Retirees meet salt-reduction campaigns on Facebook — and education is what separates their health beliefs

How should a campaign to reduce salt intake be designed to reach retired people? This study examined the relationships between media exposure, attitude towards persuasive messages, and the Health Belief Model, and which demographic characteristics made a difference.

A quantitative survey using a Google Form questionnaire distributed through social media channels and by word of mouth, with 400 retirees aged 51 to 70 living in Bangkok, proportioned by age band against the real population of 1,255,572 as of December 2019. Analysis used descriptive and inferential statistics at the 0.05 significance level.

• Overall campaign media exposure was moderate, highest on Facebook, then websites and YouTube. The least-encountered channel was radio, followed by events and posters.
• Attitudes towards persuasive messages were very high on every item. The highest-rated wishes were for messages that state how severe the disease is, and messages that can be applied in daily life — matching the principle of pairing high threat with high efficacy.
• Of eight demographic characteristics tested, only two produced a significant difference in health beliefs: education level and main source of income. Gender, age, marital status, employment status, monthly income and living arrangement made no difference.
• Persuasive messages correlated positively and moderately with four dimensions of the Health Belief Model — perceived susceptibility, perceived severity, perceived benefits, and self-efficacy — but only weakly with perceived barriers.
• Media exposure correlated significantly with both attitude and health beliefs, but every one of those correlations was low to very low — seeing the campaign more often did not move health beliefs much.
• The item respondents recognised most strongly was that eating salty food regularly carries a high risk of kidney disease, and that kidney disease would seriously affect their lives.

The authors' recommendation follows the result: direct persuasive messaging at people educated to secondary level or below, since that is the group with weaker health beliefs. And since Bangkok retirees encounter these campaigns most on Facebook, a campaign still spending on radio and posters may simply not reach them.