Computerized counseling for folate knowledge and use: a randomized controlled trial.
BACKGROUND
Periconception folate supplementation significantly reduces the risk of neural-tube defects, but few U.S. women start folate supplementation before pregnancy, and the amount of clinician time available to counsel patients about folate is limited. This study evaluated whether computer-assisted counseling and the provision of free folate tablets increases women's knowledge and use of folate supplements.


METHODS
Randomized controlled trial; follow-up began 6 months after enrollment and was completed on average 7 months after enrollment.


METHODS
A total of 446 women, aged 18-45 years, were recruited from two urgent care clinics in San Francisco from March to July 2005 (data collection was completed in 2006; data were analyzed in 2007).


METHODS
Participants received a 15-minute computerized educational session and 200 folate tablets.


METHODS
The primary outcome was the knowledge that folate can prevent birth defects; secondary outcomes included the self-reported use of a folate supplement at follow-up.


RESULTS
At follow-up, women in the intervention group were more likely to know that folate prevents birth defects (46% vs 27%, relative risk [RR]=1.72, 95% CI=1.32, 2.23); to know that folate is most important in early pregnancy (36% vs 17%, RR=2.11, 95% CI=1.50, 2.97); and to report the recent use of a folate supplement (32% vs 21%, RR=1.54, 95% CI=1.12, 2.13).


CONCLUSIONS
A one-time, brief, computerized counseling session about folate with the provision of free folate tablets increased the knowledge and use of folate supplements among women > or =6 months later.


BACKGROUND
NCT00177515.
Schwarz
Eleanor Bimla
EB
Center for Research on Health Care-Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. schwarzeb@upmc.edu
Sobota
Mindy
M
Gonzales
Ralph
R
Gerbert
Barbara
B
D000293:Adolescent; D000328:Adult; D003376:Counseling / Q000379:methods*; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009436:Neural Tube Defects / Q000517:prevention & control*; D010353:Patient Education as Topic / Q000379:methods*; D016742:Preconception Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D012306:Risk; D012495:San Francisco / Q000453:epidemiology; D014584:User-Computer Interface; D014803:Vitamin B Complex / Q000008:administration & dosage*
D014803:Vitamin B Complex; D005492:Folic Acid