title: "Folate before pregnancy": the impact on women and health professionals of a population-based health promotion campaign in South Australia.
abstract: OBJECTIVE
  To evaluate a South Australian campaign to promote and implement knowledge that taking adequate folate/folic acid in the periconceptional period can reduce the risk of having a baby with a neural tube defect.
  
  
  METHODS
  The campaign, conducted in October 1994--August 1995, targeted women of reproductive age and health professionals. Evaluation was by computer-assisted telephone interviews undertaken by random dialling throughout the State before and after the campaign, and by self-administered questionnaires to health professionals and women in the postnatal period.
  
  
  METHODS
  Women of reproductive age and four groups of health professionals.
  
  
  METHODS
  Knowledge about folate, folate-rich foods and the periconceptional period; participation of health professionals in advising women about folate; use of periconceptional folic acid supplements; sales of folic acid tablets; and prevalence of neural tube defects.
  
  
  RESULTS
  Significant increases in knowledge about folate followed the campaign. Health professionals and women in the postnatal period had higher initial levels of knowledge about folate, which also increased significantly. The proportions of women taking periconceptional folic acid supplements, and of health professionals advising women planning a pregnancy about folate, also increased significantly, and folic acid tablet sales doubled. Total prevalence of neural tube defects declined between 1966 and 1999 from a baseline of 2.0 per 1,000 births to 1.1 per 1,000 births (Poisson regression, P= 0.03; average decline of 1.0% per year).
  
  
  CONCLUSIONS
  A short educational campaign with a limited budget ($40,000) can promote folate successfully, but alternative strategies such as food fortification are likely to be needed to achieve adequate periconceptional folate intake for a very high proportion of women.
authors.affiliation: Pregnancy Outcome Unit, Department of Human Services, Adelaide, SA. Annabelle.Chan@dhs.sa.gov.au
authors.forename: A
authors.initials: A
authors.lastname: Chan
authors.forename: J
authors.initials: J
authors.lastname: Pickering
authors.forename: E
authors.initials: E
authors.lastname: Haan
authors.forename: M
authors.initials: M
authors.lastname: Netting
authors.forename: A
authors.initials: A
authors.lastname: Burford
authors.forename: A
authors.initials: A
authors.lastname: Johnson
authors.forename: R J
authors.initials: RJ
authors.lastname: Keane
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D018672:Community Health Planning / Q000458:organization & administration*; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D005527:Food, Fortified; D006266:Health Education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D009436:Neural Tube Defects / Q000453:epidemiology / Q000517:prevention & control*; D010565:Persuasive Communication; D015995:Prevalence; D015397:Program Evaluation; D012044:Regression Analysis; D013021:South Australia / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016387:Women's Health
chemical_list: D005492:Folic Acid