The use of pre-conceptional folic acid as an indicator of uptake of a health message amongst white and Bangladeshi women in Tower Hamlets, east London.
BACKGROUND
The benefit of folic acid is a simple health promotion message of proven effectiveness that is particularly pertinent to a young population with a high birth rate.


OBJECTIVE
The aim of the present study was to compare the uptake of a folic acid health message in two different ethnic groups.


METHODS
Community antenatal teams in Tower Hamlets were asked to recruit women attending for a booking between October 1997 and July 1998 to the study. Tower Hamlets, in east London, is one of the poorest areas in England and Wales, with an ethnically diverse population. A questionnaire enquiring about age, employment, level of education, use of folic acid in their current pregnancy, understanding of the benefits of folic acid and self-described ethnic group was administered verbally immediately before the booking appointment to those women who agreed to participate.


RESULTS
Completed questionnaires were received on 249 women. Univariate analysis showed that white women were 5.7 [95% confidence interval (CI) 2.5, 13.2] times more likely to have taken folic acid supplements before conception than Bangladeshi women. Having controlled for the variables, age, school leaving age, social class, parity, planned pregnancy and 'heard of folic acid', ethnic status remained a significant predictor of taking folic acid, with the odds ratio dropping to 5.2 with a 95% CI (1.1, 25.2).


CONCLUSIONS
The Bangladeshi community in the UK have been shown to have poor access to health information sources, which is consistent with the results of this survey, which shows that a simple and important message has not been acted upon equally by white and Bangladeshi women in east London. This survey lends support to the view that resources and innovative forms of health promotion are needed to ensure that ethnic minority groups have adequate access to health promotion messages.
Howell
S R
SR
Department of General Practice and Primary Care, St Bartholomew's and The Royal London School of Medicine and Dentistry, Medical Sciences Building, Queen Mary and Westfield College, London E1 4NS, UK.
Barnett
A G
AG
Underwood
M R
MR
D000328:Adult; D000704:Analysis of Variance; D001459:Bangladesh / Q000208:ethnology; D004641:Emigration and Immigration; D005006:Ethnicity / Q000193:education* / Q000523:psychology*; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D006266:Health Education / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D008131:London; D020380:Needs Assessment; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D016742:Preconception Care / Q000379:methods*; D011247:Pregnancy; D015397:Program Evaluation; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D044465:White People / Q000193:education* / Q000523:psychology*; D014930:Women / Q000193:education* / Q000523:psychology*
D005492:Folic Acid