Maternal perspectives on the use of probiotics in infants: a cross-sectional survey.

BACKGROUND: Probiotic products that may modify the intestinal microbiota are becoming increasingly available and known to consumers due to their potential to prevent or treat many pediatric health conditions. As scientific knowledge of the health benefits of probiotics increases, it is important to identify factors that may prevent their successful integration into patient care as well as to ensure effective translation of research findings. The aim of this study was to describe maternal perspectives on probiotics and their use in infants. METHODS: Mothers with a child aged two years or younger enrolled in the Alberta Pregnancy Outcomes and Nutrition (APrON) study were invited by email to complete a 29 item self-administered web-based questionnaire. RESULTS: A total of 413 mothers of the 1327 contacted completed the questionnaire. The majority (99.3%) of respondents had heard of probiotics and were aware that they contained live bacteria (87.0%); 89.3% had used a product containing probiotics themselves but only 50.8% had given one to their infant. Most mothers indicated they believed that probiotics were beneficial (73.1%) and none thought they were harmful. Over a third of mothers did not feel informed enough to make a decision on whether probiotics were safe to use in infants (36.6%). CONCLUSIONS: The study demonstrates that awareness and understanding of probiotics is high among mothers in Alberta, Canada. However, there is still uncertainty regarding the benefit of probiotics as well as safety in infants which could be important factors determining therapeutic use in the future. Further studies that demonstrate beneficial effects and safety of probiotics in healthy infants as well as targeted knowledge translation should help to address these potential concerns.

Does supplementary prenatal nursing and home visitation support improve resource use in a universal health care system? A randomized controlled trial in Canada.

BACKGROUND: The addition of supplementary prenatal support may improve the health and well-being of high-risk women and families. The objective of this randomized controlled trial was to examine the impact of supplementary prenatal care on resource use among a community-based population of pregnant women. METHODS: Pregnant women from three urban maternity clinics were randomized (a) to current standard of physician care, (b) to current standard of care plus consultation with a nurse, or (c) to (b) plus consultation with a home visitor. Participants were 1,352 women who received 3 telephone interviews. The primary outcome was resource use (e.g., attended prenatal classes, used nutritional counseling). RESULTS: Overall, those in the nurse intervention group were more likely to attend an "Early Bird" prenatal class and parenting classes, and to use nutrition counseling and agencies that assist with child care. Women provided with extra nursing and home visitation supports were more likely to use a written resource guide, nutrition counseling, and agencies that assist with child care. Among women at higher risk (e.g., language barriers, young maternal age, low income), the nurse intervention significantly increased use of early prenatal classes, whereas the nurse and home visitor intervention significantly increased use of the written resource guide and nutrition counseling. The intervention substantially increased the amount of information received on numerous pregnancy-related topics but had little impact on resource use for mental health and poverty-related needs. Among those with added support, resource use among low-risk women was generally greater than among high-risk women. CONCLUSIONS: Additional support provided by nurses, or nurses and home visitors, can successfully address informational needs and increase the likelihood that women will use existing community-based resources. This finding was true even for high-risk women, although this intervention did not reduce the difference in resource use between high- and low-risk women.

Complementary and alternative medicine use among colorectal cancer patients in Alberta, Canada.

CONTEXT: No population-based data are available on the use of complementary and alternative medicine (CAM) specifically among colorectal cancer patients. OBJECTIVE: To examine the prevalence and determinants of CAM use among colorectal cancer patients in Alberta, Canada. DESIGN: Population-based questionnaire. SETTING AND PARTICIPANTS: Patients (871 of 1240 surveyed), or their close relatives or friends, who were diagnosed with colorectal cancer in 1993 or 1995 in Alberta, Canada. MAIN OUTCOME MEASURES: Demographics, lifestyle, health status, symptoms and coping mechanisms, and attitudes about cancer cause, conventional treatments and practitioners, and CAM and practitioners. RESULTS: Seventy percent (871) of 1240 participants completed the questionnaire, and 49% used CAM. The most frequently used CAM therapies among users were psychological and spiritual therapies (65%), vitamins and minerals (46%), and herbs (42%). Sixty-eight percent of CAM users informed their medical doctors, and 69% used CAM after conventional care. Logistic regression suggested the strongest predictors of CAM use to be vegetarian diet, aged less than 50 years, female, having therapy options other than conventional treatment recommended by conventional doctors, experiencing changes in bowel habits orfatigue before diagnosis, and recommendation of chemotherapy. Nonsurviving patients were more likely to have used CAM than were survivors. CONCLUSIONS: Cancer patients are using CAM and communicating usage to physicians. This finding suggests that physicians should be prepared to discuss CAM with patients, and evidence-based information about CAM should be sought, including where CAM may pose risks. This study serves as a baseline for studies on the efficacy and safety of CAM.