"Test me and treat me"--attitudes to vitamin D deficiency and supplementation: a qualitative study

Abstract

Objective: Lay interest in vitamin D and the potential benefits of supplementation is considerable, but little information exists concerning lay knowledge, beliefs and attitudes towards vitamin D to inform public health initiatives and professional guidance.

Design: Qualitative focus group study.

Participants: 58 adults capturing diversity in disease status, gender, age and ethnicity.

Setting: A large general practice in east London.

Results: Many respondents lacked knowledge about vitamin D, including dietary sources and government recommendations. Most were positive about sun exposure, but confused by ambiguous health messages about risks and benefits of sunshine. Medicalised views of vitamin D were prominent, notably from those in favour of supplementation, who talked of "doses", "side effects" and "regular testing." Fortification of food with vitamin D was controversial, with opposing utilitarian (better overall for the majority) and libertarian (freedom to choose) views.

Conclusions: Knowledge about vitamin D was limited. Clearer messages are needed about risks and benefits of sun exposure. Testing and supplementation by health professionals, while potentially useful in some high-risk groups, have contributed to a medicalised view of vitamin D. Health policy should address the public's need for clear information on sources and effects of vitamin D, including risks and benefits of sun exposure, and take account of divergent views on fortification. Professional guidance is needed on testing and supplementation to counter inappropriate medicalisation.

Keywords: PRIMARY CARE; PUBLIC HEALTH; QUALITATIVE RESEARCH.

Figure 1

Numbers of patients prescribed vitamin D by general practices in the east London boroughs of Hackney, Tower Hamlets and Newham, and all three boroughs together (‘East London and the City’).