| The need to increase the number of physicians who incorporate folic acid nutritional counseling for female patients of childbearing age, and their limited training in this area, prompted the development and evaluation of two versions of a Web-based instruction about folic acid. The overall goal was to increase the number of clinicians who are prepared to offer folic acid counseling, and to motivate them to adopt such counseling. We sought to determine whether an abbreviated (15 minute) module more effectively promoted knowledge and behavior competency than an extended (40 minute) module. To assess the impact of the modules on knowledge, attitudes, and behavior, this study tested them among 271 students at three medical schools. Assessments were done at baseline, post-instruction, and 7 weeks after the instruction. There was a significant increase in competency over the measurement periods (p < 0.001). After their participation, students expressed confidence and preparedness to advise patients about the vitamin, and expressed intent to implement folic acid counseling in clinical practice. There were no significant differences in results for the two versions of the module, but the amount of time spent in a module was a significant variable. Students who spent >15 minutes in either program were twice as likely to achieve competency at the posttest versus those who spent <15 minutes in either training (OR 2.05; 95% CI = 1.13--4.76; p = 0.0216). Additionally, significantly higher scores were found among females than among males in two of three assessment periods, at baseline (p = 0.003) and retest (p = 0.009), suggesting that the female participants knew more about the subject at baseline, and retained more information than males. The number of females reporting daily folic acid intake also rose significantly from 36% at baseline to 46% at retest (p = 0.004). These results suggest that the modules provided effective instruction, and also effectively promoted behavior change among the females, who are both clinicians and women of childbearing age. This study appears to be the first of its kind and has yielded a variety of data that may be useful for determining the length, content, and design of Web-based programs for folic acid education and nutrition education in general. |
