title: An intervention study to increase knowledge and use of folic acid among relatives in neural tube defect-affected families in Washington, D.C.
abstract: BACKGROUND
  Little is known about the level of knowledge and use of folic acid among near relatives in U.S. families of a child with spina bifida. We hypothesized that relatives would be more knowledgeable than the general population and more likely to take folic acid. Further, we hypothesized that relatives would be more motivated by an intervention to increase their use of folic acid.
  
  
  METHODS
  We conducted an intervention study among females in families attending a hospital spina bifida clinic in Washington, DC.
  
  
  RESULTS
  The 231 subjects consisted of the affected individuals, mothers, sisters, and aunts. The average age was 34 years. At baseline, most (87.4%) reported that they had heard of folic acid; 37.6% were currently taking multivitamins with folic acid and 6.9% were taking folic acid tablets. The intervention significantly increased both knowledge (to 99%) and intake of folic acid from 41.9 to 48.5%. Folic acid intake increased significantly among African-American women and women with less education, women who were older, married, with children, and nonsmokers.
  
  
  CONCLUSIONS
  This intervention was successful in increasing folic acid intake among female relatives in spina bifida-affected families. By the end of the study, almost all women had heard of folic acid and folic acid use had increased by 16%. Among these women at higher than expected risk for having an affected child, this rate of intake, while more than the general population, still falls short of optimum. Fortification of food with folic acid may be the only way to ensure increased folic acid intake.
authors.affiliation: Westat, 1650 Research Boulevard WB474, Rockville, MD 20850-3195, USA. juliannebyrne@westat.com
authors.forename: Julianne
authors.initials: J
authors.lastname: Byrne
authors.forename: Susan
authors.initials: S
authors.lastname: Carolan
authors.forename: Rashad
authors.initials: R
authors.lastname: Arcement
authors.forename: Matthew
authors.initials: M
authors.lastname: Kozlowski
authors.forename: Inna
authors.initials: I
authors.lastname: Taller
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ried
authors.forename: Robert
authors.initials: R
authors.lastname: Keating
mesh_terms: D000293:Adolescent; D004219:District of Columbia; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009436:Neural Tube Defects / Q000517:prevention & control*; D011795:Surveys and Questionnaires
chemical_list: D005492:Folic Acid