Go Folic! A multi-lingual community clinic intervention to increase folic acid knowledge and supplementation among women not planning pregnancy

BACKGROUND The USPHS recommends that all women who can become pregnant take 400 mcg of folic acid daily to reduce the risk of having a child with a neural tube defect, preferably through vitamin supplementation. However, vitamins can be unaffordable for low-income women, and many women do not understand folic acid's preconception/health benefits. QUESTION Is it feasible for community clinic staff with limited time to implement an intervention to increase clients' folic acid knowledge and supplementation? METHODS The San Francisco Department of Public Health Go Folic! Project partners with community clinics to implement a two-minute intervention through which Chinese, English and Spanish-speaking women clients, ages 14-44, are educated about health and beauty benefits of folic acid and offered free multivitamins with 400 mcg of folic acid. In August 2010, we surveyed 43 staff to assess their ability to implement the intervention. We also surveyed 95 clients who received vitamins between October 2009 and June 2010 to determine whether the intervention had increased their intake of a daily multivitamin with folic acid. RESULTS Fifty-four percent of participating staff reported that they implemented the intervention with 25% or greater of their eligible women clients; 52% indicated that the program is a worthwhile adjunct to the clinic. Over 70% of clients surveyed reported that they learned about folic acid and started to take a multivitamin consistently because of the intervention. CONCLUSIONS Findings suggests the intervention is feasible for already busy community clinic staff and increases women's knowledge and intake of folic acid.