Abstract
Abstract Objective To determine whether a multiple intervention programme to improve women's awareness of folic acid was feasible in community pharmacy practice; to identify adjustments in organisation and materials that could improve feasibility; and to assess how the target group would experience the intervention. Method An action research study was undertaken in which four community pharmacies in the Netherlands participated. In each, a core team (one pharmacist and one to two technicians) was responsible for the organisation and implementation of the intervention. The intervention had several possible levels. As a minimum, pharmacy staff added a label about folic acid to the box of dispensed oral contraceptives (OCs) and handed out a leaflet about folic acid. The intervention was discussed during core team meetings every six weeks. Modifications were made based on the experience of the pharmacy team, on responses from pharmacy customers and on the results of a questionnaire sent to women one week after they visited the pharmacy with an OC prescription. This cycle of planning, action, observation and reflection was repeated twice. Key findings The minimum intervention was carried out by all four pharmacies. Other activities differed: two pharmacies introduced a maximum client age limit for handing out the leaflet; two installed an electronic information display; three worked with posters and window displays; and in two pharmacies the pharmacy technicians wore project badges and an information portfolio was placed in the public area of the pharmacy. Of the target group, 44% were positive about the label, 49% were neutral and 4% were negative. Over half (56%) of the target group stated that they appreciated the public health information given through the pharmacy. Conclusion Working with core teams seemed to be a successful strategy to implement practice change. By discussing and modifying the intervention during each research cycle in the core team meetings, an optimal intervention was reached that fitted in with the existing organisation within the pharmacy and possible barriers were overcome. Feedback from the target group was mainly positive and motivated the core teams to continue.
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