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

Abstract

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.

Exposure to a Vitamin D Best Practices Toolkit, Model, and E-Tools Increases Knowledge, Confidence, and the Translation of Research to Public Health and Practice

“…In a study on vitamin D knowledge in HCPs, only 1.7% felt that they were trained properly in how to properly diagnose and manage VDD [20]. In addition, upon evaluation, less than half of the HCPs were reported to have good practice at addressing VDD [22]. In another study on HCPs, the recommendation and dosing of supplements was inconsistent, and minimal patient education was provided with respect to lifestyle practices, sun exposure, nutrition, and diet around 50% of the time [24].…”

“…The development of better clinical guidelines, electronic decision aids, and visual cues has been recommended to aid the ease of moving vitamin D research into practice [17][18][19][20]. Further education and training were also recommended to increase both students' and practicing HCPs' vitamin D knowledge and increase the translation of this knowledge into practice and public health [21][22][23][24][25][26][27][28][29][30]. Research shows that HCP education increases knowledge, results in feelings of enhanced self-efficacy, and increases the sustainability of evidence-based practice (EBP); however, authors have noted that translational methods are needed to sustain a long-term practice change [31].…”