Knowledge, Attitude and Practice Related to Vitamin D and Its Relationship with Vitamin D Status among Malay Female Office Workers

Abstract

This study assessed knowledge, attitude and practice (KAP) related to vitamin D and its relationship with vitamin D status among Malay female office workers. A total of 147 women aged between 20 and 55 years were recruited from a university in Kuala Lumpur. They answered questionnaires related to KAP on vitamin D, sun exposure, dietary vitamin D intake and physical activity. Serum 25-hydroxyvitamin D (25OHD) was analysed using an enzyme-linked immunoassay. Nearly half (45%) of the subjects had good knowledge but moderate attitude (76%) and practice (84%) towards sunlight exposure and dietary vitamin D intake. Median serum 25OHD was 34.1 nmol/L with the majority (91%) had vitamin D insufficiency (25OHD < 50 nmol/L). Knowledge was weakly associated with attitude (r = 0.29, p < 0.001) but no association was found between knowledge and practice (r = 0.08, p = 0.355) nor attitude and practice (r = −0.001, p = 0.994). Serum 25OHD was positively associated with sunlight exposure (r = 0.22, p = 0.008) and dietary vitamin D intake (r = 0.37, p < 0.001). It can be implied that this group is at increased risk of low bone health status, which highlights the needs of public health campaigns to improve their vitamin D status.

Barriers towards Sun Exposure and Strategies to Overcome These Barriers in Female Indoor Workers with Insufficient Vitamin D: A Qualitative Approach

“…The participants from this study were derived from a recent study conducted among women office workers working in a medical university and teaching hospital in Kuala Lumpur, Malaysia [ 10 ]. In brief, they were indoor women workers with insufficient vitamin D level (serum 25-hydroxyvitamin D (25OHD) concentration <50 nmol/L) [ 28 ] and aged between 18 and 59 years.…”

“…To ensure the quality and trustworthiness of this study, multiple approaches were used. Prolonged engagement with study participants helped to gain their trust and establish rapport [ 32 ], as the researcher worked with the same participants during the preliminary study in February to May 2019 [ 10 ], until the FGD session conducted in October 2019. An audit trail was used to improve the quality of the instrument [ 32 ].…”

“…However, it is almost impossible to provide guidance that fulfils all aspects because several factors can influence the cutaneous synthesis of vitamin D such as the zenith angle and latitude, different times of the day, air pollution, skin pigmentation, body surface area exposed when outdoors and age [ 8 , 9 ]. Currently, there are no sun exposure guidelines in Malaysia [ 10 ].…”

“…A recent study on knowledge, attitude and practice conducted among high-risk female office workers in Kuala Lumpur, Malaysia suggested that further investigation into the factors contributing to vitamin D deficiency is essential as they have a moderate attitude and practice towards sunlight exposure and dietary intake of vitamin D [ 10 ]. This information that could be garnered from such studies would provide practical recommendations to the public and health agencies to prevent vitamin D deficiency among the Malaysian population.…”

“…This information that could be garnered from such studies would provide practical recommendations to the public and health agencies to prevent vitamin D deficiency among the Malaysian population. The current study is an extension of the previous study [ 10 ], which aimed to explore the perceived barriers towards sun exposure and strategies to overcome these barriers among indoor women workers with insufficient vitamin D status in Kuala Lumpur, Malaysia.…”