Folic acid and the prevention of neural tube defects: Western Washington women's knowledge, beliefs and opinions.

摘要

Public health recommendations include a statement aimed at women of childbearing age recommending consumption of 400 micrograms of folic acid daily to prevent neural tube defects. Studies have been undertaken to determine if women are implementing this recommendation. Studies cite gaps in knowledge and behavior related to increasing folic acid. Our study addresses opinions of diverse populations of women, about increasing their intake of folic acid. Aims of the study were to gather a broad range of women's opinions, discover what messages would assist women in acquiring knowledge about the connection between folic acid and NTDs, and learn how to reach underserved populations. Content analysis was performed on transcripts from ten focus groups. Eighty-eight women participated. Women between age 14 and 45 were recruited. Thirty-four percent of participants were from urban areas, while sixty-six percent were from rural areas. Forty-three percent were Caucasian. Twenty-three percent each were Native American and African American. Eleven percent were Asian. Thirty percent of participants were taking vitamins. Fifty percent had taken vitamins in the past, Seventeen percent never took vitamins. Our study identified factors that will motivate intake of folic acid. These are increased self-knowledge and self-care, prevention of health problems, and promotion of positive reproductive behavior. Participants stated that information must come from trusted individuals. Barriers to vitamin intake centered around four areas: negative characteristics of vitamins, lack of knowledge regarding appropriate supplementation, expense, and personal characteristics. Women felt they could increase their intake of folic acid through improved eating habits, increased knowledge, supplemented diet, and support from persons important to them. Native American and African American women cited the importance of family and community as avenues for information dissemination. Women who subscribe to a whole food philosophy are more difficult to reach because these women felt their diet was adequate without fortified foods and were resistant to supplementation. The most effective campaign to market the folic acid message will employ multiple strategies, and appeal to both women and those who are considered supportive. A broad reaching campaign with multiple messages will likely be the most successful.