title: Barriers to supplemental calcium use among women in suburban family practice: a report from the Cleveland Clinic Ambulatory Research Network (CleAR-eN).
abstract: BACKGROUND
  The majority of adult women in the United States fail to meet daily calcium intake recommendations. This study was undertaken to (1) identify predictors of calcium supplement use versus non-use, (2) understand barriers to calcium supplementation, and (3) determine the potential impact of physician recommendation on calcium supplement use.
  
  
  METHODS
  Surveys were self-administered by 185 women, ages 20 to 64, presenting consecutively for care at 6 suburban community-based family medicine practices within the Cleveland Clinic Ambulatory Research Network (CleAR-eN). We compared demographic characteristics, health beliefs, and health behaviors of those women who reported never using calcium supplements with those who presently took calcium supplements. Women who never took calcium were also queried about reasons for non-use and whether physician recommendation would influence their adoption of calcium supplementation.
  
  
  RESULTS
  Multivitamin use, self-perceived risk of osteoporosis, and age were independent predictors of calcium supplement use. Leading barriers for never-users were lack of knowledge about the need/importance of increasing calcium intake, lack of motivation to start supplements, and the belief that their dietary calcium intake alone was sufficient. Ninety-six percent of never-users reported that they would consider taking a calcium supplement if recommended by their physician.
  
  
  CONCLUSIONS
  Many patient-identified barriers to calcium supplementation seem amenable to focused and brief office-based interventions that could increase the number of women meeting calcium intake guidelines.
authors.affiliation: Department of Family Medicine, Cleveland Clinic, Cleveland, Ohio 44111, USA. carl.tyler@fairviewhospital.org
authors.forename: Carl V
authors.initials: CV
authors.lastname: Tyler
authors.forename: James J
authors.initials: JJ
authors.lastname: Werner
authors.forename: Vanessa
authors.initials: V
authors.lastname: Panaite
authors.forename: Sandra M
authors.initials: SM
authors.lastname: Snyder
authors.forename: Donald B
authors.initials: DB
authors.lastname: Ford
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Conway
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Young
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Powell
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Smolak
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Zyzanski
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D002136:Calcium, Dietary / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005194:Family Practice / Q000379:methods*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology / Q000517:prevention & control*; D012424:Rural Population; D011795:Surveys and Questionnaires
chemical_list: D002136:Calcium, Dietary