Folic acid promotion and monitoring in a pregnant and parenting program

Background: To reduce the risk for neural tube birth defects, women of reproductive age should consume at least 400µg of folic acid daily. Adolescence is an important time to encourage folic acid intake because, overwhelmingly, pregnancies during this time are unplanned. Additionally, habits established during adolescence may continue throughout the lifecourse. According to the 2010 California Maternal and Infant Health Assessment, fewer adolescents (23.9%, 95%CI 17.5-30.2) between 15-19 years of age with a recent live birth consumed a folic acid supplement daily before the pregnancy than the 33.9% (95%CI 31.9-36.0) of women between 20-44 years of age. Using Title V funding, the California Adolescent Family Life Program (AFLP) addresses the consequences of adolescent pregnancy by providing comprehensive case management to pregnant and parenting teens, including nutrition guidance. This serves as an excellent contact point for interconception counseling regarding folic acid consumption. Methods: To engage pregnant and parenting teens, web-based folic acid guidelines were developed for the AFLP case management intervention. These new guidelines promoted folic acid as important for beauty and overall health without an emphasis on reproduction. Complementary preconception social marketing materials were used to target non-pregnant teens in California. Results: The new Guidelines have been incorporated into all 37 AFLP programs that serve over 8,000 clients annually. AFLP will continue to trend adolescent folic acid consumption. Conclusion: States should use Title V funds to incorporate folic acid interventions into existing programs to meet the needs of adolescents. Folic acid use among teens should be regularly monitored.