Understanding optimal nutrition among women of childbearing age in the United States: Employing formative research to lay the foundation for a national birth defects prevention campaign

Numerous studies have shown that periconceptional use of folic acid, alone or in multivitamins, is effective for reducing the risk of serious birth defects (i.e., neural tube defects—NTDs). The U.S. Public Health Service and Institute of Medicine issued separate recommendations that all women capable of becoming pregnant consume 400 micrograms (µg) of folic acid daily. Since folic acid fortification of the U.S. food supply began in 1998, the prevalence of NTDs has been reduced by 26%. However, even with fortification, most women do not reach the daily recommended level; therefore, increasing the use of vitamins containing folic acid remains an important component of NTD prevention.

As the first stage of formative research in planning a prevention campaign, an exploratory, qualitative study was conducted to understand the complexity of vitamin use among women of childbearing age and to assist in the development of a national communication and education intervention. To this end, English-speaking women of childbearing age (18–34 years) participated in a total of 24 focus groups in four locations across the United States. The focus groups were designed to explore issues related to women's perceptions of health, the perceived relationship between diet and the need for multivitamins, women's knowledge about folic acid, and women's perceptions about taking a multivitamin daily. The implications of these results will be discussed in terms of their contribution to the development of a creative, new approach to increase multivitamin consumption among women of childbearing age.