title: The relationship between awareness and supplementation: which Canadian women know about folic acid and how does that translate into use?
abstract: OBJECTIVE
  Although the benefit of folic acid (FA) to prevent neural tube defects (NTD) is well established, not all women take supplements in the periconceptional period. This study used data from the Public Health Agency of Canada's Maternity Experiences Survey to evaluate determinants of awareness of FA among recently pregnant women in Canada, and the extent to which that translated into actual supplement usage.
  
  
  METHODS
  Telephone interviews took place between October 23, 2006 and January 31, 2007 with women who were 5 to 14 months postpartum to survey their experiences during pregnancy, birth and the postpartum period. These analyses were conducted on women who responded to questions relating to FA supplementation. The 6,421 respondents were weighted to represent 76,508 women using weights which corresponded to the sampling strata, the mother's first language and Aboriginal status.
  
  
  RESULTS
  Overall, 77.6% of surveyed women knew that taking FA periconceptionally could help protect against NTD. Women who were younger, single or separated reported less awareness and use of FA, while higher maternal age, level of education and income were positively associated with both knowledge and use. Despite longstanding national guidelines for supplementation, there were regional variations in knowledge and use of FA.
  
  
  CONCLUSIONS
  The data indicate clear socio-demographic differences among Canadian women with respect to their knowledge and use of FA. Although most women understood the benefits of FA supplementation, a little over a third of them did not take FA supplements prior to becoming pregnant, and less than half supplemented according to national guidelines. Identification of those subpopulations whose use of supplements is suboptimal may allow for targeted educational or other interventions to further encourage FA use.
authors.affiliation: Public Health Agency of Canada. chantal.nelson@phac-aspc.gc.ca.
authors.forename: Chantal R M
authors.initials: CR
authors.lastname: Nelson
authors.forename: Juan Andres
authors.initials: JA
authors.lastname: Leon
authors.forename: Jane
authors.initials: J
authors.lastname: Evans
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009436:Neural Tube Defects / Q000517:prevention & control*; D011247:Pregnancy; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D005492:Folic Acid
keywords: Canada; Folic acid; Maternity Experiences Survey; knowledge; pregnancy
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