March 2023 to November 2023. Convenience sampling was used to select middle-aged and elderly hypertensive patients aged 45 years or older from 38 districts and counties in Chongqing Municipality as the study population ( n = 558). We developed and administered a face-to-face questionnaire. The inclusion criteria were as follows: mean systolic blood pressure ≥ 140 mm Hg (1 mm Hg = 0.133 kPa); mean diastolic blood pressure ≥ 90 mm Hg; or self-reported intake of antihypertensive medication in the past two weeks ( 29 ) ; as well as age ≥ 45 years old, patients with previous hypertension ( 30 ) , patients with hypertension diagnosed at a township health center/community health service center or a healthcare facility above immediately before the start of the survey at each monitoring site, and patients who voluntarily participated in this survey. The exclusion criteria included the following: people with mental disorders or those who have difficulty expressing their thoughts clearly. Before conducting this study, we obtained ethical approval from the Ethics Committee of Chongqing Medical University to ensure adherence to strict ethical standards (approval number 2021041). All participants were informed about the study at the beginning of the questionnaire, and consent forms were obtained. 2.2 Measures A self-administered questionnaire was used, and it consists of two parts, namely, the essential demographic characteristics of hypertensive patients (e.g., gender, ethnicity, family residence, education level, family history of hypertension, etc.) and TPB constructs(Supplementary Material 1.pdf). The overall scale consists of four subscales, with a total of 13 items: three items pertaining to the salt reduction diet intention dimension, three items on the salt reduction diet perceived behavioral control dimension, three items on the salt reduction diet subjective norms dimension, and four items on the salt reduction diet attitude dimension. Each subscale was scored using a Likert-type response set, with higher scores indicating excellent agreement with the content of the item. 2.3 Quality control In the survey design stage, after the theoretical intention model was constructed, subscales were designed for each of the four core variables of the model by the principles and methods of scale development. Reliability and validity tests were carried out, and subscales with poor measurement performance were finely revised and perfected. The survey researchers underwent a unified, rigorous, and professional training before formally carrying out the cross-sectional surveys. During the survey implementation stage and the data collation and analysis stage, verification and proofreading were conducted at all times. Mistakes, omissions, and logical errors were found and revised promptly, and the questionnaire entry was double-checked and entered. 2.4 Statistical analysis Data were cleaned and analyzed using Amos 28.0 and STATA 18.0. The overall population was divided into high- and low-salt-reducing dietary intention populations by using the median score as the criterion. Mean, standard deviation, and constitutive ratio were used to describe the data. Independent sample t-test and ANOVA analyzed population differences. Structural equation modeling (SEM) was used to explore the relationship between salt-reducing dietary intention and its salt-reducing dietary attitudes, subjective norms, and perceived behavioral control, as well as salt-reducing attitudes, subjective norms, and perceived behavioral control. The two-by-two correlation among salt reduction attitude, subjective norms, and perceived behavioral control was also determined. All statistical tests were two-tailed, and P < 0.05 was considered significant. 3. Results 3.1 Participants’ characteristics A total of 590 middle-aged and elderly hypertensive patients completed the questionnaire, 12 middle-aged and elderly hypertensive patients refused to participate in the survey, obtaining a completion rate of 98%. Twenty questionnaires were excluded due to a large number of missing values, resulting in 558 valid questionnaires, with a validity rate of 96.5%. About 55.2% of the questionnaires were answered by females, 91.8% were Han Chinese, 48% were educated at junior high school or above, 73.5% were married, and 44.1% of respondents were home cooks. Households with home addresses in “Central City,” “Main City New Area,” “Northeast Chongqing Three Gorges Reservoir Town Cluster,”= and ‘Southeast Chongqing Wuling Mountains Town Cluster’ accounted for 29.4%,27.6%,29.6%,and 13.4%, respectively, 50.5% had no chronic diseases other than hypertension, 61.3% were elderly, and 38.7% were middle-aged. Salient demographic characteristics are shown in Table 1 . Table 1 Basic characteristics of survey respondents (n = 558) Factors Groups n n(%) Salt Reduction Dietary Intentions not 163 29.2 yes 395 70.8 Sex Women 308 55.2 Man 250 44.8 Ethnicity Ethnic Han 512 91.8 Nation minority 46 8.2 Education Primary and below 290 52.0 Junior 151 27.1 High school/secondary/vocational 79 14.2 College/university above 38 6.8 Marital status Unmarried 3 0.5 Married 410 73.5 Divorcee 38 6.8 widowhood 107 19.2 Home cooks oneself 246 44.1 mate 139 24.9 Oneself or mate 41 7.3 Woman and son-in-law 108 19.4 others 8 1.4 Babysitter or carer 16 2.9 Region CC 164 29.4 MCNA 154 27.6 NCTGRTC 165 29.6 SCWMTC 75 13.4 Suffering from other chronic diseases not 282 50.5 yes 276 49.5 Age grouping Middle-aged adults 216 38.7 elderly 342 61.3 CC, Central City; MCNA, Main City New Area; NCTGRTC, Northeast Chongqing Three Gorges Reservoir Town Cluster; SCWMTC, Southeast Chongqing Wuling Mountains Town Cluster 3.2 Difference analysis 3.2.1 Univariate analysis Independent-sample t-test showed statistically significant differences in salt-reduction dietary attitude, subjective norms, perceived behavioral control, and intention scores between ethnic groups and places of residence (P < 0.05). There was also a statistically significant difference in perceived behavioral control scores for salt reduction between genders, with males scoring slightly lower than females in this domain (P < 0.05). Univariate regression analysis revealed statistically significant differences in scores across different family residence areas for all four dimensions: salt-reduction dietary attitude, perceived behavioral control, subjective norms, and intention (P < 0.05). Additionally, statistically significant differences were observed in salt-reduction dietary perceived behavioral control, attitude, and intention among groups with different family histories of hypertension (P < 0.05). When grouped by education level, differences in scores were found for the dimensions of salt-reduction dietary subjective norms and intention (P < 0.05). Furthermore, there were statistically significant differences in salt-reduction dietary perceived behavioral control scores among those who were the primary family cooks (P < 0.05, Table 2 ). Table 2 Univariate Regression Analysis of Different Demographic Characteristics PBC SN INT ATT t/F P t/F P t/F P t/F P Sex 2.564 0.011 0.065 0.948 1.024 0.306 0.120 0.904 Age grouping 0.032 0.974 -1.755 0.080 0.422 0.673 -1.424 0.155 Family History of Hypertension 2.374 0.018 1.460 0.145 2.463 0.014 2.078 0.038 Region -3.543 0.000 -3.249 0.001 -5.465 0.000 -6.464 0.000 Education 0.901 0.368 2.916 0.004 2.362 0.019 1.691 0.091 Income Status 0.234 0.815 1.891 0.059 0.406 0.685 0.804 0.422 Occupation 0.400 0.690 -0.936 0.350 0.347 0.729 -0.173 0.863 Suffering from other chronic diseases -0.278 0.781 -0.823 0.411 -0.690 0.491 -1.042 0.298 Ethnicity 3.203 0.001 2.532 0.012 3.046 0.002 3.648 0.000 Marital status -0.111 0.912 -3.331 0.001 -0.165 0.869 -1.719 0.086 place of residence -4.539 0.000 -5.686 0.000 -5.638 0.000 -6.153 0.000 Home cooks -2.012 0.045 -0.558 0.577 -1.280 0.201 -0.874 0.383 3.2.2Multiple linear regression The results of the multiple linear regression analysis indicated that demographic characteristics such as family residence and family history of hypertension were the primary influencing factors for salt-diet intention (P < 0.05). Gender and place of residence were associated with scores for subjective norms related to salt-reduction diet (P < 0.05). Place of residence and marital status were correlated with scores for self-regulation in salt-reduction diet (P < 0.05). Additionally, place of residence and family residence were related to scores for attitudes toward salt-reduction diet (P < 0.05).(Table 3 ) Table 3 Multiple Linear Regression Analysis of Different Demographic Characteristics implicit variable Independent variable regression coefficient t P B β PBC Sex -0.150 -0.106 -2.547 0.011 place of residence 0.240 0.174 3.932 0.000 SN place of residence 0.251 0.206 4.364 0.000 Marital status -0.096 -0.124 -3.005 0.003 INT Region -0.100 -0.153 -3.496 0.001 Family History of Hypertension 0.100 0.085 2.060 0.040 place of residence 0.219 0.166 3.503 0.000 ATT Region -0.121 -0.188 -4.333 0.000 place of residence 0.228 0.176 4.103 0.000 3.3Validation or factor analysis results 3.3.1 Convergent validity In the salt-reduced diet model, the mean-variance extraction AVE values of the three factors of salt-reduced diet attitude, salt-reduced diet perceived behavioral control, and salt-reduced diet intention were all more than 0.5. The subjective norms of salt-reduced diet were also very close to the statistical cut-off value of 0.5. The combination of the CR values of the reliabilities is more significant than 0.7, which indicates that the scale data of the present analysis has good convergent validity (Table 4 ). Table 4 Convergent validity of the questionnaire model dimension entry Estimate AVE CR ATT ATT1 0.874 0.649 0.880 ATT2 0.872 ATT3 0.753 ATT4 0.710 PBC PBC3 0.736 0.548 0.782 PBC2 0.635 PBC1 0.836 INT INT2 0.856 0.536 0.767 INT3 0.798 INT1 0.487 SN SN1 0.720 0.480 0.734 SN2 0.709 SN3 0.647 3.3.2 Structural validity The following standard fitting indices were used to evaluate the model's overall fit. The model's RMSEA = 0.083, AGFI = 0.886, GFI = 0.926, χ 2 /df = 4.822, which can be considered as an overall good model fit (Table 5 ). Table 5 Construct validity statistical test Criteria for adaptation or threshold value Model test results Model fit judgement Absolute fit indices RMR < 0.05 0.032 yes RMSEA < 0.08 favorable, 0.9 desirable, > 0.8 acceptable 0.926 yes c 2 /df < 2 favorable, < 3 ordinary, 0.9 desirable, > 0.8 acceptable 0.886 yes Incremental fit index NFI > 0.9 0.926 yes RFI > 0.9 0.902 yes IFI > 0.9 0.940 yes TLI(Tucker-Lewis Index) > 0.9 0.920 yes CFI > 0.9 0.940 yes Simple fit statistics PGFI > 0.5 0.600 yes PNFI > 0.5 0.700 yes PCFI > 0.5 0.711 yes 3.3.3 Discriminant validity For the salt-reduced diet attitude, its AVE square root value was 0.806, which was greater than the maximum absolute value of the inter-factor correlation coefficient of 0.028 (between the two factors of salt-reduced diet attitude and subjective norms of salt-reduced diet) and 0.030 (between the two factors of salt-reduced diet attitude and perceptual-behavioral control of salt-reduced diet). This finding implies that salt-reduced diet attitude scale has good discriminant validity. For the subjective norms of salt-reduced diet, its AVE square root value is 0.693, which is greater than the absolute maximum value of 0.027 for the correlation coefficients between the two factors (subjective norms of salt-reduced diet and perceived behavioral control of salt-reduced diet), implying that the subjective norms of salt-reduced diet scale has good discriminant validity. This finding supports that the scale had good discriminant validity (Table 6 ). Table 6 Discriminant validity items ATT SN PBC ATT 0.649 SN 0.028 *** 0.480 PBC 0.030 *** 0.027 *** 0.548 AVE square root 0.806 0.693 0.740 3.2 Results of structural modeling analysis Figure 2 shows the results of the final SEM model, and Table 7 shows the results of the path coefficient tests for salt reduction diet attitudes, subjective norms, and perceptual behavioral control to intention. The following information can be obtained: the significance level of both paths, salt-reducing diet attitudes, and salt-reducing diet perceptual-behavioral control to salt-reducing diet intention. Values at P < 0.001 indicate that H1 and H3 can be accepted, expressly; H1: attitudes have a significant positive direct effect on intention (β = 0.22, P < 0.001); and H3: perceptual-behavioral control has a significant positive direct effect on intention (β = 0.70, P < 0.001). 0.70, P < 0.001) had a significant positive direct effect. This means that for every variance increase in salt-reducing diet attitudes, salt-reducing diet intentions increased by 0.22 variance; for every variance increase in salt-reducing diet perceptual behavioral control, salt-reducing diet intentions followed by 0.70 variance. Table 7 Path coefficient test results for salt reduction dietary attitudes, subjective norms, and perceived behavioral control and intentions latent variable Ustd. S.E. T C.R P P Std. result Salt Reduction Dietary Intentions ← Attitudes toward salt-reduced diets 0.220 0.055 3.962 *** 0.222 acceptance ← Subjective norms for salt-reduced diets 0.140 0.074 1.892 0.058 0.114 rejection ← Perceived Behavioral Control of Salt Reduction Diet 0.744 0.066 11.223 *** 0.698 acceptance Unstd. unstandardized; S.E., standard error; Std., standardized. 4 Discussion This study explored the psychosocial factors affecting salt reduction dietary intention in middle-aged and elderly hypertensive patients over 45 years of age in Chongqing City. Psychosocial factors had a significant effect on salt reduction dietary intention, consistent with the results of related studies at home and abroad ( 31 , 32 ) . Based on the theory of planned behavior, this study showed that salt reduction diet intention is determined by salt reduction attitude and perceived behavioral control, and the influence of perceived behavioral control of salt reduction diet is more prominent. In addition, the intention to reduce salt diet was also influenced by some salient demographic characteristics. Information included a family history of hypertension and family residence, and hypertensive patients with a family history of hypertension and residence in the primary and central urban areas who had a higher intention to reduce salt. 4.1 Differences in the presence of salt reduction dietary intentions in middle-aged and elderly hypertensive patients with different demographic characteristics In this study, the intention rate of salt reduction among middle-aged and elderly hypertensive patients aged 45 years or older in Chongqing was 70.8%, which is significantly lower than the results of a survey conducted by a domestic researcher. A 10-day salt survey based on the WeChat public platform of the China National Healthy Lifestyle Action in 2019 and 2020 found that 90.2% of participants were willing to reduce the amount of salt used in home cooking in 2020 ( 33 ) . Basing on demographic characteristics, we found gender variability in salt reduction diets; that is, men had lower intention rates than women. Consistent with previous findings ( 23 , 34 ) , this finding may be related to the fact that women run the household diet. Therefore, health education and promotion activities related to the core attitudinal shift regarding salt and hypertension prevention and control should be increased in dietary salt reduction for hypertension prevention interventions. The group of hypertensive patients with a family history of hypertension generally had a higher rate of intention to reduce salt diet than those without a family history of hypertension. Middle-aged and elderly hypertensive patients with a family history of hypertension had more favorable attitude related to salt reduction to prevent hypertension than others. Meanwhile, the rates of intention to reduce salt diet were higher in the groups of middle-aged and elderly hypertensive patients living in the central urban area, the new leading city area, and the towns in the Three Gorges Reservoir area in northeast Chongqing than in the cities in the Wuling Mountain area in southeast Chongqing. This study demonstrated that the rate of salt reduction dietary intention among middle-aged and elderly hypertensive patients in Chongqing is at a low level, which is a significant challenge for public health. In this regard, effective interventions and management measures should be explored to increase the rate of salt reduction dietary behavior among hypertensive patients in Chongqing and to reduce the risk of diseases caused by high salt diet. 4.2 Effects of salt reduction dietary attitudes, subjective norms, and perceived behavioral control on salt reduction dietary intentions in middle-aged and elderly hypertensive patients Salt-reducing diet attitudes and salt-reducing diet perceptual–behavioral control directly affected the salt-reducing diet intentions of middle-aged and elderly patients in Chongqing. The effect of salt-reducing diet perceptual–behavioral control was pronounced. This result is consistent with a retrospective study by Godin et al. ( 41 ) , who showed that subjective norms were insignificant in predicting health-related behaviors and had a lesser effect on behaviors than attitudes and perceived behavioral control. The results of the present study showed that the more positive the attitude toward a salt-reduction diet, the greater the intention to reduce salt, which is consistent with the findings of existing studies. Most consumers are willing to purchase salt-reduced foods even if there is no salt-reduction goal, suggesting that consumers perceive positive health outcomes from salt-reduction ( 35 ) . Residents with high salt-reduced dietary attitudes are likelier to initiate salt-reduction measures ( 19 , 36 , 37 ) . Individuals' perceptual evaluation of approval or disapproval of behavior, though that is, their attitude toward that behavior ultimately influences the actual implementation of their behavior ( 38 ) . For example, hypertensive patients who believe that reducing the amount of salt in their daily diet is beneficial to the control or improvement of their blood pressure are more likely to engage in salt reduction, even if they have thoughts of a high-salt diet. That is, the more positive attitudes and individual perceived facilitators of salt reduction diet among middle-aged and elderly hypertensive patients, the stronger the intention to reduce salt. The present study also showed that a salt reduction diet perceptual-behavioral control could significantly influence salt reduction diet intention indication. Perceived behavioral control is regarded as a direct determinant of intention and has the same status as attitudes and subjective norms ( 39 – 41 ) . If the barriers of internal and external factors are excluded, their hypertensive patients are more willing to engage in a salt-reduction diet. Obstacles to salt-reduced diets are the difficulty of adhering to a low-salt diet ( 42 ) and the “hidden” salt in processed foods, which makes it impossible to control salt intake at will. Growing inequalities in the food system exacerbate this problem and are another barrier to controlling salt intake in individual diets. The most effective salt reduction interventions are those implemented at the population level and include a participatory approach involving government, education, and the food industry ( 43 ) . Although the public knows that high sodium intake is unhealthy, most reported that it is difficult to find practical ways to reduce salt, especially when eating out. Yet, the contribution of restaurant dishes to the population's salt intake is not negligible ( 44 , 45 ) . Half the target audience reported difficulty adhering to a low-sodium diet long-term, and one-third reported difficulty controlling salt in food prepared outside the home. A popular monthly lifestyle and health magazine was developed with WHO and Health Trends, in China, launched a six-month salt reduction campaign: revealing hidden salt in everyday foods, demystifying dietary myths, and providing easy tips for cooking low-sodium meals at home. Information was again collected through focus group interviews and online. About 85% of the respondents said the campaign materials had a “great” or “fairly great’ impact on their attitudes and behaviors; participants said they had already taken action to reduce their salt intake, such as consuming vegetables cooked with less salt and reducing the use of salt-containing condiments; and 90% of participants indicated an intention to reduce their salt intake ( 46 ) . This suggests that efforts to promote salt-reducing diets may be less comprehensive by relying solely on health websites or blogs written by pop doctors. Distributing salt-reducing-related entertainment and pop culture stories through social media may be more effective. The subjective norms of salt reduction in this study were not significant, probably because Chongqing has unique dietary characteristics and dietary culture, that is, it is a “hot pot city” with “heavy tastes.” The residents of Chongqing and their friends, relatives, and family members often share the same dietary characteristics. It may be due to the unique nutritional characteristics and dietary culture of Chongqing, that is, the “heavy taste” known as the “hotpot city” and the lack of communication and advice on salt reduction dietary knowledge because colleagues, friends, relatives, and family members around them often share meals and have the same nutritional characteristics. A national study found that advice from doctors and family members' reminders helped residents start reducing salt ( 36 ) , while another study showed that family disagreement was a barrier to reducing salt intake ( 42 ) . In summary, the results showed that salt-reducing dietary attitudes and salt-reducing dietary perceived behavioral control had a direct impact on the actual salt-reducing dietary intentions, so salt-reducing dietary attitudes and salt-reducing dietary perceived behavioral control should be targeted to improve the salt-reducing dietary intentions in middle-aged and old-aged hypertensive patients. To strengthen the salt-reducing diet strategy, we should focus on sodium-reducing education, including the measurement of actual nutritional sodium intake and educating hypertensive patients about the sources of sodium to make them establish a correct perception of salt-reducing diet, fully understand the hazards of high-salt diet, and change their negative attitudes towards salt-reducing diet; if they already have positive attitudes towards a low-salt diet, then the salt-reducing attitude can be further strengthened through the sodium-reducing educational interventions. Perceived behavioral control of a salt-reduced diet can be strengthened by adjusting food recipes to reduce salt content, choosing food products with labels indicating less sodium/salt on the package, improving the ability to identify ‘invisible salt’, and paying attention to salt-reducing related science, cultural and entertainment stories posted on social media, etc., as well as formulating a public food procurement policy to restrict the amount of high salt in public institutions, such as hospitals, schools, workplaces, and nursing homes, and to restrict the amount of high salt in the food supply. The formulation of public food procurement policies and restriction of foods high in salt or sodium in public organizations such as hospitals, schools, workplaces, and nursing homes can reduce sodium intake. The study has some limitations. A cross-sectional survey design was used, so specifying the time series of statistical associations is difficult; as such, no causal inferences can be made. Moreover, information bias and other biases may occur because data are self-reported. According to the developers of TPB, qualitative elicitation interviews should precede the development of the instrument. We encourage other researchers to undertake elicitation interviews before developing their instruments. Conclusion The SEM results of factors influencing the salt reduction diet of middle-aged and elderly hypertensive patients in Chongqing are well-fitted and credible. The rate of intention to reduce salt diet among middle-aged and elderly hypertensive patients in Chongqing is still at a relatively low level. In this regard, targeted interventions, such as salt reduction diet publicity, should be carried out according to the salient demographic characteristics of different populations, with a focus on males and hypertensive groups living in the Wuling mountainous townships of southeastern Chongqing. Attitude and perceived behavioral control of a salt-reducing diet directly affected the actual salt-reducing diet intention, and the most significant impact was on the perceived behavioral control of a salt-reducing diet. In the future, health education may prioritize exploring practical ways to move from attitude to practice. Abbreviations English abbreviation English full name TPB Theory of Planned Behavior SEM Structural Equation Modeling INT salt reduction intention ATT attitude towards salt reduction SN subjective norms of salt reduction PBC perceived behavioral control of salt reduction Declarations Ethics approval and consent to participate: This study was conducted in accordance with the ethical principles of the Declaration of Helsinki. Ethical approval was granted by [Chongqing Medical University] Ethics Committee (Approval No. 2021041), and all participants provided written informed consent. Consent for publication: Not applicable. Competing interests: The authors declare no conflict of interest. Non-financial associations that may be relevant to the submitted manuscript. We have read and understood BMC public health policy on declaration of interests and declare that we have no competing interests. Funding: This work was supported by the [Science Popularization and Communication Research Fund of China Nutrition Society] under Grant [number CNS-SCP2020-34]. Contributors: X.L. ,Y.W. wrote the draft of this paper together. Y.W., X.L,Y.Z., L.L., and D.Z. contributed to the design, data analysis, data interpretation, and revision of the paper; Y.W., X.L., L.L., Y.S., and D.Z. conducted an on-site study, database establishment, and data entry; Y.W.,X.L and Y.Z. contributed to data analysis, data interpretation, and revision of the paper; Z.S., M.S. edited and provided critical comments on the entire manuscript. All authors helped in the revision of the paper. All authors have read and approved the final version of the paper. Acknowledgements: We would like to express our gratitude to the Chenjiaqiao Community Health Service Center for their valuable assistance and support in this study. References The L (2016) Trauma: a neglected US public health emergency. The Lancet 388. Zhou M, Wang H, Zeng X, et al. (2019) Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet (London, England) 394, 1145-1158. Jizhe MN (2021) Main Data of the Seventh National Population Census. https://www.stats.gov.cn/english/PressRelease/202105/t20210510_1817185.html Thomas SA, Qiu Z, Chapman A, et al. (2020) Editorial: Chronic Illness and Ageing in China. Frontiers in public health 8, 104. Yuzhen Song* QZ, Xinzhu Zhou (2023) Analysis of Chronic Disease and Healthy Lifestyle of the Elderly in China—Empirical Analysis Based on Data of CLHLS 2018. Operations Research and Fuzziology 13, 4041-4051. Chen X, Giles J, Yao Y et al. (2022) The path to healthy aging in China: a Peking University-Lancet Commission. Lancet (London, England) 400, 1967-2006. Nations U (2019) World Population Prospects 2019. https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/un_2019_wpp_vol2_demographic-profiles.pdf Hypertension. https://www.who.int/china/health-topics/hypertension Organization WH Global report on hypertension: the race against a silent killer https://www.who.int/publications/i/item/9789240081062 Feng DX-bTW-gCL-lCTGYXJL (2023) Multimorbidity and influencing factors of hypertension， hyperlipidemia, and hyperglycemia among residents（30-79 years old） in Chongqing city. Chinese Journal of Prevention and Control of Chronic Diseases Ziping HYCJC (2017) Epidemiology analysis of inpatients with cardiovascular diseases in a certain hospital of Hefei in 2012 ～ 2014. Strazzullo P, D'Elia L, Kandala NB et al. (2009) Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ (Clinical research ed) 339, b4567. al ZZZHLJe (2017) Prevalence rate of H-type hypertension and its risk factors among medical examination population in a hospital of Shanghai in 2015. Anhui Medical Journal . China NHCotPsRo (2020) Report on the Nutrition and Chronic Diseases Status of Chinese Residents 2020. ACTA NUTRIMENTA SINICA . Society CN (2023) DIETARY REFERENCE INTAKES FOR CHINA. Beijing: People's Medical Publishing House. Zhang JY, Zhang B, Tang J, et al. (2021) [Deaths and life expectancy losses attributed to high-salt diet in Shandong province]. Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 42, 527-530. Diet high in sodium - Level 3 risk. WANG ZENGWU HS (2023) Interpretation of Report on Cardiovascular Health and Diseases in China 2022. Chinese Journal of Cardiovascular Medicine . WANG Si-qi XJ-w, BAI Ya-min, LIU Min, JI Ning, LI Yuan, ZHANG Pu-hong, LI Ying-hua, WU Jing (2020) Salt reduction related knowledge, attitude, practice and its influencing factors among residents in six provinces of China in 2018. Chinese Journal of Health Education . Organization WH (2023) WHO global report on sodium intake reduction. Filippini T, Malavolti M, Whelton PK et al. (2022) Sodium Intake and Risk of Hypertension: A Systematic Review and Dose-Response Meta-analysis of Observational Cohort Studies. Current hypertension reports 24, 133-144. Jie-ming DX-fLM-bFLWL-yYMZ (2018) Analysis of Sodium Chloride Intake and Affecting Factors in Rural Community of Zhejiang Province. ACTA NUTRIMENTA SINICA . fu YY-pMS-lLX-hZJ-lHZ-yZC-yCX-yDX- (2019) Investigation on knowledge， attitude, and behavior of salt reduction for hypertension prevention in Liandu District. Preventive Medicine . Wei Yan ZL, Liping Xu, Jiahong Liu, Xu Yan, ZhaoJun, Xiaona Chen (2022) Analysis of salt intake and its influencing factors among residents of Hengfeng County of Jiangxi Province. Jiangxi Medical Journal . CHANG Xiao-yu DY, HE Jun, WANG Zhuo, LI Ya-ling, YAN Yi-han, CAO Jie, WANG Ding-bang, LIU Min, XU Jian-wei (2021) Analysis on salt-related knowledge, attitude, practice and its influencing factors among residents in two counties of Sichuan Province. Chinese Journal of Health Education . ZHANG Xing ZX-r, SHEN Ying, CAI Ying, HU Kang, DONG Jing, GUO Xiao-lei, MA Ji-Xiang, SUN Xin-Ying (2018) Analysis on salt-reduction behaviors among patients with hypertension based on health belief model: a qualitative study. Chinese Journal of Health Education . Ming-fei FFLY-hZP-hLYLLLＲNX-qWS-fZGWL-lS (2022) Analysis on the salt-related knowledge， attitudes， and behaviors among Chinese population. Chinese Journal of Health Education . AJZEN I. From intentions to actions: A theory of planned behavior [M]. Action control: From cognition to behavior. Springer. 1985: 11-39. Geriatrics CHPaCGRCHACHBoCAftPoIEoHHBoC (2024) Chinese Guidelines for the Prevention and Treatment of Hypertension (2024 Revision). Chin J Hypertens . The National Essential Public Health Service Program Office for Management of Hypertension in Primary Health Care NC & Care. fCDNCoHMiPH (2021) National Clinical Practice Guidelines on the Management of Hypertension in Primary Health Care in China (2020). Chinese Circulation Journal . Marakis G, Marques Domingues A, Crispo A et al. (2023) Pertinence of Salt-Related Knowledge and Reported Behaviour on Salt Intake in Adults: A Cross-Sectional Study. Nutrients 15. Chen S, Shan LC, Tao W et al. (2020) A survey of Chinese consumers' knowledge, beliefs and behavioural intentions regarding salt intake and salt reduction. Public Health Nutrition 23, 1450-1459. Yang Y, Wang J, Ma J et al. (2021) Comparison of Salt-Related Knowledge and Behaviors Status of WeChat Users between 2019 and 2020. Nutrients 13. HU Li-hua* HX, CAI Hua-xiu, LIANG Qian, et al. (2017) Investigation on prevalence of hypertension and risk factors among urban and rural residents in Jiangxi province. Chin J Hypertens . Mørk T, Lähteenmäki L Grunert KG (2019) Determinants of intention to reduce salt intake and willingness to purchase salt-reduced food products: Evidence from a web survey. Appetite 139, 110-118. Xinying3* ZXDJGYXJBYLMZXGXMJS (2024) Influencing Factors of Salt-reduction Behavior among Residents： a Mixed Methods Research Based on the PRECEDE Model. Chinese General Practice . DING Jing-min LY, DU Wen-wen, ZHANG Ji-Guo, et al. (2022) Barriers and facilitators of salt reduction in Chinese restaurants in Chengdu. Chinese Journal of Health Education . Morris JM, Algert CS, Falster MO, et al. (2012) Trends in planned early birth: a population-based study. American Journal of Obstetrics and Gynecology 207, 186.e181-188. Armitage CJ & Conner M (2001) Efficacy of the Theory of Planned Behaviour: a meta-analytic review. The British journal of social psychology 40, 471-499. Rich A, Brandes K, Mullan B et al. (2015) Theory of planned behavior and adherence in chronic illness: a meta-analysis. Journal of Behavioral Medicine 38, 673-688. McEachan RRC, Conner M, Taylor NJ et al. (2011) Prospective prediction of health-related behaviours with the Theory of Planned Behaviour: a meta-analysis. Health Psychology Review 5, 97-144. Morowatisharifabad MA, Salehi-Abargouei A, Mirzaei M, et al. (2019) Behavioral beliefs of reducing salt intake from the perspective of people at risk of hypertension: An exploratory study. ARYA atherosclerosis 15, 59-66. Hunter RW, Dhaun N Bailey MA (2022) The impact of excessive salt intake on human health. Nature reviews Nephrology 18, 321-335. Zhao F, Zhang P, Zhang L et al. (2015) Consumption and sources of dietary salt in family members in Beijing. Nutrients 7, 2719-2730. Zhang L, Zhao F, Zhang P, et al. (2015) A pilot study to validate a standardized one-week salt estimation method evaluating salt intake and its sources for family members in China. Nutrients 7, 751-763. Pacific WHOROftW (2022) Reducing salt intake in China: cooking healthier meals at home. https://www.who.int/westernpacific/news-room/feature-stories/item/reducing-salt-intake-in-china--cooking-healthier-meals-at-home Additional Declarations No competing interests reported. Supplementary Files SupplementaryMaterial1.pdf SupplementaryMaterial2covdata.pdf SupplementaryMaterial3rawdata.xlsx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 15 Sep, 2025 Reviewers agreed at journal 14 Sep, 2025 Reviewers invited by journal 10 Sep, 2025 Editor assigned by journal 26 Aug, 2025 Editor invited by journal 20 Aug, 2025 Submission checks completed at journal 19 Aug, 2025 First submitted to journal 19 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7325252","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":515461133,"identity":"1d75d6e0-7444-4389-a9a9-c0aa11b30218","order_by":0,"name":"By Yaqi Wen","email":"","orcid":"","institution":"Chongqing Medical University","correspondingAuthor":false,"prefix":"","firstName":"By","middleName":"Yaqi","lastName":"Wen","suffix":""},{"id":515461134,"identity":"fac38f03-a316-4a51-932c-527e582a15ba","order_by":1,"name":"Xia Li","email":"","orcid":"","institution":"Chongqing Medical University","correspondingAuthor":false,"prefix":"","firstName":"Xia","middleName":"","lastName":"Li","suffix":""},{"id":515461136,"identity":"c50a24b3-2dee-465d-88e9-25e97e521e3b","order_by":2,"name":"Ya Shi","email":"","orcid":"","institution":"Chongqing Medical University","correspondingAuthor":false,"prefix":"","firstName":"Ya","middleName":"","lastName":"Shi","suffix":""},{"id":515461137,"identity":"887d7107-7b7c-40d8-9f1b-fd082df49bb1","order_by":3,"name":"Lei Luo","email":"","orcid":"","institution":"Chongqing Medical University","correspondingAuthor":false,"prefix":"","firstName":"Lei","middleName":"","lastName":"Luo","suffix":""},{"id":515461138,"identity":"4c4729fa-ba40-40df-80bb-af2dcbbd6c96","order_by":4,"name":"Du Zhang","email":"","orcid":"","institution":"Chongqing Medical University","correspondingAuthor":false,"prefix":"","firstName":"Du","middleName":"","lastName":"Zhang","suffix":""},{"id":515461139,"identity":"dcf7d963-0d97-4e73-b4f6-5a16e1f0ec47","order_by":5,"name":"Zumin Shi","email":"","orcid":"","institution":"Qatar University","correspondingAuthor":false,"prefix":"","firstName":"Zumin","middleName":"","lastName":"Shi","suffix":""},{"id":515461140,"identity":"73136673-aa44-4e26-a4da-1a760bbb9c78","order_by":6,"name":"Manoj Sharma","email":"","orcid":"","institution":"University of Nevada","correspondingAuthor":false,"prefix":"","firstName":"Manoj","middleName":"","lastName":"Sharma","suffix":""},{"id":515461141,"identity":"2cb5912e-676e-4023-bf68-5db595f6c49c","order_by":7,"name":"Yong Zhao","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4ElEQVRIiWNgGAWjYDACCSjND6UZG4jWItlAshaDA8RqkZ/d/PAxT8Udu83HD2/dzMNgI7vhAPOzB/i0MM45ZmzMc+ZZ8rYzaWW3eRjSjDccYDM3wKeFWSLBTJq37XCy2Q0eM6CWw4kbDvCwSeDTwiaR/g2sxXgGWMt/wlp4JHLAttgZSIC1HCCsRUIip9hwzpnDCRJAv9ycY5BsPPMwmxleLfIz0jc+eFNx2J6//fC2G28q7GT7jjc/w6sFBJh4GBgSG4BRA0YMzITUAwHjDwYGewaI+lEwCkbBKBgFmAAAyzBIBOEKsEUAAAAASUVORK5CYII=","orcid":"","institution":"Chongqing Medical University","correspondingAuthor":true,"prefix":"","firstName":"Yong","middleName":"","lastName":"Zhao","suffix":""}],"badges":[],"createdAt":"2025-08-08 08:38:31","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7325252/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7325252/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":91561887,"identity":"45d3f5f7-83ec-4b9a-8147-0f311d4ad902","added_by":"auto","created_at":"2025-09-17 18:50:35","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":93412,"visible":true,"origin":"","legend":"\u003cp\u003eModel hypothesis testing\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7325252/v1/38b092e88f9c548a69644319.png"},{"id":91561891,"identity":"cc83b76a-3b07-4215-9e8d-4da04511f5a1","added_by":"auto","created_at":"2025-09-17 18:50:35","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":193639,"visible":true,"origin":"","legend":"\u003cp\u003eStructural equation modeling of factors influencing salt reduction dietary intentions in elderly hypertensive patients\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7325252/v1/03b7dc9098ecc59d54291bb5.png"},{"id":91564737,"identity":"595845f2-4f1f-4de1-a037-bdafac93a234","added_by":"auto","created_at":"2025-09-17 19:14:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1505251,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7325252/v1/4ed0a3c5-116b-44cc-b835-bf0d3c6cc015.pdf"},{"id":91562690,"identity":"1839f21c-669f-47fa-b1ed-86764fec6a71","added_by":"auto","created_at":"2025-09-17 18:58:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":164796,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryMaterial1.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7325252/v1/d4d5e89020e41c377eddda64.pdf"},{"id":91563406,"identity":"6c23d37e-fa7b-4c9b-8f43-b20c504dc258","added_by":"auto","created_at":"2025-09-17 19:06:35","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":144461,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryMaterial2covdata.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7325252/v1/2e9d97646e074c0b1b3e11b7.pdf"},{"id":91561890,"identity":"7048e97a-90fd-443c-9d0a-c3e184722ed7","added_by":"auto","created_at":"2025-09-17 18:50:35","extension":"xlsx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":108826,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryMaterial3rawdata.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-7325252/v1/9c2c572a97a21c96481e4779.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Salt reduction dietary intention and influencing factors in middle-aged and elderly hypertensive patients based on the theory of planned behavior","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eIn recent years, China has experienced a dramatic population aging and health transition\u003csup\u003e(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/sup\u003e. As of 2020, 18.7% of China\u0026rsquo;s total population will be aged 60 and over\u003csup\u003e(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/sup\u003e; by 2040, 28% of China\u0026rsquo;s population will be aged 60 years and over\u003csup\u003e(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/sup\u003e. This group is prone to a high incidence of chronic diseases; the most common of which is hypertension, which causes physical and psychological suffering to patients\u003csup\u003e(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eHypertension is a common chronic non-communicable disease that increases mortality from stroke and the rates of disability, kidney disease, and cardiovascular disease; with more people dying each year from cardiovascular disease than from any other cause\u003csup\u003e(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/sup\u003e. According to the Report on Nutrition and Chronic Disease Status of Chinese Residents (2020), the prevalence of hypertension among Chinese people over 60 years old is as high as 59.2%. The Global Hypertension Report (2023) shows that the number of adults aged 30\u0026ndash;79 years with hypertension in China is about 256.7\u0026nbsp;million, with an overall age-standardized prevalence rate of 27%\u003csup\u003e(9)\u003c/sup\u003e, a hypertension diagnosis rate of 52%, a treatment rate of 39%, and an up-to-date treatment rate of only 16%. Data from another study based on a sample size of 23,308 drawn from 13 districts (counties) in Chongqing also showed that the prevalence of hypertension among community residents aged 30\u0026ndash;79 years in Chongqing was 35.07%\u003csup\u003e(10)\u003c/sup\u003e, which was higher than the overall prevalence level of hypertension in China\u003csup\u003e(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/sup\u003e. However, the cure and hypertension control rates were only 47.3% and 14.6%, respectively\u003csup\u003e(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/sup\u003e. The economic benefit-to-cost ratio of improved hypertension treatment programs is estimated to be approximately 18:1\u003csup\u003e(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/sup\u003e, which has significant financial costs to patients and their families, the health system, and the population\u0026rsquo;s economy.\u003c/p\u003e\u003cp\u003eAccording to the World Health Organization (WHO), the average global sodium intake of adults is 4310 mg/day (i.e., equivalent to 10.78 g/day of salt), which is more than twice the WHO recommended sodium intake of less than 2000 mg/day (5 g/day of salt). The China\u0026rsquo;s \u0026ldquo;Report on Nutrition and Chronic Disease Status of Chinese Residents (2020)\u0026rdquo; also shows that the average daily salt intake of Chinese residents is as high as 9.3 g\u003csup\u003e(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/sup\u003e, which tends to be two times the revised recommendations for dietary nutrient sodium (sodium PI-NCD\u0026thinsp;\u0026le;\u0026thinsp;2,000 mg) for Chinese residents in 2023\u003csup\u003e(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/sup\u003e, which shows that high salt diets are prevalent globally. A high-salt diet seriously affects human health by raising blood pressure and increasing the risk of cardiovascular diseases, such as cardiovascular disease, obesity, gastric cancer, kidney disease, and osteoporosis\u003csup\u003e(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e)\u003c/sup\u003e. About 1.89\u0026nbsp;million deaths per year are related to high sodium intake\u003csup\u003e(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/sup\u003e. A high salt diet has become a significant public health problem in China, and the salt intake of residents should be reduced\u003csup\u003e(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e)\u003c/sup\u003e. A previous study was conducted on the knowledge, attitude, and behavioral survey on sodium salt reduction and control among some residents in six provinces of China; the results showed that the support rate of the attitude of salt reduction was 73.78%, but the high level of knowledge of salt reduction was only 29%\u003csup\u003e(19)\u003c/sup\u003e. This finding shows a long way to go in salt-reduction diet.\u003c/p\u003e\u003cp\u003eMany animal experiments and epidemiological and population intervention studies have confirmed that a high-salt diet is a risk factor for hypertension\u003csup\u003e(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e)\u003c/sup\u003e. The Global Hypertension Report mentions reducing dietary sodium intake as an essential step in preventing and controlling hypertension. A salt-reduced diet not only reduces blood pressure levels in middle-aged and elderly hypertensive patients but also has a vital role in improving the entire population's health and overall health literacy in the long run. However, salt-reduced diets are, in turn, affected by demographic factors, knowledge\u003csup\u003e(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e)\u003c/sup\u003e, attitudes about salt-reduced diets\u003csup\u003e(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e)\u003c/sup\u003e, dietary environments\u003csup\u003e(\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e)\u003c/sup\u003e, lifestyles of critical relational figures\u003csup\u003e(25, 26)\u003c/sup\u003e, health education\u003csup\u003e(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e)\u003c/sup\u003e, and other factors. Most current studies consider individual attitudes and knowledge about salt-reduced diets but ignore factors such as individual behavioral control and environmental factors they are exposed to; how to bridge the gap among knowledge, attitude, and behavior is a significant challenge in public health\u003csup\u003e(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e)\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eHypertension is the most common chronic disease, and a salt-reduced diet is a health-related behavior in accordance to the applicable scenarios of the Theory of Planned Behavior (TPB)\u003csup\u003e(\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e)\u003c/sup\u003e. This study used the TPB theoretical model to analyze factors influencing the intention to reduce salt diet in middle-aged and elderly hypertensive patients in Chongqing from the attitude toward salt-reducing diets, subjective norms of salt-reducing diets, and the control of salt-reducing diets in terms of perceptual behavior, that is, intention to reduce salt diet.\u003c/p\u003e\u003cp\u003eWe propose the following hypotheses based on the theoretical framework of TPB and the aim of this research (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eHypothesis 1\u003c/strong\u003e\u003cp\u003e(H1): The more robust the attitude about salt reduction diet, the greater will be the intention to reduce salt diet among middle-aged and elderly hypertensive patients.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eHypothesis 2\u003c/strong\u003e\u003cp\u003e(H2): The more robust the subjective norms regarding salt reduction diet, the greater will be the intention to reduce salt diet among middle-aged and elderly hypertensive patients.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eHypothesis 3\u003c/strong\u003e\u003cp\u003e(H3): The more robust the perceived behavioral control regarding salt reduction diet, the greater will be the intention to reduce salt diet among middle-aged and elderly hypertensive patients.\u003c/p\u003e\u003c/p\u003e\u003cp\u003eIn addition, we studied the interrelationship among salt-reducing diet attitude, salt-reducing diet competent norms, and perceived behavioral control of salt-reducing diet.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Study Design and Sample Collection\u003c/h2\u003e\u003cp\u003eThis cross-sectional study was conducted from March 2023 to November 2023. Convenience sampling was used to select middle-aged and elderly hypertensive patients aged 45 years or older from 38 districts and counties in Chongqing Municipality as the study population (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;558). We developed and administered a face-to-face questionnaire. The inclusion criteria were as follows: mean systolic blood pressure\u0026thinsp;\u0026ge;\u0026thinsp;140 mm Hg (1 mm Hg\u0026thinsp;=\u0026thinsp;0.133 kPa); mean diastolic blood pressure\u0026thinsp;\u0026ge;\u0026thinsp;90 mm Hg; or self-reported intake of antihypertensive medication in the past two weeks\u003csup\u003e(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e)\u003c/sup\u003e; as well as age\u0026thinsp;\u0026ge;\u0026thinsp;45 years old, patients with previous hypertension\u003csup\u003e(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e)\u003c/sup\u003e, patients with hypertension diagnosed at a township health center/community health service center or a healthcare facility above immediately before the start of the survey at each monitoring site, and patients who voluntarily participated in this survey. The exclusion criteria included the following: people with mental disorders or those who have difficulty expressing their thoughts clearly.\u003c/p\u003e\u003cp\u003e Before conducting this study, we obtained ethical approval from the Ethics Committee of Chongqing Medical University to ensure adherence to strict ethical standards (approval number 2021041). All participants were informed about the study at the beginning of the questionnaire, and consent forms were obtained.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Measures\u003c/h2\u003e\u003cp\u003eA self-administered questionnaire was used, and it consists of two parts, namely, the essential demographic characteristics of hypertensive patients (e.g., gender, ethnicity, family residence, education level, family history of hypertension, etc.) and TPB constructs(Supplementary Material 1.pdf). The overall scale consists of four subscales, with a total of 13 items: three items pertaining to the salt reduction diet intention dimension, three items on the salt reduction diet perceived behavioral control dimension, three items on the salt reduction diet subjective norms dimension, and four items on the salt reduction diet attitude dimension. Each subscale was scored using a Likert-type response set, with higher scores indicating excellent agreement with the content of the item.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Quality control\u003c/h2\u003e\u003cp\u003eIn the survey design stage, after the theoretical intention model was constructed, subscales were designed for each of the four core variables of the model by the principles and methods of scale development. Reliability and validity tests were carried out, and subscales with poor measurement performance were finely revised and perfected. The survey researchers underwent a unified, rigorous, and professional training before formally carrying out the cross-sectional surveys. During the survey implementation stage and the data collation and analysis stage, verification and proofreading were conducted at all times. Mistakes, omissions, and logical errors were found and revised promptly, and the questionnaire entry was double-checked and entered.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Statistical analysis\u003c/h2\u003e\u003cp\u003eData were cleaned and analyzed using Amos 28.0 and STATA 18.0. The overall population was divided into high- and low-salt-reducing dietary intention populations by using the median score as the criterion. Mean, standard deviation, and constitutive ratio were used to describe the data. Independent sample t-test and ANOVA analyzed population differences. Structural equation modeling (SEM) was used to explore the relationship between salt-reducing dietary intention and its salt-reducing dietary attitudes, subjective norms, and perceived behavioral control, as well as salt-reducing attitudes, subjective norms, and perceived behavioral control. The two-by-two correlation among salt reduction attitude, subjective norms, and perceived behavioral control was also determined. All statistical tests were two-tailed, and P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered significant.\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e3.1 Participants\u0026rsquo; characteristics\u003c/h2\u003e\u003cp\u003eA total of 590 middle-aged and elderly hypertensive patients completed the questionnaire, 12 middle-aged and elderly hypertensive patients refused to participate in the survey, obtaining a completion rate of 98%. Twenty questionnaires were excluded due to a large number of missing values, resulting in 558 valid questionnaires, with a validity rate of 96.5%. About 55.2% of the questionnaires were answered by females, 91.8% were Han Chinese, 48% were educated at junior high school or above, 73.5% were married, and 44.1% of respondents were home cooks. Households with home addresses in \u0026ldquo;Central City,\u0026rdquo; \u0026ldquo;Main City New Area,\u0026rdquo; \u0026ldquo;Northeast Chongqing Three Gorges Reservoir Town Cluster,\u0026rdquo;= and \u0026lsquo;Southeast Chongqing Wuling Mountains Town Cluster\u0026rsquo; accounted for 29.4%,27.6%,29.6%,and 13.4%, respectively, 50.5% had no chronic diseases other than hypertension, 61.3% were elderly, and 38.7% were middle-aged. Salient demographic characteristics are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eBasic characteristics of survey respondents (n\u0026thinsp;=\u0026thinsp;558)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactors\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGroups\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003en(%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSalt Reduction Dietary Intentions\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003enot\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e163\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e395\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e70.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWomen\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e308\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e55.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e250\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e44.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eEthnicity\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEthnic Han\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e512\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e91.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNation minority\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePrimary and below\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e290\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e52.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eJunior\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e151\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHigh school/secondary/vocational\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCollege/university above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnmarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e410\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e73.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDivorcee\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ewidowhood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e107\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e\u003cp\u003e\u003cb\u003eHome cooks\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eoneself\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e246\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e44.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003emate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e139\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e24.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOneself or mate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWoman and son-in-law\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e108\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eothers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBabysitter or carer\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003eRegion\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e164\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMCNA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e154\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNCTGRTC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e165\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSCWMTC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSuffering from other chronic diseases\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003enot\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e282\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e50.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e276\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e49.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eAge grouping\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMiddle-aged adults\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e216\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e38.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eelderly\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e342\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e61.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eCC, Central City; MCNA, Main City New Area; NCTGRTC, Northeast Chongqing Three Gorges Reservoir Town Cluster; SCWMTC, Southeast Chongqing Wuling Mountains Town Cluster\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Difference analysis\u003c/h2\u003e\u003cdiv id=\"Sec10\" class=\"Section3\"\u003e\u003ch2\u003e3.2.1 Univariate analysis\u003c/h2\u003e\u003cp\u003eIndependent-sample t-test showed statistically significant differences in salt-reduction dietary attitude, subjective norms, perceived behavioral control, and intention scores between ethnic groups and places of residence (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). There was also a statistically significant difference in perceived behavioral control scores for salt reduction between genders, with males scoring slightly lower than females in this domain (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Univariate regression analysis revealed statistically significant differences in scores across different family residence areas for all four dimensions: salt-reduction dietary attitude, perceived behavioral control, subjective norms, and intention (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Additionally, statistically significant differences were observed in salt-reduction dietary perceived behavioral control, attitude, and intention among groups with different family histories of hypertension (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). When grouped by education level, differences in scores were found for the dimensions of salt-reduction dietary subjective norms and intention (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Furthermore, there were statistically significant differences in salt-reduction dietary perceived behavioral control scores among those who were the primary family cooks (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05, Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eUnivariate Regression Analysis of Different Demographic Characteristics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"12\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003ePBC\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eSN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u003cp\u003eINT\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e\u003cp\u003eATT\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003et/F\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003et/F\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cem\u003et/F\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cem\u003et/F\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.564\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.011\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.065\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.948\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1.024\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.306\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.904\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge grouping\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.032\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.974\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-1.755\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.080\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.422\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.673\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e-1.424\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.155\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFamily History of Hypertension\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.374\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.018\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.460\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.145\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e2.463\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.014\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e2.078\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.038\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRegion\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-3.543\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-3.249\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-5.465\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e-6.464\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.901\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.368\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.916\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.004\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e2.362\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.019\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e1.691\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.091\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIncome Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.234\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.815\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.891\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.059\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.406\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.685\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.804\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.422\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.400\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.690\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.936\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.350\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.347\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.729\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e-0.173\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.863\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSuffering from other chronic diseases\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.278\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.781\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.823\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.411\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.690\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.491\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e-1.042\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.298\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEthnicity\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3.203\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.532\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3.046\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e3.648\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.111\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.912\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-3.331\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.165\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.869\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e-1.719\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.086\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eplace of residence\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-4.539\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-5.686\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-5.638\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e-6.153\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHome cooks\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-2.012\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.045\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.558\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.577\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-1.280\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.201\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e-0.874\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.383\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section3\"\u003e\u003ch2\u003e3.2.2Multiple linear regression\u003c/h2\u003e\u003cp\u003eThe results of the multiple linear regression analysis indicated that demographic characteristics such as family residence and family history of hypertension were the primary influencing factors for salt-diet intention (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Gender and place of residence were associated with scores for subjective norms related to salt-reduction diet (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Place of residence and marital status were correlated with scores for self-regulation in salt-reduction diet (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Additionally, place of residence and family residence were related to scores for attitudes toward salt-reduction diet (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).(Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMultiple Linear Regression Analysis of Different Demographic Characteristics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eimplicit variable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eIndependent\u003c/p\u003e\u003cp\u003evariable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eregression coefficient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003et\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eP\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eB\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eβ\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ePBC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.150\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.106\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-2.547\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.011\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eplace of residence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.240\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.174\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.932\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eSN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eplace of residence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.251\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.206\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.364\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarital status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.096\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.124\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-3.005\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.003\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eINT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRegion\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.153\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-3.496\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFamily History of Hypertension\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.085\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.060\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.040\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eplace of residence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.219\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.166\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.503\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eATT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRegion\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.121\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.188\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-4.333\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eplace of residence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.228\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.176\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.103\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e3.3Validation or factor analysis results\u003c/h2\u003e\u003cdiv id=\"Sec13\" class=\"Section3\"\u003e\u003ch2\u003e3.3.1 Convergent validity\u003c/h2\u003e\u003cp\u003eIn the salt-reduced diet model, the mean-variance extraction AVE values of the three factors of salt-reduced diet attitude, salt-reduced diet perceived behavioral control, and salt-reduced diet intention were all more than 0.5. The subjective norms of salt-reduced diet were also very close to the statistical cut-off value of 0.5. The combination of the CR values of the reliabilities is more significant than 0.7, which indicates that the scale data of the present analysis has good convergent validity (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eConvergent validity of the questionnaire model\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003edimension\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eentry\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEstimate\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAVE\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCR\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eATT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eATT1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.874\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.649\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.880\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eATT2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.872\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eATT3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.753\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eATT4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.710\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003ePBC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePBC3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.736\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.548\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.782\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePBC2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.635\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePBC1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.836\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eINT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eINT2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.856\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.536\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.767\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eINT3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.798\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eINT1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.487\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eSN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSN1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.720\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.480\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.734\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSN2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.709\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSN3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.647\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section3\"\u003e\u003ch2\u003e3.3.2 Structural validity\u003c/h2\u003e\u003cp\u003eThe following standard fitting indices were used to evaluate the model's overall fit. The model's RMSEA\u0026thinsp;=\u0026thinsp;0.083, AGFI\u0026thinsp;=\u0026thinsp;0.886, GFI\u0026thinsp;=\u0026thinsp;0.926, χ\u003csup\u003e2\u003c/sup\u003e/df\u0026thinsp;=\u0026thinsp;4.822, which can be considered as an overall good model fit (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eConstruct validity\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003estatistical test\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCriteria for adaptation or threshold value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eModel test results\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eModel fit judgement\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAbsolute fit indices\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRMR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.032\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRMSEA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.08 favorable, \u0026lt;\u0026thinsp;0.1 acceptable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.083\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGFI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;0.9 desirable, \u0026gt;\u0026thinsp;0.8 acceptable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.926\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ec\u003csup\u003e2\u003c/sup\u003e/df\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;2 favorable, \u0026lt;\u0026thinsp;3 ordinary, \u0026lt;\u0026thinsp;5 acceptable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.822\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAGFI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;0.9 desirable, \u0026gt;\u0026thinsp;0.8 acceptable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.886\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIncremental fit index\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNFI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;0.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.926\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRFI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;0.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.902\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIFI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;0.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.940\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTLI(Tucker-Lewis Index)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;0.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.920\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCFI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;0.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.940\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSimple fit statistics\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePGFI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;0.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.600\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePNFI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;0.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.700\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePCFI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;0.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.711\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eyes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section3\"\u003e\u003ch2\u003e3.3.3 Discriminant validity\u003c/h2\u003e\u003cp\u003eFor the salt-reduced diet attitude, its AVE square root value was 0.806, which was greater than the maximum absolute value of the inter-factor correlation coefficient of 0.028 (between the two factors of salt-reduced diet attitude and subjective norms of salt-reduced diet) and 0.030 (between the two factors of salt-reduced diet attitude and perceptual-behavioral control of salt-reduced diet). This finding implies that salt-reduced diet attitude scale has good discriminant validity. For the subjective norms of salt-reduced diet, its AVE square root value is 0.693, which is greater than the absolute maximum value of 0.027 for the correlation coefficients between the two factors (subjective norms of salt-reduced diet and perceived behavioral control of salt-reduced diet), implying that the subjective norms of salt-reduced diet scale has good discriminant validity. This finding supports that the scale had good discriminant validity (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDiscriminant validity\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eitems\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eATT\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePBC\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eATT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.649\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.028\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.480\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePBC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.030\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.027\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.548\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAVE square root\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.806\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.693\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.740\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Results of structural modeling analysis\u003c/h2\u003e\u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the results of the final SEM model, and Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e shows the results of the path coefficient tests for salt reduction diet attitudes, subjective norms, and perceptual behavioral control to intention. The following information can be obtained: the significance level of both paths, salt-reducing diet attitudes, and salt-reducing diet perceptual-behavioral control to salt-reducing diet intention. Values at P\u0026thinsp;\u0026lt;\u0026thinsp;0.001 indicate that H1 and H3 can be accepted, expressly; H1: attitudes have a significant positive direct effect on intention (β\u0026thinsp;=\u0026thinsp;0.22, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001); and H3: perceptual-behavioral control has a significant positive direct effect on intention (β\u0026thinsp;=\u0026thinsp;0.70, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). 0.70, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) had a significant positive direct effect. This means that for every variance increase in salt-reducing diet attitudes, salt-reducing diet intentions increased by 0.22 variance; for every variance increase in salt-reducing diet perceptual behavioral control, salt-reducing diet intentions followed by 0.70 variance.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePath coefficient test results for salt reduction dietary attitudes, subjective norms, and perceived behavioral control and intentions\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003elatent variable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUstd.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eS.E.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eT\u003c/p\u003e\u003cp\u003eC.R\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eP\u003c/p\u003e\u003cp\u003eP\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eStd.\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eresult\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eSalt Reduction Dietary Intentions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026larr; Attitudes toward salt-reduced diets\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.220\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.055\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.962\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.222\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eacceptance\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026larr; Subjective norms for salt-reduced diets\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.074\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.892\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.058\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.114\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003erejection\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026larr; Perceived Behavioral Control of Salt Reduction Diet\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.744\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.066\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11.223\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e***\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.698\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eacceptance\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003eUnstd. unstandardized; S.E., standard error; Std., standardized.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"4 Discussion","content":"\u003cp\u003eThis study explored the psychosocial factors affecting salt reduction dietary intention in middle-aged and elderly hypertensive patients over 45 years of age in Chongqing City. Psychosocial factors had a significant effect on salt reduction dietary intention, consistent with the results of related studies at home and abroad\u003csup\u003e(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e)\u003c/sup\u003e. Based on the theory of planned behavior, this study showed that salt reduction diet intention is determined by salt reduction attitude and perceived behavioral control, and the influence of perceived behavioral control of salt reduction diet is more prominent. In addition, the intention to reduce salt diet was also influenced by some salient demographic characteristics. Information included a family history of hypertension and family residence, and hypertensive patients with a family history of hypertension and residence in the primary and central urban areas who had a higher intention to reduce salt.\u003c/p\u003e\u003cp\u003e\u003cem\u003e4.1 Differences in the presence of salt reduction dietary intentions in middle-aged and elderly hypertensive patients with different demographic characteristics\u003c/em\u003e\u003c/p\u003e\u003cp\u003eIn this study, the intention rate of salt reduction among middle-aged and elderly hypertensive patients aged 45 years or older in Chongqing was 70.8%, which is significantly lower than the results of a survey conducted by a domestic researcher. A 10-day salt survey based on the WeChat public platform of the China National Healthy Lifestyle Action in 2019 and 2020 found that 90.2% of participants were willing to reduce the amount of salt used in home cooking in 2020\u003csup\u003e(\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e)\u003c/sup\u003e. Basing on demographic characteristics, we found gender variability in salt reduction diets; that is, men had lower intention rates than women. Consistent with previous findings\u003csup\u003e(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e)\u003c/sup\u003e, this finding may be related to the fact that women run the household diet. Therefore, health education and promotion activities related to the core attitudinal shift regarding salt and hypertension prevention and control should be increased in dietary salt reduction for hypertension prevention interventions. The group of hypertensive patients with a family history of hypertension generally had a higher rate of intention to reduce salt diet than those without a family history of hypertension. Middle-aged and elderly hypertensive patients with a family history of hypertension had more favorable attitude related to salt reduction to prevent hypertension than others. Meanwhile, the rates of intention to reduce salt diet were higher in the groups of middle-aged and elderly hypertensive patients living in the central urban area, the new leading city area, and the towns in the Three Gorges Reservoir area in northeast Chongqing than in the cities in the Wuling Mountain area in southeast Chongqing. This study demonstrated that the rate of salt reduction dietary intention among middle-aged and elderly hypertensive patients in Chongqing is at a low level, which is a significant challenge for public health. In this regard, effective interventions and management measures should be explored to increase the rate of salt reduction dietary behavior among hypertensive patients in Chongqing and to reduce the risk of diseases caused by high salt diet.\u003c/p\u003e\u003cp\u003e\u003cem\u003e4.2 Effects of salt reduction dietary attitudes, subjective norms, and perceived behavioral control on salt reduction dietary intentions in middle-aged and elderly hypertensive patients\u003c/em\u003e\u003c/p\u003e\u003cp\u003eSalt-reducing diet attitudes and salt-reducing diet perceptual\u0026ndash;behavioral control directly affected the salt-reducing diet intentions of middle-aged and elderly patients in Chongqing. The effect of salt-reducing diet perceptual\u0026ndash;behavioral control was pronounced. This result is consistent with a retrospective study by Godin et al. \u003csup\u003e(\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e)\u003c/sup\u003e, who showed that subjective norms were insignificant in predicting health-related behaviors and had a lesser effect on behaviors than attitudes and perceived behavioral control. The results of the present study showed that the more positive the attitude toward a salt-reduction diet, the greater the intention to reduce salt, which is consistent with the findings of existing studies. Most consumers are willing to purchase salt-reduced foods even if there is no salt-reduction goal, suggesting that consumers perceive positive health outcomes from salt-reduction\u003csup\u003e(\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e)\u003c/sup\u003e. Residents with high salt-reduced dietary attitudes are likelier to initiate salt-reduction measures\u003csup\u003e(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e)\u003c/sup\u003e. Individuals' perceptual evaluation of approval or disapproval of behavior, though that is, their attitude toward that behavior ultimately influences the actual implementation of their behavior\u003csup\u003e(\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e)\u003c/sup\u003e. For example, hypertensive patients who believe that reducing the amount of salt in their daily diet is beneficial to the control or improvement of their blood pressure are more likely to engage in salt reduction, even if they have thoughts of a high-salt diet. That is, the more positive attitudes and individual perceived facilitators of salt reduction diet among middle-aged and elderly hypertensive patients, the stronger the intention to reduce salt.\u003c/p\u003e\u003cp\u003eThe present study also showed that a salt reduction diet perceptual-behavioral control could significantly influence salt reduction diet intention indication. Perceived behavioral control is regarded as a direct determinant of intention and has the same status as attitudes and subjective norms\u003csup\u003e(\u003cspan additionalcitationids=\"CR40\" citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e)\u003c/sup\u003e. If the barriers of internal and external factors are excluded, their hypertensive patients are more willing to engage in a salt-reduction diet. Obstacles to salt-reduced diets are the difficulty of adhering to a low-salt diet\u003csup\u003e(\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e)\u003c/sup\u003e and the \u0026ldquo;hidden\u0026rdquo; salt in processed foods, which makes it impossible to control salt intake at will. Growing inequalities in the food system exacerbate this problem and are another barrier to controlling salt intake in individual diets. The most effective salt reduction interventions are those implemented at the population level and include a participatory approach involving government, education, and the food industry\u003csup\u003e(\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e)\u003c/sup\u003e. Although the public knows that high sodium intake is unhealthy, most reported that it is difficult to find practical ways to reduce salt, especially when eating out. Yet, the contribution of restaurant dishes to the population's salt intake is not negligible\u003csup\u003e(\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e)\u003c/sup\u003e. Half the target audience reported difficulty adhering to a low-sodium diet long-term, and one-third reported difficulty controlling salt in food prepared outside the home. A popular monthly lifestyle and health magazine was developed with WHO and Health Trends, in China, launched a six-month salt reduction campaign: revealing hidden salt in everyday foods, demystifying dietary myths, and providing easy tips for cooking low-sodium meals at home. Information was again collected through focus group interviews and online. About 85% of the respondents said the campaign materials had a \u0026ldquo;great\u0026rdquo; or \u0026ldquo;fairly great\u0026rsquo; impact on their attitudes and behaviors; participants said they had already taken action to reduce their salt intake, such as consuming vegetables cooked with less salt and reducing the use of salt-containing condiments; and 90% of participants indicated an intention to reduce their salt intake\u003csup\u003e(\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e)\u003c/sup\u003e. This suggests that efforts to promote salt-reducing diets may be less comprehensive by relying solely on health websites or blogs written by pop doctors. Distributing salt-reducing-related entertainment and pop culture stories through social media may be more effective. The subjective norms of salt reduction in this study were not significant, probably because Chongqing has unique dietary characteristics and dietary culture, that is, it is a \u0026ldquo;hot pot city\u0026rdquo; with \u0026ldquo;heavy tastes.\u0026rdquo; The residents of Chongqing and their friends, relatives, and family members often share the same dietary characteristics. It may be due to the unique nutritional characteristics and dietary culture of Chongqing, that is, the \u0026ldquo;heavy taste\u0026rdquo; known as the \u0026ldquo;hotpot city\u0026rdquo; and the lack of communication and advice on salt reduction dietary knowledge because colleagues, friends, relatives, and family members around them often share meals and have the same nutritional characteristics. A national study found that advice from doctors and family members' reminders helped residents start reducing salt\u003csup\u003e(\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e)\u003c/sup\u003e, while another study showed that family disagreement was a barrier to reducing salt intake\u003csup\u003e(\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e)\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eIn summary, the results showed that salt-reducing dietary attitudes and salt-reducing dietary perceived behavioral control had a direct impact on the actual salt-reducing dietary intentions, so salt-reducing dietary attitudes and salt-reducing dietary perceived behavioral control should be targeted to improve the salt-reducing dietary intentions in middle-aged and old-aged hypertensive patients. To strengthen the salt-reducing diet strategy, we should focus on sodium-reducing education, including the measurement of actual nutritional sodium intake and educating hypertensive patients about the sources of sodium to make them establish a correct perception of salt-reducing diet, fully understand the hazards of high-salt diet, and change their negative attitudes towards salt-reducing diet; if they already have positive attitudes towards a low-salt diet, then the salt-reducing attitude can be further strengthened through the sodium-reducing educational interventions. Perceived behavioral control of a salt-reduced diet can be strengthened by adjusting food recipes to reduce salt content, choosing food products with labels indicating less sodium/salt on the package, improving the ability to identify \u0026lsquo;invisible salt\u0026rsquo;, and paying attention to salt-reducing related science, cultural and entertainment stories posted on social media, etc., as well as formulating a public food procurement policy to restrict the amount of high salt in public institutions, such as hospitals, schools, workplaces, and nursing homes, and to restrict the amount of high salt in the food supply. The formulation of public food procurement policies and restriction of foods high in salt or sodium in public organizations such as hospitals, schools, workplaces, and nursing homes can reduce sodium intake.\u003c/p\u003e\u003cp\u003eThe study has some limitations. A cross-sectional survey design was used, so specifying the time series of statistical associations is difficult; as such, no causal inferences can be made. Moreover, information bias and other biases may occur because data are self-reported. According to the developers of TPB, qualitative elicitation interviews should precede the development of the instrument. We encourage other researchers to undertake elicitation interviews before developing their instruments.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe SEM results of factors influencing the salt reduction diet of middle-aged and elderly hypertensive patients in Chongqing are well-fitted and credible. The rate of intention to reduce salt diet among middle-aged and elderly hypertensive patients in Chongqing is still at a relatively low level. In this regard, targeted interventions, such as salt reduction diet publicity, should be carried out according to the salient demographic characteristics of different populations, with a focus on males and hypertensive groups living in the Wuling mountainous townships of southeastern Chongqing. Attitude and perceived behavioral control of a salt-reducing diet directly affected the actual salt-reducing diet intention, and the most significant impact was on the perceived behavioral control of a salt-reducing diet. In the future, health education may prioritize exploring practical ways to move from attitude to practice.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 39.0845%;\"\u003e\n \u003cp\u003eEnglish abbreviation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60.9155%;\"\u003e\n \u003cp\u003e\u0026nbsp;English full name\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 39.0845%;\"\u003e\n \u003cp\u003eTPB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60.9155%;\"\u003e\n \u003cp\u003eTheory of Planned Behavior\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 39.0845%;\"\u003e\n \u003cp\u003eSEM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60.9155%;\"\u003e\n \u003cp\u003eStructural Equation Modeling\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 39.0845%;\"\u003e\n \u003cp\u003eINT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60.9155%;\"\u003e\n \u003cp\u003esalt reduction intention\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 39.0845%;\"\u003e\n \u003cp\u003eATT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60.9155%;\"\u003e\n \u003cp\u003eattitude towards salt reduction\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 39.0845%;\"\u003e\n \u003cp\u003eSN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60.9155%;\"\u003e\n \u003cp\u003esubjective norms of salt reduction\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 39.0845%;\"\u003e\n \u003cp\u003ePBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60.9155%;\"\u003e\n \u003cp\u003eperceived behavioral control of salt reduction\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003eThis study was conducted in accordance with the ethical principles of the Declaration of Helsinki. Ethical approval was granted by [Chongqing Medical University] Ethics Committee (Approval No. 2021041), and all participants provided written informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eThe authors declare no conflict of interest. Non-financial associations that may be relevant to the submitted manuscript.\u0026nbsp;We have read and understood BMC public health policy on declaration of interests and declare that we have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThis work was supported by the [Science Popularization and Communication Research Fund of China Nutrition Society] under Grant [number CNS-SCP2020-34].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContributors:\u003c/strong\u003e X.L. ,Y.W. wrote the draft of this paper together. Y.W., X.L,Y.Z., L.L., and D.Z. contributed to the design, data analysis, data interpretation, and revision of the paper; Y.W., X.L., L.L., Y.S., and D.Z. conducted an on-site study, database establishment, and data entry; Y.W.,X.L and Y.Z. contributed to data analysis, data interpretation, and revision of the paper; Z.S., M.S. edited and provided critical comments on the entire manuscript. All authors helped in the revision of the paper. All authors have read and approved the final version of the paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003eWe would like to express our gratitude to the Chenjiaqiao Community Health Service Center for their valuable assistance and support in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eThe L (2016) Trauma: a neglected US public health emergency. \u003cem\u003eThe Lancet\u003c/em\u003e 388.\u003c/li\u003e\n\u003cli\u003eZhou M, Wang H, Zeng X,\u003cem\u003e et al.\u003c/em\u003e (2019) Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. \u003cem\u003eLancet (London, England)\u003c/em\u003e 394, 1145-1158.\u003c/li\u003e\n\u003cli\u003eJizhe MN (2021) Main Data of the Seventh National Population Census. https://www.stats.gov.cn/english/PressRelease/202105/t20210510_1817185.html \u003c/li\u003e\n\u003cli\u003eThomas SA, Qiu Z, Chapman A,\u003cem\u003e et al.\u003c/em\u003e (2020) Editorial: Chronic Illness and Ageing in China. \u003cem\u003eFrontiers in public health\u003c/em\u003e 8, 104.\u003c/li\u003e\n\u003cli\u003eYuzhen Song* QZ, Xinzhu Zhou (2023) Analysis of Chronic Disease and Healthy Lifestyle of the Elderly in China\u0026mdash;Empirical Analysis Based on Data of CLHLS 2018. \u003cem\u003eOperations Research and Fuzziology\u003c/em\u003e 13, 4041-4051.\u003c/li\u003e\n\u003cli\u003eChen X, Giles J, Yao Y\u003cem\u003e et al.\u003c/em\u003e (2022) The path to healthy aging in China: a Peking University-Lancet Commission. \u003cem\u003eLancet (London, England)\u003c/em\u003e 400, 1967-2006.\u003c/li\u003e\n\u003cli\u003eNations U (2019) World Population Prospects 2019. https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/un_2019_wpp_vol2_demographic-profiles.pdf \u003c/li\u003e\n\u003cli\u003eHypertension. https://www.who.int/china/health-topics/hypertension \u003c/li\u003e\n\u003cli\u003eOrganization WH Global report on hypertension: the race against a silent killer https://www.who.int/publications/i/item/9789240081062 \u003c/li\u003e\n\u003cli\u003eFeng DX-bTW-gCL-lCTGYXJL (2023) Multimorbidity and influencing factors of hypertension， hyperlipidemia, and hyperglycemia among residents（30-79 years old） in Chongqing city. \u003cem\u003eChinese Journal of Prevention and Control of Chronic Diseases \u003c/em\u003e\u003c/li\u003e\n\u003cli\u003eZiping HYCJC (2017) Epidemiology analysis of inpatients with cardiovascular diseases in a certain hospital of Hefei in 2012 ～ 2014.\u003c/li\u003e\n\u003cli\u003eStrazzullo P, D\u0026apos;Elia L, Kandala NB\u003cem\u003e et al.\u003c/em\u003e (2009) Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. \u003cem\u003eBMJ (Clinical research ed)\u003c/em\u003e 339, b4567.\u003c/li\u003e\n\u003cli\u003eal ZZZHLJe (2017) Prevalence rate of H-type hypertension and its risk factors among medical examination population in a hospital of Shanghai in 2015. \u003cem\u003eAnhui Medical Journal\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eChina NHCotPsRo (2020) Report on the Nutrition and Chronic Diseases Status of Chinese Residents 2020. \u003cem\u003eACTA NUTRIMENTA SINICA\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eSociety CN (2023) \u003cem\u003eDIETARY REFERENCE INTAKES FOR CHINA. \u003c/em\u003eBeijing: People\u0026apos;s Medical Publishing House.\u003c/li\u003e\n\u003cli\u003eZhang JY, Zhang B, Tang J,\u003cem\u003e et al.\u003c/em\u003e (2021) [Deaths and life expectancy losses attributed to high-salt diet in Shandong province]. \u003cem\u003eZhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi\u003c/em\u003e 42, 527-530.\u003c/li\u003e\n\u003cli\u003eDiet high in sodium - Level 3 risk.\u003c/li\u003e\n\u003cli\u003eWANG ZENGWU HS (2023) Interpretation of Report on Cardiovascular Health and Diseases in China 2022. \u003cem\u003eChinese Journal of Cardiovascular Medicine\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eWANG Si-qi XJ-w, BAI Ya-min, LIU Min, JI Ning, LI Yuan, ZHANG Pu-hong, LI Ying-hua, WU Jing (2020) Salt reduction related knowledge, attitude, practice and its influencing factors among residents in six provinces of China in 2018. \u003cem\u003eChinese Journal of Health Education\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eOrganization WH (2023) WHO global report on sodium intake reduction. \u003c/li\u003e\n\u003cli\u003eFilippini T, Malavolti M, Whelton PK\u003cem\u003e et al.\u003c/em\u003e (2022) Sodium Intake and Risk of Hypertension: A Systematic Review and Dose-Response Meta-analysis of Observational Cohort Studies. \u003cem\u003eCurrent hypertension reports\u003c/em\u003e 24, 133-144.\u003c/li\u003e\n\u003cli\u003eJie-ming DX-fLM-bFLWL-yYMZ (2018) Analysis of Sodium Chloride Intake and Affecting Factors in Rural Community of Zhejiang Province. \u003cem\u003eACTA NUTRIMENTA SINICA\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003efu YY-pMS-lLX-hZJ-lHZ-yZC-yCX-yDX- (2019) Investigation on knowledge， attitude, and behavior of salt reduction for hypertension prevention in Liandu District. \u003cem\u003ePreventive Medicine\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eWei Yan ZL, Liping Xu, Jiahong Liu, Xu Yan, ZhaoJun, Xiaona Chen (2022) Analysis of salt intake and its influencing factors among residents of Hengfeng County of Jiangxi Province. \u003cem\u003eJiangxi Medical Journal\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eCHANG Xiao-yu DY, HE Jun, WANG Zhuo, LI Ya-ling, YAN Yi-han, CAO Jie, WANG Ding-bang, LIU Min, XU Jian-wei (2021) Analysis on salt-related knowledge, attitude, practice and its influencing factors among residents in two counties of Sichuan Province. \u003cem\u003eChinese Journal of Health Education\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eZHANG Xing ZX-r, SHEN Ying, CAI Ying, HU Kang, DONG Jing, GUO Xiao-lei, MA Ji-Xiang, SUN Xin-Ying (2018) Analysis on salt-reduction behaviors among patients with hypertension based on health belief model: a qualitative study. \u003cem\u003eChinese Journal of Health Education\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eMing-fei FFLY-hZP-hLYLLLＲNX-qWS-fZGWL-lS (2022) Analysis on the salt-related knowledge， attitudes， and behaviors among Chinese population. \u003cem\u003eChinese Journal of Health Education\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eAJZEN I. From intentions to actions: A theory of planned behavior [M]. Action control: From cognition to behavior. Springer. 1985: 11-39.\u003c/li\u003e\n\u003cli\u003eGeriatrics CHPaCGRCHACHBoCAftPoIEoHHBoC (2024) Chinese Guidelines for the Prevention and Treatment of Hypertension (2024 Revision). \u003cem\u003eChin J Hypertens\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eThe National Essential Public Health Service Program Office for Management of Hypertension in Primary Health Care NC \u0026amp; Care. fCDNCoHMiPH (2021) National Clinical Practice Guidelines on the Management of Hypertension in Primary Health Care in China (2020). \u003cem\u003eChinese Circulation Journal\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eMarakis G, Marques Domingues A, Crispo A\u003cem\u003e et al.\u003c/em\u003e (2023) Pertinence of Salt-Related Knowledge and Reported Behaviour on Salt Intake in Adults: A Cross-Sectional Study. \u003cem\u003eNutrients\u003c/em\u003e 15.\u003c/li\u003e\n\u003cli\u003eChen S, Shan LC, Tao W\u003cem\u003e et al.\u003c/em\u003e (2020) A survey of Chinese consumers\u0026apos; knowledge, beliefs and behavioural intentions regarding salt intake and salt reduction. \u003cem\u003ePublic Health Nutrition\u003c/em\u003e 23, 1450-1459.\u003c/li\u003e\n\u003cli\u003eYang Y, Wang J, Ma J\u003cem\u003e et al.\u003c/em\u003e (2021) Comparison of Salt-Related Knowledge and Behaviors Status of WeChat Users between 2019 and 2020. \u003cem\u003eNutrients\u003c/em\u003e 13.\u003c/li\u003e\n\u003cli\u003eHU Li-hua* HX, CAI Hua-xiu, LIANG Qian, et al. (2017) Investigation on prevalence of hypertension and risk factors among urban and rural residents in Jiangxi province. \u003cem\u003eChin J Hypertens\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eM\u0026oslash;rk T, L\u0026auml;hteenm\u0026auml;ki L Grunert KG (2019) Determinants of intention to reduce salt intake and willingness to purchase salt-reduced food products: Evidence from a web survey. \u003cem\u003eAppetite\u003c/em\u003e 139, 110-118.\u003c/li\u003e\n\u003cli\u003eXinying3* ZXDJGYXJBYLMZXGXMJS (2024) Influencing Factors of Salt-reduction Behavior among Residents： a Mixed Methods Research Based on the PRECEDE Model. \u003cem\u003eChinese General Practice\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eDING Jing-min LY, DU Wen-wen, ZHANG Ji-Guo, et al. (2022) Barriers and facilitators of salt reduction in Chinese restaurants in Chengdu. \u003cem\u003eChinese Journal of Health Education\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eMorris JM, Algert CS, Falster MO,\u003cem\u003e et al.\u003c/em\u003e (2012) Trends in planned early birth: a population-based study. \u003cem\u003eAmerican Journal of Obstetrics and Gynecology\u003c/em\u003e 207, 186.e181-188.\u003c/li\u003e\n\u003cli\u003eArmitage CJ \u0026amp; Conner M (2001) Efficacy of the Theory of Planned Behaviour: a meta-analytic review. \u003cem\u003eThe British journal of social psychology\u003c/em\u003e 40, 471-499.\u003c/li\u003e\n\u003cli\u003eRich A, Brandes K, Mullan B\u003cem\u003e et al.\u003c/em\u003e (2015) Theory of planned behavior and adherence in chronic illness: a meta-analysis. \u003cem\u003eJournal of Behavioral Medicine\u003c/em\u003e 38, 673-688.\u003c/li\u003e\n\u003cli\u003eMcEachan RRC, Conner M, Taylor NJ\u003cem\u003e et al.\u003c/em\u003e (2011) Prospective prediction of health-related behaviours with the Theory of Planned Behaviour: a meta-analysis. \u003cem\u003eHealth Psychology Review\u003c/em\u003e 5, 97-144.\u003c/li\u003e\n\u003cli\u003eMorowatisharifabad MA, Salehi-Abargouei A, Mirzaei M,\u003cem\u003e et al.\u003c/em\u003e (2019) Behavioral beliefs of reducing salt intake from the perspective of people at risk of hypertension: An exploratory study. \u003cem\u003eARYA atherosclerosis\u003c/em\u003e 15, 59-66.\u003c/li\u003e\n\u003cli\u003eHunter RW, Dhaun N Bailey MA (2022) The impact of excessive salt intake on human health. \u003cem\u003eNature reviews Nephrology\u003c/em\u003e 18, 321-335.\u003c/li\u003e\n\u003cli\u003eZhao F, Zhang P, Zhang L\u003cem\u003e et al.\u003c/em\u003e (2015) Consumption and sources of dietary salt in family members in Beijing. \u003cem\u003eNutrients\u003c/em\u003e 7, 2719-2730.\u003c/li\u003e\n\u003cli\u003eZhang L, Zhao F, Zhang P,\u003cem\u003e et al.\u003c/em\u003e (2015) A pilot study to validate a standardized one-week salt estimation method evaluating salt intake and its sources for family members in China. \u003cem\u003eNutrients\u003c/em\u003e 7, 751-763.\u003c/li\u003e\n\u003cli\u003ePacific WHOROftW (2022) Reducing salt intake in China: cooking healthier meals at home. https://www.who.int/westernpacific/news-room/feature-stories/item/reducing-salt-intake-in-china--cooking-healthier-meals-at-home \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Middle-age, Elderly, hypertension, salt, theory of planned behavior, structural equation modeling, influencing factors","lastPublishedDoi":"10.21203/rs.3.rs-7325252/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7325252/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003e This study aims to guide the development of behavioral interventions and promote salt reduction dietary practices. Using the Theory of Planned Behavior (TPB) as the theoretical framework and Structural Equation Modeling (SEM) as the methodological basis, we explored the current status of salt reduction dietary intention and its influencing factors in middle-aged and elderly hypertensive patients.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eFrom March to November 2023, convenience sampling was employed to conduct face-to-face surveys by using the Likert scale among 590 middle-aged and elderly hypertensive patients across 38 districts and counties in Chongqing. Structural Equation Model (SEM) was used to analyze the relationship between salt reduction intention (INT) and attitude towards salt reduction (ATT), subjective norms of salt reduction (SN), and perceived behavioral control of salt reduction (PBC). We also evaluated the bivariate correlation among attitude towards salt reduction, subjective norms of salt reduction, and perceived behavioral control of salt reduction in middle-aged and elderly hypertensive patients aged 45 years and above.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e\u003cp\u003eA sample size of 558 respondents was included in the analysis, of which 70.8% had the intention to reduce salt in their diets; 55.2% were female; 48% had junior high school education or higher; 73.5% were married; 44.1% were home cooks; households with home addresses in \u0026ldquo;Central City(CC),\u0026rdquo; \u0026ldquo;Main City New Area (MCNA),\u0026rdquo; \u0026ldquo;Northeast Chongqing Three Gorges Reservoir Town Cluster (NCTGRT),\u0026rdquo; and \u0026ldquo;Southeast Chongqing Wuling Mountains Town Cluster (SCWMT\")\u0026rdquo; accounted for 29.4%, 27.6%, 29.6%, and 13.4%, respectively; 50.5% had no chronic diseases, except hypertension; and 61.3% were elderly, and 38.7% were middle-aged individuals. Salt-reducing diet attitudes (β\u0026thinsp;=\u0026thinsp;0.22, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and perceived behavioral control (β\u0026thinsp;=\u0026thinsp;0.70, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) had a positive effect on salt-reducing diet intentions. The effect of perceived behavioral control of salt-reduced diets was pronounced. Subjective scope (β\u0026thinsp;=\u0026thinsp;0.14, P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) had a non-significant effect on salt-reducing diet intentions.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThis study highlights the central influence of salt-reducing dietary attitudes and perceived behavioral control in salt-reducing dietary intentions among middle-aged and elderly hypertensive patients. Future nutritional health education should prioritize exploring pragmatic ways of attitude-to-practice.\u003c/p\u003e","manuscriptTitle":"Salt reduction dietary intention and influencing factors in middle-aged and elderly hypertensive patients based on the theory of planned behavior","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-17 18:50:30","doi":"10.21203/rs.3.rs-7325252/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"263456405612860558956224662128024054048","date":"2025-09-15T16:09:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"109095138340135023945528848548226314003","date":"2025-09-15T03:58:13+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-10T14:36:03+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-26T06:54:16+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-20T08:09:04+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-19T10:29:30+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-08-19T10:25:53+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fb67c772-86e2-475a-9c8b-7cf98a314bc0","owner":[],"postedDate":"September 17th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-09-17T18:50:30+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-17 18:50:30","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7325252","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7325252","identity":"rs-7325252","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}