Raleigh, NC (October 19, 2009) – A recent study conducted by the North Carolina Folic Acid Campaign found that educating health care providers about folic acid can increase their knowledge and ability to counsel their patients. The program, called the Office Champion Program, increased health care providers’ knowledge of the proper timing of folic acid supplementation, the correct folic acid daily dose, and the correct recurrence prevention dose for those who have had a baby with a neural tube defect (NTD).

These findings are important because health care providers are the leading source of folic acid information for women. If all women took adequate folic acid before and during pregnancy, 50 to 70 % of NTDs, like spina bifida, could be prevented. Unfortunately, only one-third of women ages 18-45 have discussed the benefits of folic acid with their health care provider, even though 89 percent of women who do not take multivitamins say they would be likely to do so on the recommendation of their health care provider.

In order to close this gap, the Folic Acid Campaign developed a unique education initiative to remind health care providers about folic acid so that they can influence their patients’ behavior. This Office Champion program provides in-service educational sessions and trainings to public and private health care providers throughout North Carolina.

An evaluation of the Office Champion Program took place from 2006-2008 to examine the knowledge, attitudes and recommendation behavior related to folic acid and multivitamin use among private health care providers. Evaluators randomly selected OB-GYN and family practice offices from a statewide database. Prior to the in-service, staff administered a confidential survey to those in attendance to assess the baseline knowledge and behavior of providers. Three to four months later, a second survey was sent by mail to measure how individual health care providers’ knowledge, attitudes and counseling behaviors related to folic acid and multivitamins had changed as a result of the in-service and program.

A total of 104 respondents, including 57 nurses, 29 doctors, 14 mid-level providers and two health educators, completed the survey. The results showed that the Office Champion Program strengthened provider knowledge with regard to:

·        Proper timing of folic acid supplementation: 87% of respondents answered correctly (at least one month before conception) before the in-service and 94% after the in-service. North Carolina providers have high knowledge about the importance of taking folic acid before pregnancy.

·        Correct folic acid daily dose: Improvement from 53% to 73% of respondents who correctly identified 400 mcg.

·        Correct recurrence prevention dose: Improvement from 24% to 45% of providers who knew that 4000 mcg before pregnancy is the correct dose to prescribe if a patient has a history of a prior NTD-affected pregnancy.....

·        U.S. unintended pregnancy rate: Improvement from 63% correctly identifying the correct rate (~50%) before the in-service to 66% after the in-service. Health care providers still need convincing that unintended pregnancy is an important issue.

The program also appears to be effective in influencing health care provider counseling behaviors in regard to folic acid and multivitamins. The proportion of providers who reported discussing folic acid and multivitamin use with at least half their female patients of childbearing age at annual exams jumped from 51% before the in-service to 69% afterward.

Discussing folic acid and multivitamin use at routine visits is of particular interest because those visits are often related to chronic medical conditions (such as diabetes) that could affect future pregnancies. Encouragingly, 25% of providers surveyed made a positive shift toward counseling the majority of their female patients about folic acid and multivitamin use at these visits, from 36% before the intervention to 55% after.

These results demonstrate that the Office Champion program has the potential to influence provider knowledge and behavior regarding one important health message, folic acid consumption. As a result of this program evaluation, the Folic Acid Campaign will be able to strengthen the Office Champion curriculum and provide feedback to existing Office Champion practices. These results will also be useful as the Office Champion program grows, potentially adding information about other health topics for providers.

“This research not only helps the Folic Acid Campaign strengthen its programs, but it’s a great way to remind health care providers that it only takes 15 seconds to start a conversation with their patients about folic acid and multivitamins,” said Amy Mullenix, MSW, MPSH, the Folic Acid Campaign’s statewide coordinator. “Health professionals are important motivators in changing patient behavior, and patients value the opinion of their health care provider.”

For more information about the results of this study, please contact Megan Fazekas, at 919-424-2151 ormfazekas@marchofdimes.com. The North Carolina Folic Acid Campaign, a collaboration between the North Carolina Folic Acid Council and the March of Dimes, uses innovative initiatives to educate women about the benefits of folic acid and the birth defects it helps to prevent. The statewide program’s mission is to improve health by promoting the benefits and consumption of folic acid by taking a daily multivitamin. Established in 1994, the program advocates that all women of child bearing age take 400 mcg of folic acid daily to help prevent birth defects of the brain and spine, called neural tube defects (NTDs). Membership in our Council is free. Visit www.getfolic.com for more information.