The increasing knowledge of the role of periconceptional folate in Victorian women of child-bearing age: Follow-up of a randomised community intervention trial

Objectives: To determine the changes since 1996 in knowledge of folate for the prevention of neural tube defects (NTDs) among women of child-bearing age and measure the residual effect of an earlier consumer-directed information campaign. Design: A community, randomised trial with three matched pairs of geographically distinct local government areas in Victoria. Intervention: Printed information recommending folate intake to decrease the risk of NTDs was disseminated in 1997 to women of child-bearing age. Main outcome measure: The proportion of women aware of the association between folate and spina bifida was established in 1996, 1997 and 2000 (approximately 200 respondents per local government area in each survey). Results: 12.5% (adjusted for population sampling fraction) of 1,196 women interviewed in 1996, prior to the intervention, were aware of folate and NTDs. Independent surveys after the intervention in 1997 and again in 2000 showed that this had increased to 17.4% (n=1204) and 30.2% (n=1227) respectively. The intervention had a significant impact on folate awareness (a 4% difference in 1997 and a residual 3.3% in 2000, OR_adj=1.24, 95% CI 1.19-1.37, p=0.007). Conclusions and implication: There has been a continuing increased awareness of folate in women of child-bearing age since 1996. Within this setting, the provision of printed educational material in a brief intervention in 1997 has caused enduring increased awareness of the association between folate and NTDs. The need for ongoing health promotion action on folate remains.