title: Pregnancy intentions and folic acid supplementation exemplars: findings from the Central Pennsylvania Women's Health Study.
abstract: One Healthy People 2010 objective is that 80% of women in the United States start a pregnancy with optimal levels of folic acid. This often requires women to use folic acid supplements preconceptionally to get adequate levels. Efforts to achieve the objective have resulted in a suboptimal floor effect at less than 50% of women. We advance a framework based on exemplification theory, identifying supplementation as an additive action in which two role models exemplify folic acid supplementation among women of reproductive age able to become pregnant (n = 1,258). The women were participants in Phase I of the Central Pennsylvania Women's Health Study (CePAWHS). One exemplar identified represents the positive habits aligned with supplementers considering a pregnancy sometime in their future, while the other resides in the exemplification of positive habits aligned with supplementers not considering a pregnancy sometime in their future but still able to become pregnant. Among women not considering a future pregnancy, daily green salad consumption, weekly fish consumption, having had a health care visit in the past year, and having had any ob/gyn visit in the past 2 years resulted in increased odds of folic acid supplement use in a multivariable model. In the same model, an increase in age resulted in increased odds of folic acid supplement use. Among women considering a future pregnancy, not smoking cigarettes, having higher levels of psychosocial stress, and having higher levels of interaction social support resulted in increased odds of folic acid supplement use in a multivariable model. In the same model, those who have had a health care visit in the past year, as well as those who have received pregnancy planning counseling, were also more likely to use a folic acid supplement. Implications for strategic communication are considered.
authors.affiliation: Department of Communication Arts & Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA. rlp18@psu.edu
authors.forename: Roxanne
authors.initials: R
authors.lastname: Parrott
authors.forename: Julie E
authors.initials: JE
authors.lastname: Volkman
authors.forename: Marianne M
authors.initials: MM
authors.lastname: Hillemeier
authors.forename: Carol S
authors.initials: CS
authors.lastname: Weisman
authors.forename: Gary A
authors.initials: GA
authors.lastname: Chase
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Dyer
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000097:blood; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009436:Neural Tube Defects / Q000517:prevention & control; D010414:Pennsylvania; D011247:Pregnancy; D055815:Young Adult
chemical_list: D005492:Folic Acid