Abstract
BACKGROUND: Unhealthy dietary habits such as high-sodium intake, are socially embedded and often resistant to individual-level interventions. Family-led approaches, where 1 member initiates change within the household, may offer a more effective alternative. OBJECTIVES: This pilot study assessed the feasibility and preliminary impact of a digitally delivered, young adult-led sodium reduction intervention on household-level knowledge, attitudes, and behaviors in Singapore. METHODS: In a pre-post, single-group design, young adults completed a co-created, self-paced online course featuring video lessons, interactive assignments, and personalized feedback. Over 2 weeks, participants developed sodium-reduction goals and implemented them through tailored 4-wk action plans. Weekly reflections and course metadata captured goal progress, effort, strategies, and barriers. Family members completed parallel preintervention and postintervention surveys, although they did not receive the intervention directly. Surveys assessed constructs from the Theory of Planned Behavior. Multivariable linear mixed models evaluated changes over time, adjusting for demographic and health characteristics. RESULTS: Overall, 35 young adults (mean age: 24.4 y; standard deviation [SD]: 3.1) and 79 family members (mean age: 43.0 y; SD: 15.5) completed the intervention. Young adults took a mean of 7.7 d to complete the course, with most crafted goals focusing on reducing sodium intake when eating out. Participants reported higher effort and success with personal goals than family-oriented ones. Perceived behavioral control showed the greatest improvement among both young adults (+2.64, 95% confidence interval [95% CI]: 2.05, 3.22) and family members (+1.82, 95% CI: 1.42, 2.22). Significant gains were also observed in knowledge, behaviors, subjective norms, and behavioral intentions for all participants (all P < 0.001). Engagement metrics (e.g., time spent on the course, effort put into the action plans) were not associated with differential changes in most outcomes. CONCLUSIONS: A young adult-led, family-focused digital intervention was feasible and demonstrated preliminary improvements in household sodium-related outcomes, warranting further evaluation in larger, more diverse populations.