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Vitamin D

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laura Taylor

on 24 February 2016

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Transcript of Vitamin D

Vitamin D
Are people achieving the recommended dose?
Health promotion
July 2010 study by British the Paediatric Respiratory society and the British Society of Paediatric Gastroenterology, Hepatology and Nutrition
Published in the Archives of Disease in Childhood in 2011
116 health professionals
77 responded
Questions:
1. What percentage of midwives and GP's said that they routinely advise pregnant women about vitamin d supplementation?
1a. Midwives: 24% 51% 73%
1b. GP's: 10% 30% 60%
5. What percentage of Health Visitors, GP's and Midwives said they would like further guidance on vitamin D supplementation?
2. What percentage knew when to supplement formula fed babies with vitamin D?
2a. Health visitors: 21% 50% 68%
2b. GP's: 13% 52% 73%
3. What percentage could name more than one group who were at risk of vitamin D deficiency?
3a. Midwives: 55% 65% 75%
3b. Health visitors: 57% 67% 77%
3c. GP's: 11% 31% 61%
4. What percentage of midwives, GP's and Health visitor's said they were aware of the healthy start scheme?
4b. GP's: 0% 15% 100%
4a. Midwives: 10% 65% 100%
4c. HV's: 5% 30% 95%
5a. GP: 35% 65% 95%
5b. Midwives: 24% 64% 74%
5c. Health visitors: 20% 35% 50%
Tannahill's model of health promotion (1996)
RCPCH have produced a leaflet in response to the survey 'Poor knowledge of vitamin D deficiency amongst health professionals'.
Reference List
National Health Service (2012) Making Every Contact Count. Available at: http://www.makingeverycontactcount.co.uk/index.html. (Accessed 24/05/2014)
National Institute for Health and Care Excellence (2012) Making sure pregnant and breastfeeding women receive vitamin D. Available at: http://www.nice.org.uk/newsroom/features/MakingSurePregnantAndBreastfeedingWomenReceiveVitaminD.jsp (Accessed 22 March 2014)
National Institute for Health and Care Excellence (2008) Improving the nutrition of pregnant and breastfeeding mothers and children in low-income household. Available at: http://www.nice.org.uk/nicemedia/pdf/PH011guidance.pdf. (Accessed 39/03/14)
Centre For The Advancement Of Interprofessional Education (2002) The Definition and Principles of Interprofessional Education. Available at: http://caipe.org.uk/about-us/the-definition-and-principles-of-interprofessional-education/. (Accessed 1 March 2014).
The Royal College of Midwives (2010) Midwives have Key Role in Public Health. Available at: http://www.rcm.org.uk/college/about/media-centre/press-releases/30-11-10midwives-have-key-role-in-public-health/. (Accessed 28 February 2014)
V Jain, R Raychaudhuri, W Barry (2011) A Survey of healthcare professionals' awareness of Vitamin D supplementation in pregnancy, infancy and childhood - midwives, gps and health visitors have their say. BMJ. Volume 96. Issue 1.
BBC News (2014) Vitamin D 'Boosts Child Muscles'. Available at: http://www.bbc.co.uk/news/health-25549055. (Accessed 22/05/2014)
HM Government (2010) Our Health and Wellbeing Today. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215911/dh_122238.pdf. (Accessed 23/05/2014)
British Association of Dermatologists (2013) Vitamin D and the Sun. Available at:http://www.bad.org.uk/for-the-public/skin-cancer/vitamin-d. (Accessed 26/05/2014)
Arthritis Research UK (2012). New campaign aims to address vitamin D deficiency. Available at: http://www.arthritisresearchuk.org/news/general-news/2012/december/new-campaign-aims-to-address-vitamin-d-deficiency.aspx. (Accessed 2/05/2014)
Medical News Today (2014). Vitamin D levels during pregnancy linked to offspring muscle strength. Available at: http://www.medicalnewstoday.com/articles/270823.php. (Accessed 22/05/2014)
Practically Perfect PA(2013). Smart Objectives. Available at:http://www.practicallyperfectpa.com/2013/smart-objectives-assistants/11/11/. (Accessed 11/06/14)
Royal College of Paediatrics and Child Health (2013). Guide for Vitamin D in Childhood. Available at: http://www.rcpch.ac.uk/system/files/protected/page/vitdguidancedraftspreads%20FINAL%20for%20website.pdf. (Accessed 7/05/2014).
HM Government (2010) Our Health and Wellbeing Today. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215911/dh_122238.pdf (Accessed 03/05/14)
Royal College of Paediatrics and Child Health (2012). RCPCH Launches Vitamin D Campaign. Available at:http://www.rcpch.ac.uk/news/rcpch-launches-vitamin-d-campaign. (Acessed 03/05/14)
Stapleton H, Kirkham M, Thomas G (2002). Qualitative study of evidence based leaflets in maternity care. British Medical Journal. 324:629
Journal Of Family Health Care. Vitamin D ‘mission’ to improve awareness (2014) Available at http://www.jfhc.co.uk/saphna/vitamin-d-mission-improve-awareness/ Accessed on 08/06/14

Health Education
Health protection
Prevention
Vitamin D
What we have seen in practice across the three different trusts.
Pocket Guide for Health Professionals: Focusing on early prevention rather than identifying and treating symptoms
Aim of our intervention:
However their campaign focuses on 'highlighting the signs of vitamin D deficiency in children; aches and pains, poor muscle growth, muscle weakness and seizures.'
Healthy Start
Royal College of Paediatricians and Child Health - Guide for Vitamin D in Childhood 2013.
Healthy Start is a government scheme where women who qualify get free vouchers every week to spend on milk, fresh and frozen fruit, vegetables, and infant formula milk. With these vouchers you can also get free vitamins, for both the woman and child until they are 4 years old.
The vitamins for the woman contain folic acid, vitamin D and vitamin C.
http://www.healthystart.nhs.uk
http://www.healthystart.nhs.uk
- The focus on health equality + targeting disadvantaged groups overshadows the importance of preventing vitamin D deficiency of the unborn for
every
pregnant and breastfeeding woman.
- No separate or concise information on vitamin D for professionals to access
-No information re: when, where and who to target - explaining the professionals role in regards to promoting the health intervention as a whole


Health Education
Health protection
Prevention
Informative pocket guide that highlights the importance of vitamin D supplementation in pregnancy.
Aimed at
all professionals
, to ensure they all have the
same understanding
and provide
consistent information
to women.

HM Government (2010) - Our Health and Wellbeing aim in
'Starting well: Early on, the health of mothers before and during pregnancy and good parenting are crucial to getting the best start in life'



An intervention targeted at all health professionals.
Educating professionals.
Confidence in promoting vitamin D supplementation increases.
Why, Who, When, Dosage.
Simple, easily accessible pocket guide to refer to.
The same information given across all agencies and professionals
Women will receive up to date evidence based knowledge regarding vitamin D supplementation for herself and the baby
High quality of care due to inter-professional working
July 2010 study by British the Paediatric Respiratory society and the British
Society of Paediatric Gastroenterology, Hepatology and Nutrition
Published in the Archives of Disease in Childhood in 2011
July 2010 study by British the Paediatric Respiratory society and the British
Society of Paediatric Gastroenterology, Hepatology and Nutrition
Published in the Archives of Disease in Childhood in 2011
July 2010 study by British the Paediatric Respiratory society and the British
Society of Paediatric Gastroenterology, Hepatology and Nutrition
Published in the Archives of Disease in Childhood in 2011
July 2010 study by British the Paediatric Respiratory society and the British
Society of Paediatric Gastroenterology, Hepatology and Nutrition
Published in the Archives of Disease in Childhood in 2011
Tannahill's model of health promotion 1996
To raise awareness of vitamin D supplementation for health professionals
Inform health professionals about
when
to target women,
making every contact count
Who
to target + high risk groups for vitamin D deficiency
Provide health professionals with information on the healthy start scheme
Offer health professionals
resources
to access themselves to broaden knowledge around Vitamin D supplementation
Provide information of the correct dosage for women in pregnancy and during breastfeeding, as well as that for 0-6 months.
Southampton Women's Survey (Vitamin D levels during pregnancy linked to offspring muscle strength) January 2014
"Higher levels of maternal vitamin D during pregnancy have been linked to better muscle development in children," BBC News reports.
678
women aged 20-34 & their children at 4 years. All pregnant with 1 child.
Blood test at
34
weeks gestation (height, weight & how long they breastfed for considered)
Hand grip strength measured at
4 years old
(height, weight & body composition also considered)
Only
9.2%
of women were taking a vitamin D supplement in late pregnancy (34 weeks of gestation).
Our Intervention
The impact on the woman

Measuring the success of our intervention
AN and PN notes
The stages of change model (Prochaska and Diclemente 1984)

We could have chosen this model, however our intervention is for professionals not for women, therefore the stages would not be applicable.
Model of Health Promotion - Beattie 1993

We could have chosen this model,
however it focuses on the midwives role and how she can change their behaviour rather than educating interprofessionally.


Harvey N, Moon R, Sayer A. et al. (2014) Maternal Antenatal Vitamin D Status Journal of Clinical Endocrinology and Metabolism.
Tannahill's health promotion model 1990
Health Education
Health Protection
Prevention
2
7
4
1
6
5
3
Davies, M & Macdowall, W (2006). Health Promotion Theory . London : London School of Hygiene & Tropical Medicine. 16-17
RCPCH (2013) A guide for vitamin D in children http://www.rcpch.ac.uk/system/files/protected/page/vitdguidancedraftspreads%20FINAL%20for%20website.pdf
HM Government - Our Health and Wellbeing Today (2010) https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215911/dh_122238.pdf
http://www.healthystart.nhs.uk
http://www.healthystart.nhs.uk
RCPCH (2013) A guide for vitamin D in children http://www.rcpch.ac.uk/system/files/protected/page/vitdguidancedraftspreads%20FINAL%20for%20website.pdf
RCPCH (2013) A guide for vitamin D in children http://www.rcpch.ac.uk/system/files/protected/page/vitdguidancedraftspreads%20FINAL%20for%20website.pdf
RCPCH (2013) A guide for vitamin D in children http://www.rcpch.ac.uk/system/files/protected/page/vitdguidancedraftspreads%20FINAL%20for%20website.pdf
RCPCH (2013) A guide for vitamin D in children http://www.rcpch.ac.uk/system/files/protected/page/vitdguidancedraftspreads%20FINAL%20for%20website.pdf
RCPCH (2013) A guide for vitamin D in children http://www.rcpch.ac.uk/system/files/protected/page/vitdguidancedraftspreads%20FINAL%20for%20website.pdf
http://www.healthystart.nhs.uk
Vitamin D
Laura, Becky, Jess, Hannah, Nikki & Meg
"It is estimated that 40% of young children are vitamin D deficient, which can lead to the brittle bone disease rickets. Over the last few years, numbers have increased fourfold, with more than 760 children were admitted to hospital with the condition in 2013"

Journal Of Family Health Care (2014)
http://www.jfhc.co.uk/saphna/vitamin-d-mission-improve-awareness/
Discussion Time

How have you seen vitamin D promoted?
Where? When? Who by?

Conclusions
This model is
aimed at professionals
to support and influence their practice to benefit service users and is not aimed at the service users themselves.
A main strength of this model is that it places emphasis on health promotion being a
continuous circle
with overlapping activities.
We felt that this model effectively showed how many areas of practice can
interlink
and can allow healthcare professionals to work holistically.
Specific

-

What is our objective ?
Measurable

-

Can we measure ?
Achievable

-

Can we achieve our objective ?
Relevant

-

Is it current, relevant and evidence based ?
Time

-

Do we have clear timescales ?
www.practicallyperfectpa.com
Full transcript