Knowledge and attitude of vitamin D and sun exposure practices amongst New Zealand mothers with children aged five years and under : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics, Massey University, Albany, New Zealand
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Date
2019
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Massey University
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Abstract
Background: Currently, there is no research in New Zealand that assesses the knowledge and attitudes of mothers in New Zealand regarding vitamin D. It is unknown whether public health messages are sufficient and if mothers are receiving the correct advice and support to ensure both themselves and their young children reach and maintain adequate vitamin D status. Aim: The primary aim was to assess the overall knowledge of vitamin D and common practices involving sun exposure amongst New Zealand women with children under five years of age. Methods: This cross-sectional online questionnaire was administrated in 2009 and received responses from 9,220 mothers from around New Zealand. From this, 8,032 responses were analysed. The questionnaire items were based on expert advice, literature and guidelines available in 2009. Mothers were only included if their youngest child was 5 years old or under. The online questionnaire was developed and reviewed by a panel of experts and then piloted before it was advertised to participants. To measure knowledge, mothers were expected to answer true/false questions or choose the answers to questions they thought were most accurate. Answers were determined accurate if they aligned with the literature and guidelines available in 2009. When measuring sun exposure practices mothers were asked to either agree, disagree or choose an answer most suitable to their practices. Statistical analysis included descriptive statistics using SPSS. Results: Knowledge of vitamin D was generally poor amongst this sample of mothers. There was a deficit in knowledge relating to vitamin D sources, 88.9% correctly identified sunlight as the single most important source of vitamin D. However, 63.2% thought breast milk was a good source and less than a quarter thought toddler or infant formula were good sources of vitamin D. There was a knowledge deficit for risk factors for deficiency, including poor awareness for dark skin and exclusive breast feeding being high risk factors. Knowledge of barriers to vitamin D synthesis were poor, mothers were unaware of the impact of skin covering on vitamin D status and 67.2% of mothers thought it was true or were unsure when asked if sun through a window is just as effective at synthesising vitamin D. Participants followed vigilant sun exposure practices for their children and themselves, especially during summer months, 55.9% and 73.2% reported always/usually keeping their child in the shade or dressing their child in protective clothing. Of those mothers surveyed, 86.5% would always/usually put a hat on their child and 78% would always/usually apply sunblock to their child’s skin. There were strong concerns of sun exposure leading to skin damage and skin cancer, 80.9% agreed that they worry sun will damage their child’s skin. Only 15.8% of mothers chose health professionals as their main source of information regarding vitamin D. A very small proportion of mothers received advice from health professionals regarding vitamin D supplementation (3.1%) and safe sun exposure for adequate vitamin D for their infant (30.5%). Half of mothers agreed they did not know what to do when it came to sun exposure and vitamin D and a further 72.4% agreed skin cancer prevention messages make it difficult to understand vitamin D messages. Conclusion: In 2009, knowledge of vitamin D amongst mothers and sun exposure practices amongst this group was unknown. This research provides the first insight into both knowledge and sun exposure practices amongst New Zealand mothers. However, considering the development of vitamin D guidelines over the past 10 years, findings from this study must be interpreted with caution, especially when applying them to current times. More up to date research is required to determine current knowledge and attitudes on vitamin D.
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vitamin D knowledge, mothers' attitudes, pregnancy, infancy