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Barriers to Supplemental Calcium Use Among Women in Suburban Family Practice: A Report from the Cleveland Clinic Ambulatory Research Network (CleAR-eN)

Department of Family Medicine, Cleveland Clinic (CVT, SMS, DBF, JLC, CWY, BLP, MJS), Cleveland, Ohio
Department of Family Medicine (CVT, JJW, VP, SJZ), Case Western Reserve University, Cleveland, Ohio
Department of Epidemiology and Biostatistics (SJZ), Case Western Reserve University, Cleveland, Ohio

Correspondence: Corresponding author: Carl V. Tyler, MD, MS, Fairview Hospital/Cleveland Clinic Family Medicine Residency Program, 18200 Lorain Avenue, Cleveland, OH 44111 (E-mail: carl.tyler{at}fairviewhospital.org)

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.

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