Knowledge, attitude, and practice of general practitioners in Dammam, Saudi Arabia towards Vitamin D supplementation to infants

Knowledge, attitude, and practice toward pediatric vitamin D deficiency among parents

Objective

To investigate the knowledge, attitude, and practice (KAP) towards pediatric vitamin D deficiency (VitD) among parents and explore the risk factors of their knowledge, attitude, and practice.

Methods

This cross-sectional study enrolled parents in our Hospital between November 2022 and January 2023.

Results

A total of 621 valid questionnaires were collected in this study. The knowledge, attitude, and practice scores were 6.13 ± 3.07 (theoretical score range: 0-13), 31.13 ± 6.20 (theoretical score range: 9-45), and 27.47 ± 4.21 (theoretical score range: 9-45), respectively; the mean knowledge score was <60%, indicating poor knowledge. Commercial and service industry workers and a monthly income ≥5,000 CNY were independently associated with sufficient knowledge (all P < 0.05). The knowledge score, ethnic minorities, divorced/widows, and spouses with a master's degree or above were independently associated with positive attitudes (all P < 0.05). The attitude score, female, non-urban, undergraduate education, commercial and service industry worker, and office worker were independently associated with proactive practice (all P < 0.05). Those characteristics could help design future KAP interventions on vitD deficiency.

Conclusions

This study demonstrated poor knowledge, positive attitude, and proactive practice regarding pediatric VitD deficiency among parents. Targeted interventions and educational programs should be developed to improve parental knowledge.

Risk perception of sun exposure and knowledge of vitamin D among the healthcare providers in a high-risk country: a cross-sectional study

BACKGROUND

High levels of vitamin D deficiency are commonly reported even in regions with abundant sunshine. This necessitates a comprehensive understanding of the determinants that influence sun exposure practices. As the primary source of health-related knowledge for the general public, the attitude of the healthcare professionals towards sunlight and their awareness related to vitamin D deficiency can be critical in this regard.

METHODS

A cross-sectional survey was conducted among 2,242 physicians, intern doctors, and senior medical students in Bangladesh from October 2019 to February 2020. A pre-tested structured questionnaire (containing twelve close-ended questions) was used. The perceptions of health risks due to sun exposure, and basic knowledge of the physiological and epidemiological aspects of vitamin D deficiency were tested.

RESULTS

An overall negative attitude towards sunlight in the context of Bangladesh was highlighted - 68% participants thought regular sun exposure would be harmful or very harmful; 26% thought the level of UV radiation was very high; 44% recommended using sunscreen always; skin burns, heat stroke, and cancer were selected as potential consequences of regular sun exposure by 45%, 21%, and 30% respondents respectively. Overall knowledge regarding vitamin D deficiency appeared to be biased towards bone health; other symptoms and associated illnesses not having obvious link to Calcium-metabolism were identified much lesser frequently. Furthermore, 'sunrise to 10 am' was identified as the best time to get vitamin D by 69% participants; 60% believed < 30 min of weekly sun exposure would be sufficient for the Bangladeshi population; an only 33% identified that prevalence of vitamin D insufficiency in Bangladesh would be 50% or more. Taking vitamin D-rich food was suggested by more respondents over regular sun exposure (43% vs. 33%) as more effective remedial strategy to curb vitamin D deficiency in Bangladesh.

CONCLUSION

In addition to highlighting some crucial knowledge gaps, results from this study provides a comprehensive baseline dataset for knowledge and attitude regarding the public health aspects of vitamin D deficiency among the healthcare providers in Bangladesh, which would be generalizable to other countries with similar socio-demographic context, and will facilitate taking more effective policies worldwide.

Factors influencing initiation and discontinuation of vitamin D supplementation among children 1-24-months-old

OBJECTIVES

To determine vitamin D supplementation frequency among children aged 1-24 months, factors that influence adherence, and reasons for discontinuation of initiated vitamin D.

METHODS

This cross-sectional study was conducted using a questionnaire administered to the mothers via face-to-face interview of 560 children aged from 1 to 24 months admitted to outpatient clinics from June to December 2017.

RESULTS

A total of 351 children were administered vitamin D, and the rate of supplementation in the first year of life was 83%, while it was only 28% between 13 and 24 months. The rate of vitamin D supplementation was higher among exclusively formula-fed children (p < .05). When the data were analyzed using logistic regression analysis, only visit family physicians were statistically significant independent variable in increasing supplementation (p < .05). Compared with family refusal, the rate of discontinuation of vitamin D by the healthcare providers was higher after the first year of life (p < .05). The rate of vitamin D discontinuation by healthcare providers, especially by nurses who considered the duration of supplementation adequate, was statistically significantly higher when compared with the fontanel closure and other independent variables (p < .05).

CONCLUSION

The rate of vitamin D supplementation was higher among families who visited family physicians, which suggests the importance of well-baby visits. Since vitamin D supplementation was less common among exclusively breastfed children, mothers should be educated. Healthcare professionals need further education about the importance of vitamin D supplementation and indications for discontinuation.

Outcomes of an intervention program for family physicians on well-child care for children under 5 years in Suez Canal region, Egypt

Background

Family physicians play a critical role in providing well-child care (WCC) in Egypt to children under five. Family physicians’ knowledge, attitudes, and practices (KAP) on WCC must be appropriately developed to optimize health status and developmental potential in children. The study aimed to evaluate the effect of an innovative, 6-month educational training program on the KAP of family physicians toward WCC. This pre-post interventional study was conducted from September 2014 to March 2016 on a convenience (Suez Canal University) sampling of 39 family physicians who were under training in the Family Medicine Department at the Faculty of Medicine Suez Canal University. After 6 months of implementing the training program, KAP toward WCC was assessed by a 79-item questionnaire at baseline.

Results

The overall mean percentage of participants’ KAP scores was statistically and significantly increased from 23.68% ± 13.68%, 67.15% ± 6.75%, and 40.98% ± 12.24% to 88.46% ± 8.09%, 88.62% ± 5.17%, and 71.79% ± 14.63%, respectively (p < 0.001). Recognizing the appropriate anticipatory guidance for the use of car seats made up the epitome of what was lacking in posttest knowledge (53.8%). Tendency of performing red reflex testing especially reduced refinement in posttest attitudes (53.8%). The least improved post-intervention practices were anticipatory guidance (7.7%), examination for developmental hip dysplasia (28.2%), and caries (43.6%), eliciting parents’ concerns for hearing and speech (38.5%) and vision screening (38.5%).

Conclusions

The educational program had positive effects on family physicians’ KAP toward well-child care for children under five. Further interventions are needed for improving the family physicians’ practices of sensory screening, assessment of hip dysplasia, oral health, and anticipatory guidance.

Knowledge, attitude and practice of health care workers on measuring adult vitamin D level, diagnosis of deficiency, and management of consequent health conditions in three ecologies of Ethiopia: a cross-sectional study

BACKGROUND

Vitamin D is essential for health and its shortage exacerbates overall mortality. Health care workers (HCWs) need to educate on its uses and sources although studies indicate their low level of practice. The main aim of this study is therefore to assess the knowledge, attitude and practice of measuring adult vitamin D status, diagnosis of deficiency and managing health consequences among HCWs in Ethiopia.

METHODS

This study was conducted in three ecologies covering lowland, midland and highland districts. A total of 405 health care workers with different levels were interviewed. Tablets were used for data collection to archiving in a cloud server. Data were exported to Stata version 14 software for cleaning and analysis. Rates were computed and the Chi-square test was used to compare differences between the two groups. Binary logistic regression was used to measure the strength, direction and significance of the association between different covariates and the practice of HCWs.

RESULT

The level of knowledge, positive attitude and good practice in measuring adult vitamin D status, diagnosis of deficiency and managing health consequences among HCWs was 210 (51.8%), 261(63.5%) and 195(47.4%) respectively. The odds of good practice in the provision of adult vitamin D service were AOR = 6.87: 95% CI (3.57, 13.21) and AOR = 2.20: 95% CI (1.23, 3.92) times higher among HCWs in Addis Ababa and highlands compared with those working in lowlands. Good practice among clinicians was AOR = 4.26: 95% CI (1.48, 12.25) times higher compared with those working in leadership positions. The likelihood was AOR = 1.96: 95% CI (1.19, 3.23) times higher among those with good knowledge compared with those with poor knowledge. Besides, good practice in adult vitamin D service provision was AOR = 2.30: 95% CI (1.40, 3.78) times higher among those with positive attitude compared with those who had negative attitude.

CONCLUSIONS

A little over half of HCWs have good knowledge and close to two-thirds of them have positive attitude while less than half of them have good practice on adult vitamin D deficiency. Besides, HCWs' residential ecology, clinical position, knowledge and attitude is associated with good practice on adult vitamin D. It is essential to provide rigorous and continuous training for HCWs focusing on their deployment ecology.

Knowledge, attitude and practice of health care practitioners in Saudi Arabia, with regard to prevention of vitamin D deficiency in infancy

Objectives:

To understand the knowledge, attitude, and practice of healthcare practitioners in Saudi Arabia, with regard to vitamin D supplementation.

Methods:

A cross-sectional survey was conducted among healthcare practitioners in the Tabuk region of Saudi Arabia between January 2015 and December 2016. A questionnaire assessing knowledge, attitude and practice with regard to prevention of vitamin D deficiency was distributed to 100 healthcare practitioners.

Results:

There was a good understanding of the importance of vitamin D deficiency; and overall practices were good. The average knowledge score was 4.75/8 (range 2-7), largely due to 85% of recipients identifying sun exposure between 6-7 am as the optimal time. There was a lack of understanding also, that as little as 10 minutes exposure is of benefit.

Conclusion:

This study highlights the need for distribution of the recommendations for vitamin D supplementation in KSA, as widely as possible. This study suggests that healthcare practitioners understand the importance of correction of vitamin D deficiency. Deficiencies in knowledge with regard to sun exposure were identified. Dissemination of this information is, therefore, likely to impact significantly on the practice of a receptive clinical population.

The Prevalence of Hypovitaminosis D and Its Associated Risk Factors Among Women of Reproductive Age in Saudi Arabia: A Systematic Review and Meta-Analysis

Vitamin D deficiency is currently a worldwide epidemic. Middle Eastern countries, including Saudi Arabia, have high vitamin D deficiency prevalence, most prominently among women, despite their plentiful year-round sunshine. Previous research investigating vitamin D status among Saudi women of reproductive age (15-49 years) is scarce, and no study has used a nationally representative sample, so this review quantified overall hypovitaminosis D prevalence among women in Saudi Arabia and explored the associated risk factors. The Web of Science, Scopus, and Medline databases were searched for prior studies in Saudi Arabia exploring vitamin D status among women of reproductive age, published between January 1, 2000 and May 25, 2017. Data were extracted from the identified studies, and a random effects model meta-analysis established the overall hypovitaminosis D prevalence. The initial search yielded 223 possibly relevant articles; 13 were confirmed as eligible, with samples totaling 2877 women aged between 15 and 49 years. Meta-analysis revealed a mean serum 25-hydroxyvitamin D, 25(OH)D, level of 13.1 ng/mL (95% confidence interval [CI]: 11.6-14.6) and an overall prevalence of hypovitaminosis D, defined as 25(OH)D < 30 ng/mL, of 77.4% (95% CI: 63.2-87.3), mostly due to insufficient sunlight exposure and low dietary vitamin D intake. There is therefore a need for a national strategy to raise vitamin D levels among women in Saudi Arabia by advising them on natural vitamin D sources, and recommending the timing and duration of sun exposure, while also defining a national approach to vitamin D fortification and supplementation.