A Village-Based Intervention: Promoting Folic Acid Use among Rural Chinese Women

BACKGROUND Folic acid supplementation is effective in reducing the risk of neural tube defects (NTDs). However, the use of folic acid is low among rural women in China. Nutrition education can provide information about folic acid and encourage its use. The primary objective of this study was to test the effectiveness of a village-based nutrition intervention on folic acid use among rural women. METHODS Sixty villages were randomly selected using multiple-stage sampling and were divided into control and intervention groups. The intervention included nutritional education at village clinics, written materials, and text messages (SMS). Folic acid use knowledge and behavior was assessed at baseline and after the intervention. RESULTS Self-reported compliance with folic acid supplement use increased from 17.0%-29.2% at baseline to 41.7%-59.2% one year post-intervention. During the same period, the folic acid knowledge score in the intervention group increased from 3.07 to 3.65, significantly higher than the control group (3.11 to 3.35). Multivariate binary logistic regression showed that the women who received folic acid education and SMS intervention were more likely to comply with folic acid supplement recommendations. CONCLUSIONS The results indicated that an integrated village-based folic acid education intervention may be an effective way of promoting folic acid use for the prevention of NTDs in rural women.