title: Folic acid awareness in Michigan, 1996-1999.
abstract: OBJECTIVE
  To evaluate the prevalence and trend of folic acid awareness among Michigan mothers during 1996-1999 and to identify maternal characteristics predictive of folic acid awareness.
  
  
  METHODS
  We analyzed data from the Michigan Pregnancy Risk Assessment Monitoring System, a population-based survey of women with recent live births. A positive response to the question, "Before you became pregnant, did you know that folic acid could help prevent some birth defects?" was used as an indicator of folic acid awareness. Logistic regression was used to evaluate trends in folic acid awareness prevalence and the association between folic acid awareness and certain maternal characteristics.
  
  
  RESULTS
  Of the women invited to participate, 7252 responded (67.3%). Overall, folic acid awareness increased from 1996 to 1999 (60.3-71.4%; P < .001). However, folic acid awareness decreased for women with no high school education from 1997 to 1999 (59.3-13.8%, P = .05). In addition, folic acid awareness was lower among black women (adjusted odds ratio [OR] 0.43; 95% confidence interval [CI] 0.4, 0.5, versus other races), women with unplanned pregnancies (adjusted OR 0.6; 95% CI 0.5, 0.8, versus those with planned pregnancies), and those with no high school education (adjusted OR 0.08; 95% CI 0.03, 0.2, versus women with college education).
  
  
  CONCLUSIONS
  Although folic acid awareness has increased among Michigan mothers overall during 1996-1999, it has decreased among women with less than a high school education, and substantial gaps exist among socioeconomic subgroups. Continued efforts are needed to improve folic acid awareness and consumption of folic acid among women of reproductive age, with special attention focused on populations experiencing gaps or declines in folic acid awareness.
authors.affiliation: Epidemic Intelligence Service (assigned to the Michigan Department of Community Health), Epidemiology Program Office, USA. aloziec@michigan.gov
authors.forename: Chidinma N
authors.initials: CN
authors.lastname: Alozie Arole
authors.forename: Karoline S
authors.initials: KS
authors.lastname: Puder
authors.forename: Melissa
authors.initials: M
authors.lastname: Reznar
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Eby
authors.forename: Bao-Ping
authors.initials: BP
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000013:Congenital Abnormalities / Q000517:prevention & control*; D005260:Female; D005494:Folic Acid Deficiency / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008824:Michigan / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies; D011795:Surveys and Questionnaires