Impact of a pharmacist-directed educational program on the long-term knowledge and use of folic acid among college women: a 12-month follow-up study
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Few studies have examined the impact of educational interventions on participants’ long-term knowledge and use of folic acid for prevention of neural tube defects (NTD).
Objective: The objective of this pilot study was to evaluate changes in knowledge and behaviors in a sample of college women one year after such a program.
Methods: Female students of a residential college campus voluntarily attended the event, which was advertised to the campus community as a women’s health seminar. Participants completed a multiple-choice test assessing knowledge of folic acid and NTD and frequency of multivitamin use before and immediately after a 30-minute oral presentation. Following 3 reminder messages sent via email or mail, knowledge and multivitamin use were re-assessed 1-month and 12-months post-intervention.
Results: Thirty-two college women participated in the educational intervention; 27 (84%) completed the 12-month post-test. At 12 months, statistically significant increases in knowledge from baseline remained for questions pertaining to food high in folic acid (p=0.023); completion of spinal column (p=0.011); and 2 questions on NTD prevention (p=0.044). Increases in knowledge regarding recommended daily allowance of folic acid (p=0.817) and difficulty in receiving adequate folic acid from diet alone (p=0.617) were not statistically significant from baseline. Regular multivitamin use (≥4 times per week) was not statistically significantly increased from baseline (p=0.592).
Conclusion: Although it was encouraging that the women retained much of the information learned during the program, it appears that the changes in multivitamin use seen at 1-month were not sustained at 12-months. Further study with larger groups of college women is recommended.
2. Centers for Disease Control and Prevention. Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. MMWR Recomm Rep. 1992;41(RR-14):1-7.
3. United States Preventive Services Task Force. Folic acid for the prevention of neural tube defects: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;150(9):626-631.
4. Food and Drug Administration. Food Standards: Amendment of standards of identify for enriched grain products to require addition of folic acid. Fed Reg 1996;61:8781-8797.
5. U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Healthy People 2020. Washington, DC. Accessed at http://healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicid=26 (accessed October 21, 2011).
6. Gallup Organization and March of Dimes Foundation. Improving preconception health: women’s knowledge and use of folic acid. Accessed at http://www.marchofdimes.com/peristats/pdfdocs/2008FolicAcidSurveyReport.pdf (accessed October 21, 2011).
7. Racette SB, Deusinger SS, Strube MJ, Highstein GR. Deusinger RH. Changes in weight and health behaviors from freshman through senior year of college. J Nutr Educ Behav. 2008;40(1):39-42.
8. Nelson MC, Larson NI, Barr-Anderson D, Neumark-Sztainer D, Story M. Disparities in dietary intake, meal patterning, and home food environments among young adult nonstudents and 2- and 4-year college students. Am J Public Health. 2009;99(7):1216-1219.
9. Lawrence JM, Watkins ML, Ershoff D, Petitti DB, Chiu V, Postlethwaite D, Erickson JD. Design and evaluation of interventions promoting periconceptional multivitamin use. Am J Prev Med. 2003;25(1):17-24.
10. Murphy BL, DiPietro NA, Kier KL. Knowledge and use of folic acid among college women: A pilot health promotion program led by pharmacy students and faculty. Pharm Pract (Internet). 2010;8(4):220-225.
11. Chivu CM, Tulchinsky TH, Soares-Weiser K, Braunstein R, Brezis M. A systematic review of interventions to increase awareness, knowledge, and folic acid consumption before and during pregnancy. Am J Health Prom. 2008;22(4):237-245.
12. Schwarz EB, Sobota M, Gonzales R, Gerbert B. Computerized counseling for folate knowledge and use: A randomized controlled trial. Am J Prev Med. 2008;35(6):568-571.
13. Quillin JM, Silberg J, Board P, Pratt L, Bodurtha J. College women's awareness and consumption of folic acid for the prevention of neural tube defects. Genet Med 2000;2(4):209-213.
14. DiPietro NA, Kier KL. An educational intervention about folic acid and healthy pregnancies targeted at college-age women. J Am Pharm Assoc. 2001;41(2):283-285.
15. Milan JE, White AA. Impact of a stage-tailored, web-based intervention on folic acid-containing multivitamin use by college women. Am J Health Promot. 2010;24(6):388-395.
16. Wade GH, Herrman J, McBeth-Snyder L. A preconception care program for women in a college setting. MCN Am J Matern Child Nurs. 2012;37(3):164-170.