“Folate Before Pregnancy”: The Impact on Women and Health Professionals of a Population-Based Health Promotion Campaign in South Australia

Abstract

A Folate Before Pregnancy campaign targeting both women of reproductive age and healthcare professionals was carried out in South Australia over an 11-month period in 1994 to 1995. The key messages were as follows: 1) If women of reproductive age take adequate folate/folic acid, it may lower the risk of neural tube defects such as spina bifida. 2) Green leafy vegetables, fruits, and cereals are good sources of folate. 3) An adequate supply of folate/folic acid is especially important before pregnancy and in the first trimester. Computer-aided phone interviews were conducted with about 400 women ranging in age from 15 to 44 years. The health professionals targeted included general practitioners, pharmacists, dietitians, and nurses and medical staff at child health services. Information was disseminated through posters, pamphlets, shopping centers, local libraries, family daycare and childcare centers, preschools, and high schools. Women had acquired significant knowledge of folate after the campaign. Those most knowledgeable at the outset were health professionals and postnatal women, and both of these groups exhibited significantly increased knowledge. The proportion of women taking folic acid supplements periconceptionally rose significantly, as did that of health professionals who advised women planning pregnancy about folate. In addition, sales of folic acid tablets doubled. The overall prevalence of neural tube defects in South Australia dropped from 2 to 1.1 per 1000 births over the years 1966 to 1999. These findings show that it is feasible to increase knowledge and health-related behaviors through a brief, modestly funded campaign. A future goal is to promote the use of folate especially strongly among women who are less aware of the benefits. The frequency of unplanned pregnancy demands that folate supplementation be encouraged whenever there is any chance of pregnancy.