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Trial registered on ANZCTR
Registration number
ACTRN12621000642886
Ethics application status
Approved
Date submitted
19/04/2021
Date registered
28/05/2021
Date last updated
23/08/2024
Date data sharing statement initially provided
28/05/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Investigating the impact of Online Grocery Shopping on Blood Pressure in Individuals with Hypertension
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Scientific title
The Online Grocery Shopping (OGS) Trial: Investigating the impact of a Novel Method on Blood Pressure Among Individuals with Hypertension.
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Secondary ID [1]
303490
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National Health and Medical Research Council APP1200105
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Universal Trial Number (UTN)
U1111-1264-6104
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Trial acronym
OGS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hypertension
320808
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Condition category
Condition code
Cardiovascular
318629
318629
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0
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Hypertension
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Each participant in the intervention arm of the study will receive an Online Grocery Shopping (OGS) web-browser application, such that every time they purchase groceries online, OGS application will provide immediate on-screen, interpretive (i.e. colour-coded symbol) nutrition information and specific suggestions for lower salt alternatives. Participants will be asked to self measure their blood pressure at 3 time points (baseline, week 6 and week 12) during the study using a wireless home blood pressure monitor which will be provided to them. Participants will also be required to attend a local pathology centre to provide a spot urine sample for electrolyte measurement at two time points (baseline and week 12). Participants will be required to use the Online Grocery Shopping (OGS) web-browser application to carry out all of their grocery shopping for a period of 12 weeks.
Participants will be given detailed instructions on how to download the web-browser extension (the intervention tool). Once downloaded, it works by way of a pop up screen offering healthy alternatives to certain products which the participant can select to purchase if they so wish. No training is necessary as it is self-explanatory; however, the intervention group will be supplied with a FAQs sheet on what to expect and how to interpret the information provided on the pop up screen if needed.
We will be conducting a mixed method process evaluation of the intervention which includes assessing implementation fidelity. We will triangulate routinely-collected data captured by the web browser (e.g. food purchases and frequency of use of the intervention tool) and semi-structured interviews with a subset of intervention participants to understand acceptability of the intervention, implementation fidelity and the barriers and facilitators of implementation.
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Intervention code [1]
319779
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Treatment: Other
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Comparator / control treatment
No Treatment
Control group will still be required to purchase their groceries online via Woolworths.
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Control group
Active
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Outcomes
Primary outcome [1]
326592
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Difference in mean sodium density (mg sodium per kcal energy) of grocery purchases between the intervention and control groups over 12 weeks.
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Assessment method [1]
326592
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Timepoint [1]
326592
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baseline to 12 weeks
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Secondary outcome [1]
392019
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Change in mean systolic and diastolic blood pressure from baseline to 12 weeks. Measured with a wireless blood pressure monitor validated for home blood pressure monitoring supplied to all participants.
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Assessment method [1]
392019
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Timepoint [1]
392019
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from baseline to 12 weeks
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Secondary outcome [2]
392020
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Change in mean urinary salt (sodium) excretion
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Assessment method [2]
392020
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Timepoint [2]
392020
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from baseline to 12 weeks
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Secondary outcome [3]
392021
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Change in mean salt content of purchased food overall and by categories.
The web browser tool will collect participant data on what foods were purchased.
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Assessment method [3]
392021
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Timepoint [3]
392021
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from baseline to 12 weeks.
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Secondary outcome [4]
392022
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Change in self-reported mean dietary salt intake.
We will be using the Automated Self-Administered 24-hour (ASA 24) Dietary Assessment Tool to collect information about dietary intake (https://asa24.nci.nih.gov/)
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Assessment method [4]
392022
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Timepoint [4]
392022
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from baseline to 12 weeks.
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Secondary outcome [5]
395652
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Change in self-reported mean dietary fruit intake.
We will be using the Automated Self-Administered 24-hour (ASA 24) Dietary Assessment Tool to collect information about dietary intake (https://asa24.nci.nih.gov/)
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Assessment method [5]
395652
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Timepoint [5]
395652
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from baseline to 12 weeks.
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Secondary outcome [6]
395653
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Change in self-reported mean dietary vegetable intake.
We will be using the Automated Self-Administered 24-hour (ASA 24) Dietary Assessment Tool to collect information about dietary intake (https://asa24.nci.nih.gov/)
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Assessment method [6]
395653
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Timepoint [6]
395653
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from baseline to 12 weeks.
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Secondary outcome [7]
395666
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Change in self-reported mean dietary processed meats intake.
We will be using the Automated Self-Administered 24-hour (ASA 24) Dietary Assessment Tool to collect information about dietary intake (https://asa24.nci.nih.gov/)
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Assessment method [7]
395666
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Timepoint [7]
395666
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from baseline to 12 weeks
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Secondary outcome [8]
395667
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Change in self-reported mean dietary salty snacks intake.
We will be using the Automated Self-Administered 24-hour (ASA 24) Dietary Assessment Tool to collect information about dietary intake (https://asa24.nci.nih.gov/)
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Assessment method [8]
395667
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Timepoint [8]
395667
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baseline to 12 weeks
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Secondary outcome [9]
395668
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Change in self-reported mean dietary sauce intake.
We will be using the Automated Self-Administered 24-hour (ASA 24) Dietary Assessment Tool to collect information about dietary intake (https://asa24.nci.nih.gov/)
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Assessment method [9]
395668
0
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Timepoint [9]
395668
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baseline to 12 weeks
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Eligibility
Key inclusion criteria
We will include people who:
• Are adults between 18 and 75 years of age.
• Have a diagnosis by their clinician of high blood pressure or are currently taking a stable dose of blood pressure lowering medication, defined as no change to the dose in the past 6 months.
• Regularly shop and purchase most of their groceries online via Woolworths and plan to continue for the approx. 4 months duration of the study, OR Regularly shop and purchase most of their groceries online via a non-Woolworths retailer (e.g. Coles); but are willing to switch to shop at Woolworths online for the duration of the study.
• Use, or will use, a computer (laptop or desktop) to shop for their groceries online (i.e. not a mobile phone or tablet/iPad)
• Are assessed as demonstrating high salt purchasing behaviour
• Do not have another household member already participating in this trial
• Are the main person who shops for food and groceries in their household
• Have an upper arm circumference of less than 42cm (i.e. do not require an extra-large blood pressure cuff when measuring blood pressure)
• Successfully completes the run-in procedures, which will occur at the beginning of the study
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
We will exclude those who:
• Are less than 18 years of age or 75 years of age or older
• Are unable or unwilling to provide informed consent.
• Have an upper arm circumference of more than 48cm (measured mid-way between your shoulder and elbow).
• Have one or more of the following advanced medical conditions:
o Congestive heart failure (stage D)
o Stage 4/advanced/metastatic cancer
o Chronic kidney disease (CKD), Chronic Kidney failure (stage 4) and end-stage renal disease on dialysis (Stage 5)
o Advanced liver disease, Cirrhosis, end-stage liver disease (ESLD)
o Those with a life expectancy less than 1 year
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by phone/fax/computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation).
Stratified allocation: randomisation will be performed by an online computerised system in a 1:1 ratio and stratified by age (=50 years/>50 years), sex, and baseline BP medication use (Yes/No).
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
We randomised a total of 185 participants. For primary outcome analyses, our target sample size provides >95% power to detect a reduction a 20% reduction in sodium density between the intervention and comparator arms assuming a two-sided 5% level of significance and a mean (SD) sodium density of purchased packaged foods = 1.08 (0.35) mg/kcal
The change to primary outcome was made in August 2022, by which point 35 participants (2% of sample size planned for original primary outcome, 27% of sample size planned for revised primary outcome, 19% of final sample size) had been randomised.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
30/09/2021
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Actual
2/07/2021
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Date of last participant enrolment
Anticipated
30/06/2023
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Actual
30/06/2023
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Date of last data collection
Anticipated
29/09/2023
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Actual
29/09/2023
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Sample size
Target
127
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Accrual to date
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Final
185
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,TAS,WA,VIC
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Funding & Sponsors
Funding source category [1]
307907
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Government body
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Name [1]
307907
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NHMRC
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Address [1]
307907
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16 Marcus Clarke St,
Canberra ACT 2601
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Country [1]
307907
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Australia
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Primary sponsor type
Other Collaborative groups
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Name
The George Institute for Global Heath
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Address
Level 5, 1 King St
Newtown
NSW 2042
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Country
Australia
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Secondary sponsor category [1]
308620
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None
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Name [1]
308620
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Address [1]
308620
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Country [1]
308620
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
307906
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University of New South Wales Human Research Ethics Committee (UNSW HREC)
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Ethics committee address [1]
307906
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UNSW Sydney Research Ethics and Compliance Support (RECS) Rupert Myers Building Kensington Sydney NSW 2033
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Ethics committee country [1]
307906
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Australia
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Date submitted for ethics approval [1]
307906
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23/11/2020
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Approval date [1]
307906
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01/02/2021
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Ethics approval number [1]
307906
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HC200970
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Summary
Brief summary
Approximately 4.1 million Australian adults suffer from hypertension, which was estimated to cause 26,000 deaths in Australia in 2017. Excess dietary salt consumption is a leading cause of high blood pressure, and dietary guidelines specifically recommend the avoidance of foods high in salt for blood pressure lowering. Yet, current individual-based education and clinical counselling to reduce salt intakes has shown limited effectiveness, is resource intensive, costly, and has limited reach. Hypertensive patients in Australia currently consume on average ~10g salt per day, nearly twice the World Health Organisation recommended maximum; with most (~80%) dietary salt derived from eating packaged and processed foods. Thus, innovative strategies are urgently needed to help hypertensive patients reduce their dietary salt intake. The overall goal of this research is to determine the effectiveness of a novel, scalable, and sustainable salt reduction intervention (online grocery shopping, OGS) for lowering blood pressure (BP) amongst patients with hypertension. We will do this by conducting a large-scale randomised controlled trial (RCT) using an online grocery shopping intervention designed specifically for Woolworths, Australia’s largest online grocery retailer. The OGS will be provided to the study participants as a web-browser application, such that every time participants purchase groceries online, OGS will provide immediate on-screen, interpretive (i.e. colour-coded symbol) nutrition information and specific suggestions for lower salt alternatives. The personalised approach – consumers can maintain their usual dietary patterns and are guided to choose similar, but lower-salt alternative products – offers flexibility and caters to personal preferences. If this intervention demonstrates even a 2 mmHg BP lowering effect, then it would be meaningful because 2 mmHg lower BP translates into an approximately 10% reduction in premature cardiovascular disease (CVD) amongst hypertensive patients. There is currently no other platform that could improve dietary behaviours more rapidly to reduce BP amongst Australians. The OGS online grocery shopping intervention has the potential to have a major effect on BP control and prevention of CVD in Australia and globally.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
108886
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A/Prof Jason Wu
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Address
108886
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The George Institute for Global Health
Level 5, 1 King St
Newtown
NSW 2042
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Country
108886
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Australia
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Phone
108886
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+61 2 8052 4648
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Fax
108886
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Email
108886
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[email protected]
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Contact person for public queries
Name
108887
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Jason Wu
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Address
108887
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The George Institute for Global Health
Level 5, 1 King St
Newtown
NSW 2042
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Country
108887
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Australia
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Phone
108887
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+61 2 8052 4648
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Fax
108887
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Email
108887
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[email protected]
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Contact person for scientific queries
Name
108888
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Jason Wu
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Address
108888
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The George Institute for Global Health
Level 5, 1 King St
Newtown
NSW 2042
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Country
108888
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Australia
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Phone
108888
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+61 2 8052 4648
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Fax
108888
0
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Email
108888
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
We have not obtained ethical approval for individual participant data to be publicly shared. Furthermore we are not obtaining consent from participants to make their individual participant data publicly available. Only study investigators will have access to de-identified individual participant data, as approved by ethics.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
10734
Ethical approval
[email protected]
381457-(Uploaded-17-02-2021-16-08-36)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Protocol for a novel sodium and blood pressure reduction intervention targeting online grocery shoppers with hypertension - the SaltSwitch Online Grocery Shopping randomized trial.
2022
https://dx.doi.org/10.1016/j.ahj.2022.06.007
N.B. These documents automatically identified may not have been verified by the study sponsor.
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