Develop And Evaluate A Folic Acid Education Program For Rural Women At Birth Age In Changsha County

Objective:In order to investigate completion degree of the "Supplements of Folic Acid to Prevent Neutral Tube Defects (NTDs)(SFAPN)" and analysis its influence factors, preliminary establish the education model of folic acid base on village clinic, to provide reference materials and evidences aiming at promoting the implementation of SFAPN.Methods:A multi-stage stratified cluster sampling method was applied to sample10towns and60villages in Changsha County, Changsha, Hunan Province in July2013. A total of10towns’officials who in charge of women and child affair,60village doctors and birth planning officials,661women who planned to pregnant at birth age was included. The questionnaire investigation included:(1) a questionnaire to collect the basic demographic characters of sampled women, their knowledge, attitude and practice of folic acid, as well as knowledge of SFAPN implementation;(2) basic demographic characters of towns’ officials who in charge of women and child affair, village doctors and birth planning officials, their knowledge of folic acid and self-report implementation of SFAPN. Sixty sampled villages were randomly divided into intervene group (30villages in total) and control group (30villages in total); the intervention group received a6months folic acid education which began in September2013. In March2014, the effect of intervene was evaluated.Results:1. SFAPN implementation conditionsThe average knowledge score of folic acid of village doctors and birth planning officials was (5.7±1.5). The average score of self-report SFAPN implementation was (8.1±0.8).2. The knowledge, attitude and practice of rural women of birth age on folic acid supplementation to prevent NTDsThe average folic acid knowledge score of rural women of birth age was (3.2±1.1). A multiple linear regression indicated that the average knowledge score of folic acid of village doctors X1(b=0.092) positively correlated to the average folic acid knowledge score, while rural women classified as migrants workers X3(b=-0.642) identified a negative correlation. The average attitude score towards folic acid supplementation of rural women of birth age was (9.3±1.3). A multiple linear regression showed that this is positively correlated with the average knowledge score of folic acid of village doctors X1(b=0.130) and knowledge of folic acid of rural women X7(b=0.361), while negatively correlated with rural women classified as migrant workers (b=-2.138). The knowledge rate of folic acid of rural women was25.1%; intake rate was72.1%; compliance rate was32.2%.The knowledge rate and intake rate of folic acid of rural women was lower than SFAPN final goal (2011).3. The effect of folic acid education interventionAfter folic acid education intervention, knowledge of prevalent of NTDs in China, knowledge of NTDs and folic acid supplementation to prevent NTDs, as well as knowledge of SFAPN of towns’officials who in charge of women and child affair, village doctors and birth planning officials were significantly improved. The folic acid knowledge score of rural women at birth age was improved as time passed by. The intervention interacted with time. The improvement of knowledge score in intervene group was more than in control group. A multiple linear regression indicated folic acid knowledge score was positively correlated with the average knowledge score of folic acid of village doctors X1(b=0.062), education X6(b=0.171), attitude score of folic acid X5(b=0.232), classified as intervene group X3(b=0.268). After intervention, the recent three mouth compliance rate of the intervention group is higher than the control group.Conclusions:1. Village doctors and birth planning officers in Changsha County possess a poor knowledge of folic acid while reported a high complete level of SFAPN. Folic acid training could effectively improve their knowledge of folic acid. 2. The knowledge rate and intake rate of rural women in Changsha County failed to meet the SFAPN final goal (2011). The compliance rate of folic acid intake was low.3. Via the folic acid education base on village clinic, the knowledge, intake and compliance rate of rural women was effectively improved.