Factors Affecting the Knowledge, Attitude and Practice of Vitamin D Supplement Use among Adults: a Multi-Arab Countries Study

Abstract

BACKGROUND: Vitamin D, an essential fat-soluble metabolite, plays a critical role in various physiological functions and human growth and development. This study investigates the factors influencing the knowledge, attitudes, and practices of the population regarding vitamin D supplementation. METHODS: A self-administered questionnaire was distributed via social media platforms (Facebook, Instagram, X, WhatsApp, LinkedIn) to collect responses from adult participants aged 18 + in Saudi Arabia, Jordan, Egypt, and Iraq from November 2023 to February 2024. Following Tabachnick and Fidell's guidelines, a minimum sample size of 200 was targeted for ten independent variables (Approval number: 2023-PHA-50).The reliability and internal consistency score via Cronbach's α (= 0.8) for the Likert scale in the practice section and (= 0.7) for the attitude section. Statistical analysis involved frequency, percentages, and simple/multiple-linear regression analysis to assess study predictors. RESULTS: A total of 1340 responses were obtained from four countries: Saudi Arabia (n = 412, 30.8%), Egypt (n = 400, 29.9%), Jordan (n = 310, 23.1%), and Iraq (n = 217, 16.2%). Median knowledge scores (± IQR) in Egypt, Jordan, and Iraq indicated a moderate level of understanding regarding vitamin D supplementation (11 ± 3, 11 ± 2, and 11 ± 3, respectively), whereas Saudi Arabia exhibited lower levels of knowledge (7 ± 2). Neutral attitudes toward vitamin D were observed across all countries, while Jordan and Iraq showed good median practice scores (17 ± 5, 16 ± 5), compared to moderate levels in Saudi Arabia and Egypt (13 ± 3, 15 ± 5), respectively. Multi-linear regression analysis indicated that in Saudi Arabia, younger respondents exhibited higher knowledge, attitudes, and practice scores, while individuals working in the non-health sector displayed higher attitudes and practice scores (p-value = 0.06, 0.009, < 0.001). Similarly, in Iraq and Jordan, those working in the non-health sector demonstrated higher knowledge scores (p-value < 0.001, < 0.001, respectively). Furthermore, males attained higher attitude scores in samples from Jordan, Egypt, and Iraq (p-value < 0.001, 0.003, < 0.001). CONCLUSION: This study highlights varying levels of knowledge, attitudes, and practices regarding vitamin D supplementation across different demographic groups and countries. Addressing misconceptions and promoting awareness, particularly among younger individuals and those working outside the health sector, is crucial for optimizing vitamin D supplementation practices and enhancing public health outcomes.