J Acad Nutr Diet. 2013 Aug 30. pii: S2212-2672(13)01114-3. doi: 10.1016/j.jand.2013.06.350.
Au LE, Harris SS, Jacques PF, Dwyer JT, Sacheck JM.
Vitamin D supplementation is an important strategy for preventing low levels of serum 25OHD and improving bone health and consequent associated health risks, especially in children at risk of deficiency. Although vitamin D supplements are recommended, there is limited research on the factors that influence adherence to taking them. In a cross-sectional sample of 256 child (aged 9 to 15 years) and parent pairs in the Boston, MA, area during January to March 2012, analysis of covariance was used to determine associations between health beliefs about vitamin D, parental vitamin D-containing supplement use, and the individual responsible for pill administration with supplement adherence measured by pill counts. Mean and median supplement pill count adherence over 3 months were 84% and 89%, respectively.
- Adherence was positively associated with parents' use of vitamin D-containing supplements (7% higher, P=0.008) and with
- combined child and parent responsibility for administration of the supplement compared with child only (9% higher, P=0.03).
- Parents' beliefs about vitamin D neither predicted their children's beliefs nor positively influenced children's adherence.
- Adherence was higher when parents took vitamin D-containing supplements and when parents and children shared responsibility for administering the supplement.
- Promoting child supplement use through parent involvement and role modeling may be a practical solution for registered dietitians who are aiming to improve vitamin D adherence in at-risk youth.
Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
- Initial and on-going education of the benefits (to children and parents)
such as: printed, video, presentation followed by Q/A, online information and forum,
Educate them about the benefits anticipated: fewer colds, less tooth decay, better academic performance, fewer growing pains, fewer ear infections, less asthma
- Have competition between classrooms (different classrooms take different amounts)– and let classes notice the differences
- Having a larger dose pill which need only be taken weekly or monthly
Along with calendar-associated memory aids
- Having the vitamin D incorporated into food eaten (optional fortification at school or home)
- Good tasting (e.g. gummy bear)
- Provide other forms – such as liquid: many children are uncomfortable with taking pills.
Note: In many previous studies people know that the desired outcome is to have no pills at the end of the trial, so they just throw out the remaining pills
- Delayed scholastic achievement associated with low vitamin D levels – Aug 2012
- Infants in France and Finland need 1000 IU of vitamin D, but apparently infants in US need only 400 - 2013
- Middle ear infection (Otitis Media) and Vitamin D – many studies
- Symptoms of vitamin D deficiency vary with the age of the child – Feb 2013
- UVB added in classroom reduced cavities, increased height, increased academics. etc UV instead of supplements
- Vitamin D Deficiency is a Strong Predictor (4X) of Asthma in Children – Oct 2012
- Acute lower respiratory infection 5X more frequent with low vitamin D intake – June 2012
- When prescribed by mail, vitamin D compliance is low – June 2013
- Restoring vitamin D - ways to encourage - scores of additional ways
- All items in category Follow-thru Vitamin D
See also Vitamin D Council review of this study (behind a $5 paywall)Adherence of children taking vitamin D supplements – Aug 2013
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