Health Care Provider Knowledge and Practices Regarding Folic Acid, United States, 2002–2003
Open accessAbstract
OBJECTIVE: To assess health care providers (HCP) knowledge and practices regarding folic acid (FA) use for neural tube defect (NTD) prevention. METHODS: Two identical surveys were conducted among 611 obstetricians/gynecologists (OB/GYNs) and family/general physicians (FAM/GENs) (2002), and 500 physician assistants (PAs), nurse practitioners (NPs), certified nurse midwives (CNMs), and registered nurses (2003) to ascertain knowledge and practices regarding FA. For analysis, T-tests, univariate and multivariate logistic regression modeling were used. RESULTS: Universally, providers knew that FA prevents birth defects. Over 88% knew when a woman should start taking folic acid for the prevention of NTDs; and over 85% knew FA supplementation beyond what is available in the diet is necessary. However, only half knew that 50% of all pregnancies in the United States are unplanned. Women heard information about multivitamins or FA most often during well woman visits in obstetrical/gynecology (ob/gyn) practice settings (65%), and about 50% of the time during well woman visits in family/general (fam/gen) practice settings and 50% of the time at gynecology visits (both settings). Among all providers, 42% did not know the correct FA dosage (400 mug daily). HCPs taking multivitamins were more than twice as likely to recommend multivitamins to their patients (Odds Ratio [OR] 2.27 95%, Confidence Interval [CI] 1.75-2.94). HCPs with lower income clients (OR 1.49, CI 1.22-1.81) and HCPs with practices having more than 10% minorities (OR 1.46, CI 1.11-1.92) were more likely to recommend supplements. NPs in ob/gyn settings were most likely and FAM/GENs were least likely to recommend supplements (OR 3.06, CL 1.36-6.90 and OR 0.64, CL 0.45-0.90 respectively). CONCLUSIONS: Knowledge about birth defects and the necessity of supplemental FA was high. Increasing knowledge about unintended pregnancy rates and correct dosages of FA is needed. The strongest predictor for recommending the use of FA supplements was whether the provider took a multivitamin.
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Most women recognize the value of optimizing health before pregnancy and most doctors consider preconception care important, yet few obstetrician-gynecologists or family physicians deliver comprehensive preconception care.
“Although most women understand the importance of optimizing their health before pregnancy and most physicians think PCC is important, few obstetricians/gynecologists or family physicians provide comprehensive PCC to their patients.9, 10”
From Reaching Women through Health Information Technology: The Gabby Preconception Care System (2013) · cites this paper as [10]
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- Authors
- Williams, J. L., Abelman, S. M., Fassett, E. M., Stone, C. E., Petrini, J. R., Damus, K., & Mulinare, J.
- Affiliations
- Centers for Disease Control and Prevention (US)
- March of Dimes (US)
- Corresponding author
- Williams, Jennifer L.
- Venue
- Maternal and Child Health Journal
- Published
- 2006-05-24
- Volume
- 10
- Issue
- S1
- Pages
- 67-72
- ISSN
- 1092-7875 (ISSN-L)
- 1573-6628
- OpenAlex
- W2007968444
- Cited by
- 47
- References
- 26
- Citations by year
- 2024: 1 · 2021: 3 · 2020: 4 · 2019: 1 · 2018: 2 · 2017: 2 · 2016: 3 · 2015: 4 · 2014: 1 · 2013: 2 · 2012: 5
- FWCI
- 2.63
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Maternal and Child Health Journal (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Rural Development Administration
- Centers for Disease Control and Prevention
- U.S. Food and Drug Administration
- Topics
- Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Spinal Dysraphism and Malformations
- Keywords
- folic acid supplementation, neural tube defects, prenatal care, health care provider knowledge, provider practices, unintended pregnancy, nurse practitioners, physician assistants, patient-provider communication, health disparities, low-income patients, racial and ethnic minorities, United States
- MeSH terms
- Attitude of Health Personnel, Clinical Competence, Family Practice, Female, Folic Acid, Humans, Male, Middle Aged, Neural Tube Defects, Obstetrics, Practice Patterns, Physicians', Pregnancy, Prenatal Care, Surveys and Questionnaires, United States, Health Care Surveys
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