Development of a Public Health Model for Translation of Best Practices in Addressing Vitamin D Deficiency

Abstract

Vitamin D deficiency (VDD), defined as 25(OH)D <20ng/ml, is a global public health concern. An international group of vitamin D researchers recommends targeting optimal blood levels of 40-60ng/ml to decrease global prevalence of VDD, improve patient outcomes, population health, and decrease costs. A literature review revealed no public health model of evidence-based vitamin D best practices for translating research into practice, and healthcare professionals lack vitamin D knowledge and confidence in translating evidence into practice.

The pre-, post-test, and follow-up survey study design aimed to increase nurses’ and dietitians' level of vitamin D knowledge, confidence, translation of evidence into spheres of practice and influence, and identify translation barriers. A vitamin D toolkit was developed and implemented using an online, asynchronous learning management system. Subject matter experts established face validity for the toolkit, including assessments, the Cycle of Best Practices for Addressing Vitamin D Deficiency model, educational content, and translational resources.

Participants (n=119) completed the toolkit. Knowledge scores showed a statistically significant increase from 31% to 65% (p <0.001). Follow-up survey confidence scores increased significantly from 2.0 to 3.3 (p<0.001) on a scale of 1-5. Respondents reported using the model (100%), sharing VDD knowledge (94%), and identified financial barriers and interdisciplinary team resistance.

Nurses’ and dietitians' knowledge and translation of best practices for addressing VDD are critical to improving patient outcomes, population health, and decreasing healthcare costs. Results of this pilot demonstrate implementing an evidence-based toolkit and applying a translational model with accessible resources should be part of vitamin D public health initiatives. Continuing research should include longitudinal studies in specific practice settings to track improvement in the long-term patient, staff, and financial outcomes.