Pill count adherence to prenatal multivitamin/mineral supplement use among low-income women

In the United States, the prevalence of third trimester anemia among low-income pregnant women is 29% and has not improved since the 1980s. Although low adherence has been linked to the ineffectiveness of iron supplementation programs, data regarding adherence to supplementation in low-income women are currently lacking. Hence this study was conducted to better understand the factors associated with adherence to the use of iron-containing prenatal multivitamin/mineral supplements among low-income pregnant women. Adherence to supplement use was assessed by pill counts among 244 pregnant women of 867 women who were initially randomized to receive 1 of 3 prenatal supplements. All women received care at a public prenatal clinic. Maternal characteristics associated with adherence were identified using predictive modeling. Women took 74% of supplements as prescribed. Adherence was higher among non-Hispanic white women than among non-Hispanic black women (79% vs. 72%, P 相似文献   

Use of vitamin D and other dietary supplements by Finnish children at the age of 2 and 3 years

The aims of this study were to investigate the frequency of the use of vitamin D and other dietary supplements by Finnish children at the age of 2 and 3 years, to evaluate daily nutrient intake from supplements, and to investigate the relation between supplement use and various sociodemographic factors. The families of 534 newborn infants were invited to a birth cohort study in 1996-1997. Families of 292 children at the child's age of 2 years and families of 263 children at the age of 3 years completed a three-day food record from which the daily use of dietary supplements was calculated. The frequency of dietary supplement use was 50% among the two-year-olds, and 37% among the three-year-old children. The most commonly used supplements among the two-year-olds were vitamin D or vitamin A + D combination (38%) and fluoride (16%) and among the three-year-olds fluoride (19%) and multivitamins (16%), respectively. Intake of nutrients other than vitamin D or fluoride from supplements was rare among two-year-olds, whereas 16% of the three-year-olds received also vitamin A, C, E, and several group B vitamins. Mean daily intake of vitamin D from supplements was 6.7 micrograms at the age of 2 years and 5.3 micrograms at the age of 3 years, respectively. The level of parental education was positively associated with the child's vitamin D supplementation at the age of 2 years. As the compliance with national recommendations of vitamin D supplementation was low, intensified counseling of the parents is needed at the well-baby clinics in Finland.     

The effects of parent’s health literacy and health beliefs on vaccine hesitancy

Parental vaccine hesitancy is a key factor influencing children’s vaccination against infectious diseases such as the COVID-19. The current study aims to investigate how parent’s health literacy and health belief affect parental hesitancy toward the COVID-19 vaccination, and navigate effective measures to help parents make vaccination decision for children. A mixed-mode web survey was conducted among parents of children aged 3–11 years. Parental vaccine hesitancy, health literacy, and health beliefs were assessed. Parallel mediation model examined whether the association between parent's health literacy and vaccine hesitancy was mediated by health beliefs. In total, 11.3% of the 346 participants reported vaccine hesitancy. Hesitant parents were more likely to be he mother (Father: 4.5%; Mother: 12.9%) and with children having allergic issues (Allergic: 18.3%; Non-allergic: 9.8%). Meanwhile, parents with lower health literacy were more likely to show hesitancy towards vaccinating their children (β = −6.87, 95% CI = [−10.50, −3.11]). This relationship was partially mediated by more perceived barriers in vaccination (β = −2.53, 95%CI = [−4.09, −1.02]), but not other health beliefs. In other words, parents with better health literacy may perceive fewer barriers in making vaccination decision for their children, thus being less hesitant. Accordingly, healthcare professionals and policy makers could design education service to promote parents’ health literacy, and remove the perceived barriers as well as increase their confidence in following the COVID-19 vaccine guidance for children.     

成都市婴幼儿营养补充剂应用及影响因素探讨

目的了解成都市婴幼儿营养补充剂使用现状及影响因素。方法随机选取成都市两个社区257名0～3岁婴幼儿及其家长作为研究对象,通过问卷调查收集婴幼儿营养补充剂使用相关信息和家庭基本情况,分析影响营养补充剂使用的相关因素。结果婴幼儿营养补充剂总使用率为87.5%,各类营养补充剂使用率依次为维生素D 76.3%、维生素A 75.5%、钙33.5%、锌16.3%、铁3.9%;除铁制剂外,不同月龄组间婴幼儿营养补充剂使用率差异有显著性(P<0.05),随月龄增加钙、锌使用率呈上升趋势,维生素D和维生素A在6～11月龄段使用率最高;营养补充剂使用分别与家长对婴幼儿期营养重视程度(OR=0.186,P<0.05)和婴幼儿生长发育状况(OR=2.317,P<0.05)有关。结论成都市婴幼儿营养补充剂使用已较普遍,需加强专业指导以保证营养补充剂的合理应用。     

Variables Associated With the Use of Complete Oral Calorie Supplements in Children With Feeding Problems

ObjectiveTo examine child and parent variables associated with complete oral calorie supplement use among children with feeding problems.DesignCorrelational examination of data from patient intake surveys.SettingHospital-based feeding program.ParticipantsParticipants included 281 parents of children referred to a hospital-based feeding clinic, including 114 who received supplements (70.2% boys; mean age, 60.1 months) and 167 who did not receive (79.6% boys; mean age, 67.5 months).Variables MeasuredChildren's age, gender, weight status, diagnostic category (no special needs, autism, or other special needs), supplement intake, oral motor problems, child mealtime behavior (using the Child Eating Behavior Questionnaire), parent feeding practices (using the Parent Mealtime Action Scale), and diet variety for child and parent.AnalysisChi-square analyses compared children who did and did not receive supplements for their percentage of gender, diagnostic, and weight status categories; t tests or Mann-Whitney U tests compared children who did and did not receive supplements, for age, oral motor problems, children's mealtime behavior, parent feeding practices, and diet variety.ResultsCompared with children who did not receive nutritional supplements, those who did were younger (P < .01) and more underweight (P < .001), and showed less Food Responsiveness (P < .001), less Food Enjoyment (P < .001), more Food Satiety (P < .001, and more Slow Eating (P < .001), and their parents were more likely to use Insistence on Eating (P < .001).ConclusionsWhereas supplement use was related to underweight, 78.2% of children receiving them were normal weight or overweight, which suggests that supplements are being used to address mealtime selective eating. The use of supplements should be considered carefully because they do not appear to increase diet variety and may increase the chance of overweight over time.     

Vitamin D intakes of children differ by race/ethnicity,sex, age,and income in the United States, 2007 to 2010

The 2007-2010 National Health and Nutrition Examination Survey was used to estimate vitamin D intakes of children 1 to 18 years old in the United States by race/ethnicity, sex, age, and family using 24-hour dietary intake recalls and dietary supplement use questionnaires. We hypothesized that total, dietary, and supplemental vitamin D intakes of children would differ by race/ethnicity, sex, age, and income. Statistical analyses of weighted data were performed using Statistical Analysis Software (V 9.2) to estimate means ± SE. Race and ethnic intake differences controlling for poverty income ratio (PIR), sex, and age were assessed by analysis of covariance. Total (dietary and supplement) vitamin D intake was greater in the high (7.9 ± 0.3 μg/d) vs the medium (6.5 ± 0.3 μg/d) income group, but not the low (7.2 ± 0.2 μg/d) PIR group. Total vitamin D intake of non-Hispanic (NH) white children (8.1 ± 0.2 μg/d) was greater than Hispanic (7.0 ± 0.2 μg/d) and NH black (5.9 ± 0.2 μg/d) children. Total vitamin D intake declined with age, and intake by boys was higher than girls. Only 17.4% of the children consumed supplements containing vitamin D. Overall, mean intake of vitamin D by all children in each age and ethnic group was lower than the estimated average requirement for vitamin D. Public health efforts should encourage consumption of foods high in vitamin D, expand the number of foods fortified, and target health messages to parents to increase use of vitamin D supplements by children.     

Factors associated with the intention to use vitamin D supplements: quantitative study among a sample of elderly people in a medium-sized town in the Netherlands

The objective of this study was to assess which factors are related to the intention of elderly people to use vitamin D supplements.A questionnaire that was based on several theories, feedback of experts, and personal interviews with members of the target group was distributed among a random sample of 497 elderly people in a medium-sized town in the Netherlands (response 46%). Variables measured included perceived susceptibility, severity and control with respect to developing a vitamin D deficiency or getting a bone fracture, and beliefs, perceived social norms, modeling, self-efficacy, and intention with respect to the use of vitamin D supplements. Univariate analyses of variance, chi-square tests, stepwise multiple regression, and stepwise logistic regression analysis were performed. Respondents reporting a high intention had more positive attitudes and normative beliefs, higher self-efficacy expectations with respect to using vitamin D supplements, and more often used other supplements than respondents with a low intention. Subjects who already used vitamin D supplements were more often female and already familiar with the advice and had more positive attitudes and normative beliefs than nonusers. It was concluded that many elderly people have high intentions to start using vitamin D supplements as soon as they hear about the advice. A health promotion campaign to promote the use of vitamin D supplements should aim at making elderly people familiar with the Health Council of the Netherlands' advice. Furthermore, the campaign should place emphasis on changing attitudes, perceived social norms, and self-efficacy expectations toward vitamin D supplement use.     

Higher concentrations of vitamin D in Canadian children with juvenile idiopathic arthritis compared to healthy controls are associated with more frequent use of vitamin D supplements and season of birth

A number of studies have demonstrated that patients with autoimmune disease have lower levels of vitamin D prompting speculation that vitamin D might suppress inflammation and immune responses in children with juvenile idiopathic arthritis (JIA).  The objective of this study was to compare vitamin D levels in children with JIA at disease onset with healthy children. We hypothesized that children and adolescents with JIA have lower vitamin D levels than healthy children and adolescents. Data from a Canadian cohort of children with new-onset JIA (n= 164, data collection 2007-2012) were compared to Canadian Health Measures Survey (CHMS) data (n=4027, data collection 2007-2011). We compared 25-hydroxy vitamin D (25(OH)D) concentrations with measures of inflammation, vitamin D supplement use, milk intake, and season of birth. Mean 25(OH)D level was significantly higher in patients with JIA (79 ± 3.1 nmol/L) than in healthy controls (68 ± 1.8 nmol/L P <.05). Patients with JIA more often used vitamin D containing supplements (50% vs. 7%; P <.05). The prevalence of 25(OH)D deficiency (<30 nmol/L) was 6% for both groups. Children with JIA with 25(OH)D deficiency or insufficiency (<50 nmol/L) had higher C-reactive protein levels. Children with JIA were more often born in the fall and winter compared to healthy children. In contrast to earlier studies, we found vitamin D levels in Canadian children with JIA were higher compared to healthy children and associated with more frequent use of vitamin D supplements. Among children with JIA, low vitamin D levels were associated with indicators of greater inflammation.     

Impact of pill organizers and blister packs on adherence to pill taking in two vitamin supplementation trials

The impact of pill organizers on pill taking was determined in the Trial of Antioxidant Vitamins C and E (TRACE) Study, a factorial trial of vitamin C and vitamin E supplementation in 184 individuals. Participants were recruited in 1996-1997 and randomized to one of two groups (pill organizer or no organizer) and to one of four supplement groups for 2 months. The pill count (observed/expected X 100%) distribution was similar in the organizer and no organizer group for both vitamins. Mean differences in changes in serum vitamin levels between active and placebo groups did not differ by pill organizer use. The impact of pill organizers and blister packs was compared in another trial, the Vitamins, Teachers, and Longevity (VITAL) Study, in 297 individuals randomized in 1993-1994 to receive study pills either in blister packs or in pill organizers and to take one of two supplements. Among those with lower adherence, the pill count distribution in the blister-pack group exceeded that in the organizer group. Mean differences in serum vitamin E levels between active and placebo groups did not differ by types of pill packaging. In summary, use of blister packs, but not pill organizers, improved adherence as measured by pill counts among those with lower adherence. Neither pill delivery system improved adherence as measured by serum vitamin levels.     

完全母乳喂养婴儿维生素D补充剂的应用现状

【目的】 对山东省完全母乳喂养婴儿维生素D补充剂的应用现状进行调查,并分析其影响因素。 【方法】 选取2010年11月-2011年1月来预防接种门诊进行计划免疫与健康保健的0~3岁儿童903例,以生后4个月内完全母乳喂养儿612例作为研究对象。采用自制的调查问卷对儿童抚养人进行维生素D补充剂应用方面的调查。 【结果】 完全母乳喂养婴儿维生素D补充剂的应用率为76.6%,开始添加维生素D补充剂的时间、停用时间是生后30.0(30.0)d、9.0(7.0)月,其中生后1周内、1~2周、2~4周、>4周开始添加的儿童分别占1.7%、3.4%、9.3%、85.5%;78.4%婴儿1岁以内停用了维生素D补充剂,1~2岁停用者占16.6%,2~3岁停用者占5.1%;多因素Logistic回归分析发现儿童年龄、家庭收入水平、母亲文化程度和孕期使用微营养素等是影响维生素D补充剂应用的因素(OR=0.673,0.706,1.651,1.646)。 【结论】 维生素D补充剂在完全母乳喂养婴儿中的应用普遍,但应用不合理,不符合国内外维生素D补充剂应用指南的要求。年龄、母亲文化水平、收入水平等多种因素影响维生素D补充剂的应用状况。     

Food Supplement Use Differs from the Recommendations in Pregnant Women: A Multinational Survey

The aim was to investigate, among pregnant women, (1) the use of food supplements and (2) the awareness of food supplement recommendations and beliefs about food supplement use in four European countries: Finland, Italy, Poland, and the United Kingdom. The participants (n = 1804) completed an online questionnaire with predefined statements. Daily intakes of vitamins and minerals were calculated using uploaded pictures or weblinks of the supplement packages. Country differences were assessed. Most participants (91%) used at least one food supplement during pregnancy. A prenatal multivitamin was the most commonly used supplement type (84% of the users), and 75% of the participants thought consumption of multivitamin is recommended. Of the participants, 81% knew that folic acid is recommended during pregnancy while 58% knew the recommendation for vitamin D. In 19% of the supplement users, the daily safe upper intake limit of at least one nutrient was exceeded. Nevertheless, most participants agreed that they knew which supplements (91%) and doses of supplements (87%) needed to be used during pregnancy. To conclude, the majority of the participants used food supplements, but lower proportions knew and adhered to the recommended intakes. Between-country differences were observed in the use and knowledge of and beliefs regarding supplements. The results suggest a need for assessment and monitoring of supplement use in antenatal care to ensure appropriate use.     

Contributions of the home literacy environment to preschool‐aged children’s emerging literacy and language skills

This paper reports on a study that examined both the concurrent and logitudinal connections between multiple components of the home environment and indicators of preschool‐aged children’s literacy and language development. Data were collected from 85 parents and their children at two different times. Results of structural path models indicated that (a) parental literacy habits were positively associated with parental reading beliefs, (b) parental reading beliefs were positively associated with parent–child literacy and language activities in the home, and (c) parent–child literacy and language activities were positively associated with children’s print knowledge and reading interest. Parental demographic characteristics were associated with children’s expressive and receptive language skills. The results highlight how different components of the home literacy environment are associated with different components of preschool‐aged children’s literacy and language abilities, findings that become more important as educators and policy‐makers look for ways to enhance children’s literacy and language development.     

Dietary Supplement Use by Children and Adolescents in the United States to Enhance Sport Performance: Results of the National Health Interview Survey

Dietary supplements may improve sport performance in adults. However, this has not been established in children. The aim of this study was to assess self-reported or parental-reported dietary supplement use to enhance sports performance among the child subset of the National Health Interview Survey (NHIS) dataset and determine national population estimates for that use. NHIS 2007 Child Alternative Medicine files containing records for children aged <18 years were used. Typical demographic variables were utilized as well as parental presence; parental education level; use of any herb, vitamin, and/or mineral use for sports performance by children; and age. Most (94.5%) who reported using supplements used multivitamin and/or mineral combinations followed by fish oil/omega-3 s, creatine, and fiber. Males were more likely users (OR = 2.1; 95% CI [1.3, 3.3]), and Whites reported greater usage. Mean user age was 10.8 (SD = 0.2) with 57.7% >10 years, indicating some increase in use with higher age categories (p < .001). Most were US born and reported living with both parents. Parents and children report child use of a wide variety of herbal and vitamin/mineral supplements to improve sports performance. Usage could be predicted by age, gender, and level of education but less likely by parent-based demographics.     

Psychometric Properties of a Self-Report Measure of Adherence to the Diabetes Regimen

Management of type 1 diabetes (T1D) involves a complex regimen. Adherence may improve glycemic control and health outcomes. Accurately assessing adherence is critical. A parent and child self-report measure of regimen adherence was developed: Assessment of Diabetes Adherence, Parent and Child (ADA–P/–C). One hundred sixty-five youth with T1D and parents completed the Diabetes Self-Management Profile (DSMP), psychosocial measures, and the ADA–P/–C. Results revealed good psychometric properties. Parent and child agreement was adequate. Although not intended to replace the DSMP, the ADA–P/–C may be used for multiple adherence measurements, as part of a larger assessment battery, and when a trained clinician is not available.     

It takes two: the effect of child characteristics on U.S. parents’ motivations for allowing electronic media use

Extant research on parents’ choices for child media consumption focuses exclusively on parental beliefs and motives along with demographic variables. However, given parental choices are made within the context of the parent–child relationship, this study investigates how perceived child characteristics influence parents’ motives for allowing their children to consume screen media. One hundred and fifty-one parents of children between 6 months and 6 years of age were surveyed regarding their beliefs and motives for using screen media for their child as well as their perceptions of their child’s temperaments as energetic or detached. Results revealed a child’s energetic temperament predicted parental media use motives beyond that of parental media beliefs in ways consistent with expected relational management goals. These results extend the uses and gratifications perspective by supporting the idea that media choices made within a relational context are best understood by considering both members within the relational dynamic.     

Use of vitamin and mineral supplements in long-term care home residents

Vitamin-mineral supplementation may offer older adults health and cognition-related benefits but overuse may contribute to polypharmacy. We examined the prevalence of supplement usage in long-term care facility (LTC) residents (≥ 65 years of age). As cognition may be affected by nutrition, we also examined use in those with diagnosis of dementia and those with no dementia diagnosis. The prevalence of supplement usage and overall "pill count" from pharmaceutical use was assessed in 189 LTC residents and a subsample of 56 older adults with dementia diagnosis, respectively. Participants were residing in an LTC facility of a mid-size metropolitan area during 2009. The average use of supplements was 1.0 per day for all residents, with 35% taking vitamin D supplements, 20% multivitamins, and 26% calcium. Supplement use was similar (p ≥ 0.05) for those with dementia diagnosis (53%, average 2.0 per day) and for those without such diagnosis (45%, average 2.2 per day). Usage ranged between 1-6 supplements per day. In both of these groups, ～73% of users were taking vitamin D. The number of prescribed medications ranged from 4 to 24 (average 10.2) in a subsample of residents whose supplement intake was 0 to 6 (average 2). These findings suggest an overall low rate of supplement use, with no significant differences (p ≥ 0.05) in use between residents with and without dementia diagnosis. However, some residents were at risk for supplement overuse.     

600名婴幼儿维生素D制剂应用现状及影响因素

目的 了解0~3岁婴幼儿维生素D的应用现状,分析其影响因素,为指导维生素D的合理应用提供依据。方法 随机抽取2016年1-12月在郑州大学第三附属医院儿童保健门诊进行健康体检和计划免疫的600名0~3岁婴幼儿作为调查对象,采用自制问卷对婴幼儿的主要带养人进行调查。结果 郑州市婴幼儿维生素D制剂的使用率为63.5%,平均添加时间为3月龄,平均停服时间为15月龄。多因素Logistic回归分析显示,婴幼儿年龄(OR＝0.816,95%CI:0.586~0.912)、母亲文化水平(OR＝0.573,95%CI:0.319~0.881)和喂养方式(OR＝0.346,95%CI:0.272~0.874)是影响维生素D制剂应用的因素。结论 维生素D制剂在婴幼儿中应用不规范,建议开展有效的健康教育活动,指导儿童家长合理补充维生素D制剂。     

Correction for errors in measuring adherence to prenatal multivitamin/mineral supplement use among low-income women

Adherence to prenatal multivitamin/mineral supplement use is often measured by self-reports or pill counts. Although both measures were shown to overestimate adherence, measurement error is rarely considered. In this study, we examined measurement error in adherence to prenatal supplement use among pregnant women and demonstrated a calibration method to adjust for error. In a validation subsample (n=51) from a larger clinical study of supplementation, adherence was assessed by self-reports, pill counts, and a Medication Event Monitoring System (MEMS) bottle cap that recorded the date and time of each opening of the pill bottle. Mean adherence in the validation sample as measured by the MEMS (the gold standard) was 68%; thus, adherence measured by self-report (77%) and pill count (84%) reflected overestimation. The Pearson correlation coefficients of self-reports and pill counts to MEMS were 0.35 and 0.62, respectively. When adherence was defined as taking >or=75% of the pills prescribed, sensitivity and specificity were greater for pill counts (93 and 52%, respectively) than for self-reports (88 and 44%). The regression coefficient for pill count adherence from a linear regression on MEMS adherence was applied to pill counts from a larger sample (n=244). The adjustment significantly lowered the estimate of adherence from 74 to 64% (P<0.001) in this larger sample. In conclusion, our data show that both self-reports and pill counts overestimate adherence and that linear regression in comparison to an external standard such as MEMS can be used to correct for measurement error in adherence.     

Vitamin supplement use and its correlates among elderly Japanese men residing on Oahu, HI.

Use of vitamin supplements and the association with personal characteristics were investigated among 4,654 American men of Japanese ancestry in Hawaii. A total of 58 percent of the subjects who were ages 68 to 90 took vitamin supplements. Among supplement users, multivitamins were most commonly used (77 percent), followed by vitamin C (53 percent), E (43 percent), and A (10 percent). Ninety-two percent of users took at least seven pills per week when all types of pills were combined. Vitamin supplement users were more educated, more physically active, more likely to be married, and less obese than nonusers. They also slept less, smoked less, and drank less alcohol and caffeine. They took more analgesics and stomach medication and had fewer days of hospitalization in the previous 10 years compared with nonusers. Except for physical activity, use of stomach medicines, and hospitalization, the other characteristics were also positively correlated with the amount of vitamin pill intake. These findings indicate that vitamin supplement users have different health patterns compared with nonusers.     

Beliefs About Child TV Viewing in Low-Income Mexican American Parents of Preschoolers: Development of the Beliefs About Child TV Viewing Scale (B-TV)

Objectives Parental beliefs about child television viewing may affect the way parents regulate child television viewing. Despite this, little research has focused on the development of measures of parental beliefs about child television viewing, particularly among ethnic minority parents and parents of young children. This study’s objective was to develop and test a culturally-based measure of parental beliefs about television viewing in low-income Mexican American mothers of preschoolers. Methods Using a cross-sectional study design, 22 items reflecting parental beliefs about influences of TV on children were developed and assessed for psychometric properties in a sample of 312 low-income Mexican American mothers of preschoolers. Results Using exploratory factor analysis, we identified four factors reflecting four domains of parental beliefs: positive general beliefs, positive sleep-related beliefs, positive functional beliefs, and negative general beliefs. Internal reliabilities were acceptable (Cronbach’s alpha?=?0.70–0.89) for all factors except negative general beliefs (Cronbach’s alpha?=?0.61). Positive sleep-related beliefs and Positive Functional Beliefs were correlated with children’s average daily hours of TV (r?=?0.16, p?<?.01; r?=?0.22, p?<?.001, respectively) and with mother’s average daily hours of TV (r?=?0.14, p?<?.05; r?=?0.22, p?<?.001, respectively), providing initial support for construct validity. Conclusions for Practice The Beliefs about Child TV viewing scale measures four domains of parental beliefs regarding child TV viewing, and has good initial reliability and validity for three factors. Future use will allow investigators to conduct more in-depth evaluations on the influence of parental beliefs on the way parents shape their child’s use of the TV.