Preferences of Young Adults Regarding Dissemination of Online Vitamin D Information

Assessment of knowledge, attitudes and practice towards Vitamin D among university students in Pakistan

Background

Pakistan has one of the highest reported incidence of vitamin D deficiency in studies conducted worldwide. However, there has been very limited exploration of vitamin D related knowledge, attitudes and practices among healthy youth in Pakistan.

Methods

A cross-sectional survey was conducted among youth (aged > 16 years) from two engineering universities in Pakistan. Participants were asked questions on their concern about vitamin D levels, testing, and supplementation practices. Knowledge was examined using questions about food sources, health benefits and factors affecting vitamin D production within the human body. Of the 900 eligible students invited to participate, 505 (56%) completed the questionnaire and were included in the analysis.

Results

Only 9% participants were able to identify the correct food sources of vitamin D, 33% were aware of the bone health benefits (bone health and calcium absorption) of vitamin D and 36% identified sunlight exposure as a factor influencing vitamin D production. Knowledge about food sources and health benefits of vitamin D was not associated with gender and individuals concern about their levels. Those tested and taking supplements were more likely to identify bone related health benefits and factors affecting vitamin D production. Forty percent male and 52% female students expressed concern that their vitamin D levels were too low. However, 72% participants reported that they had never been tested for vitamin D levels. Use of supplements was significantly higher among female students (F = 52% vs M = 37%; P = 0.003). Those who had been tested for vitamin D deficiency were more likely to take supplements.

Conclusion

Despite being identified as a high-risk population, knowledge about vitamin D was limited among university students. Interventions are needed to increase awareness about the importance of vitamin D for health, including the need for exposure to sunlight and adequate dietary intake of vitamin D. Our study provides much needed baseline evidence for making health-policy recommendations for this vulnerable population group.

Exploring young adult perspectives on the use of gamification and social media in a smartphone platform for improving vegetable intake

Young adults are the poorest consumers of vegetables. Social media and smartphones are frequently used by this demographic and could serve as an engaging medium for nutrition promotion. Five focus groups were conducted to capture participants' perceptions of a theory-based gamified self-monitoring app for improving vegetable intake of young adults. Ranking activities were used to gather feedback on preferences for social media posts. Data arising from group discussion were analysed using NVivo software using a deductive approach to group common ideas into themes. Thirty two participants (14 males) attended (mean age 23.1 (SD 2.7) years). Qualitative analyses of open discussion revealed two major themes regarding preferred features for a smartphone app; (1) the use of visual guides for estimating quantities of vegetables and tracking progress, and (2) a simple interface. Gamification strategies such as earning badges were viewed more positively than the use of a self-reward framework. Social media posts which presented food pictures and recipes were ranked most motivating, while awareness-raising posts received lower scores. Participants indicated a preference for viewing but reluctance to post information onto social media. "Just in time" situational cues were ranked highly and the use of an "authoritative" tone was preferred and associated with credibility. Young adults also ranked messages containing "Gen Y" language highly, with a preference for those which were personally relevant. The proposed use of social media and mobile-gaming was seen as an acceptable approach for improving vegetable intake. Materials should be visually appealing, simply designed, credible, and personally relevant to appeal to this population. This feedback may inform future mobile-phone based interventions targeting improved nutrition in young adults.

A randomized, controlled trial evaluating the efficacy of an online intervention targeting vitamin D intake, knowledge and status among young adults

Background

Vitamin D plays a key role in bone health. Consuming adequate vitamin D during young adulthood is important due to the development of peak bone mass; however, many Canadian young adults do not meet vitamin D recommendations. This study aimed to improve knowledge, perceptions, dietary intake and blood concentrations of vitamin D among a sample of young adults.

Methods

Using a pre-post design, 90 Ontario adults (38 men, 52 women; 18–25 years), were randomly assigned to intervention or control groups. Participants completed a socio-demographic survey, pre-post food frequency questionnaire, and a vitamin D knowledge questionnaire (3 time-points). The intervention group watched a video, received online information and tracked intake of vitamin D using a mobile application for 12 weeks. A sub-sample of participants completed pre-post blood 25(OH)D₃ tests. Univariate ANOVA tested pre-post between-group differences in vitamin D intake and status. Repeated-measures ANOVA tested between-group differences in vitamin D knowledge and perceptions across 3 time-points.

Results

Mean vitamin D intake in the sample increased significantly from pre-test (M = 407, SD = 460 IU) to post-test (M = 619, SD = 655 IU), t(88) = 5.37, p < 0.001. Mean intake increased significantly more in the intervention than control group after controlling for gender and education, F(1, 85) = 4.09, p = 0.046. Mean blood vitamin D₃ was significantly higher among non-Caucasian than Caucasian participants at baseline, t(56.7) = 3.49, p = 0.001. Mean blood vitamin D₃ increased significantly from pre-test (M = 28, SD = 16 nmol/L) to post-test (M = 43, SD = 29 nmol/L), t(53) = 11.36, p < 0.001, but did not differ significantly between groups. The increase in vitamin D knowledge from time 1–3 was significantly higher in the intervention than control group (t(88) = 2.26, p = 0.03). The intervention group (M = 3.52, SE = 0.13) had higher overall perceived importance of vitamin D supplementation than the control (M = 3.16, SE = 0.12), F(1, 88) = 4.38, p = 0.04, η_p² = 0.05.

Conclusions

Although recommendations suggest blood 25(OH)D₃ concentrations of ≥50-75 nmol/L, vitamin D status was below national recommendations. While participating in an intervention did not improve vitamin D status, it led to increased vitamin D intake, knowledge and perceived importance of supplementation.

Trial registration

ClinicalTrails.gov registration #: NCT02118129.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-016-0443-1) contains supplementary material, which is available to authorized users.