Improving Folic Acid Consumption in Women at Risk for Neural Tube Defects in Florida

ABSTRACT Two providers who participated in the Florida VitaGrant program, a site providing early childhood services to primarily Mexican Hispanic families (Site A) and a site providing home visiting services to pregnant women and families with infants (Site B), are presented as alternative models for improving folic acid levels in reproductive aged women in Florida. Site A distributed multivitamins and education in the context of health education provided to women in a group setting, once a month. Site B provided the services primarily through home visits of varying frequency. Folic acid knowledge and consumption were measured at program initiation and at a follow-up date to determine levels of improvements for both sites, by demographic characteristics. Analyses comparing age, race, and ethnicity of women served by Site A were compared to women served by Site B. These programs were then evaluated in-depth with respect to baseline and follow-up levels of folic acid knowledge and consumption of their participants. Site A seemed to be somewhat more effective at improving the knowledge and consumption patterns of its participants than Site B, although both experienced significant improvement overall. Initially, women who received services from Site A reported lower levels of baseline knowledge and multivitamin consumption than Site B clients. However, Site A clients reported higher levels of knowledge and consumption at follow up than Site B clients. The findings suggest that free multivitamin distribution and pre/interconception education can dramatically increase MVC among all participants. Program delivery that takes place in the context of a group setting may be a particularly effective way to reach women at-risk for neural tube defects. Florida Public Health Review, 2009; 6, 36-45