Randomized trial of a physician-based intervention to increase the use of folic acid supplements among women.
OBJECTIVE
Fewer than one third of American women take folic acid daily, although many women report that they would take folic acid if their physicians advised them to do so. This study determined the impact of a physician intervention during routine gynecologic visits on folic acid supplementation.


METHODS
Patients were assigned randomly to receive brief folic acid counseling, a reminder phone call, and 30 folic acid tablets (n = 162 women; intervention group) or to receive counseling about other preventive health behaviors and a folic acid informational pamphlet (n = 160 women; control group). Self-reported folic acid use was compared at baseline and at 2 months.


RESULTS
Of the 279 patients who completed the study, weekly folic acid intake increased in the intervention group by 68%, compared with 20% in the control group ( P =.008). No significant differences were found in daily intake. The women who were most influenced by the intervention were black and lower income and not planning pregnancies.


CONCLUSIONS
With little effort expended to encourage folic acid use, gynecologists could potentially reduce the risk of folate-preventable birth defects among their patients by as much as 11%.
Robbins
James M
JM
Department of Pediatrics, Arkansas Center for Birth Defects Research and Prevention, University of Arkansas for Medical Sciences College of Medicine, and Arkansas Children's Hospital, Little Rock, AR, USA.
Cleves
Mario A
MA
Collins
H Breck
HB
Andrews
Nancy
N
Smith
Laura N
LN
Hobbs
Charlotte A
CA
D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D016001:Confidence Intervals; D003376:Counseling; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009436:Neural Tube Defects / Q000517:prevention & control*; D016017:Odds Ratio; D010349:Patient Compliance; D010818:Practice Patterns, Physicians'; D011336:Probability; D016896:Treatment Outcome
D005492:Folic Acid