title: Folic Acid Education for Hispanic Women: The Promotora de Salud Model.
abstract: Although rates of neural tube defects (NTDs) have declined in the United States since fortification, disparities still exist with Hispanic women having the highest risk of giving birth to a baby with a NTD. The Promotora de Salud model using community lay health workers has been shown to be an effective tool for reaching Hispanics for a variety of health topics; however, literature on its effectiveness in folic acid interventions is limited.
  
  
  
  An intervention using the Promotora de Salud model was implemented in four U.S. counties with large populations of Hispanic women. The study comprised the following: (1) a written pretest survey to establish baseline levels of folic acid awareness, knowledge, and consumption; (2) a small group education intervention along with a 90-day supply of multivitamins; and (3) a postintervention (posttest) assessment conducted 4 months following the intervention.
  
  
  
  Statistically significant differences in pre- and posttests were observed for general awareness about folic acid and vitamins and specific knowledge about the benefits of folic acid. Statistically significant changes were also seen in vitamin consumption and multivitamin consumption. Folic acid supplement consumption increased dramatically by the end of the study.
  
  
  
  The Promotora de Salud model relies on interpersonal connections forged between promotoras and the communities they serve to help drive positive health behaviors. The findings underscore the positive impact that these interpersonal connections can have on increasing awareness, knowledge, and consumption of folic acid. Utilizing the Promotora de Salud model to reach targeted populations might help organizations successfully implement their programs in a culturally appropriate manner.
authors.affiliation: 1 Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities , Atlanta, Georgia .
authors.forename: Alina L
authors.initials: AL
authors.lastname: Flores
authors.affiliation: 1 Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities , Atlanta, Georgia .|2 Carter Consulting, Inc. , Atlanta, Georgia .
authors.forename: Jennifer
authors.initials: J
authors.lastname: Isenburg
authors.affiliation: 1 Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities , Atlanta, Georgia .|2 Carter Consulting, Inc. , Atlanta, Georgia .
authors.forename: Christina L
authors.initials: CL
authors.lastname: Hillard
authors.affiliation: 3 Division of Public Health , Raleigh, North Carolina.
authors.forename: Leslie
authors.initials: L
authors.lastname: deRosset
authors.affiliation: 4 Healthy Start Coalition of Hillsborough County , Tampa, Florida.
authors.forename: Lisa
authors.initials: L
authors.lastname: Colen
authors.affiliation: 5 Episcopal Health Foundation , Houston, Texas.
authors.forename: Troy
authors.initials: T
authors.lastname: Bush
authors.affiliation: 1 Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities , Atlanta, Georgia .
authors.forename: Cara T
authors.initials: CT
authors.lastname: Mai
mesh_terms: D000328:Adult; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D015438:Health Behavior; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006630:Hispanic or Latino; D006801:Humans; D009436:Neural Tube Defects / Q000517:prevention & control*; D016742:Preconception Care; D011247:Pregnancy; D014481:United States; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D014815:Vitamins; D005492:Folic Acid
keywords: Hispanics; Promotora de Salud model; folic acid; neural tube defects