Motivators and barriers to prenatal supplement use among consistent and inconsistent users -- Minority women in the U.S

Background: Minority women in the U.S. are least likely to report consistent use of prenatal supplements. Little information exists on perceived benefits and barriers to prenatal supplement use among these women.

Methods: We analyzed 12 focus groups conducted with recently pregnant, minority women of all income levels (n=102) in three U.S. cities. Groups were equally divided into consistent (5-7 times/wk and >3 months) and inconsistent (0-4 times/wk and <2 months) users of prenatal supplements. We examined motivators and barriers to supplement use related to the individual, social network contacts, health care providers (HCP), qualities of the pills and regimen, and adverse effects. All data were coded by two investigators using NVIVO software and differences were resolved by discussion. We identified themes among these factors and compared responses between consistent and inconsistent users.

Results: For both groups, convenient supply and low cost encouraged consistent use. Common barriers were poor communication from HCPs about the need and benefits of use, pill qualities (size, taste, smell), and adverse effects (nausea, vomiting). Common motivators among consistent users included HCP trust, HCP and social network (peer, relative) reinforcement of daily intake, and fear of infant adverse effects from vitamin/mineral deficiencies. Common barriers among inconsistent users included skepticism toward HCP advice about supplement efficacy and necessity, and negative feedback from their social network.

Conclusions: In this study, prenatal supplement use was influenced by many factors in women's lives. Improved HCP communication about supplements and social network support are likely to encourage consistent use among minority women.