Folic Acid Education for Hispanic Women: The Promotora de Salud Model

Abstract

Background Although rates of neural tube defects (NTDs) have declined in the United States since fortification, disparities still exist with Hispanic women having the highest risk of giving birth to a baby with a NTD. The Promotora de Salud model has been shown to be an effective tool for reaching Hispanics for a variety of health topics; however, literature on its effectiveness in folic acid interventions is limited. Methods An intervention using the Promotora de Salud model was implemented in four U.S. counties with large populations of Hispanic women. The study comprised: 1) a written pre-test survey to establish baseline levels of folic acid awareness, knowledge, and consumption; 2) a small group education intervention along with a 90-day supply of multivitamins; and 3) a post-intervention (post-test) assessment conducted four months following the intervention. Results Statistically significant differences in pre- and post-tests were observed for general awareness about folic acid and vitamins, and specific knowledge about the benefits of folic acid. Statistically significant changes were also seen in vitamin consumption and multivitamin consumption. Folic acid supplement consumption increased dramatically by the end of the study. Conclusions The Promotora de Salud model relies on interpersonal connections forged between promotoras and the communities they serve to help drive positive health behaviors. The findings underscore the positive impact that these interpersonal connections can have on increasing awareness, knowledge, and consumption of folic acid. Utilizing the Promotora de Salud model to reach targeted populations might help organizations successfully implement their programs in a culturally appropriate manner.

Enablers and barriers to women's lifestyle behavior change during the preconception period: A systematic review

“…Thirty‐seven studies reported on supplement use, 50–86 10 studies reported on diet, 50–55,87–90 10 included smoking, 50–52,54–59,91 8 included alcohol use, 50,51,54,56–59,89 and 5 included physical activity 50–53,90 . Thirty‐eight studies were quantitative, 50–52,54–58,60–64,66–74,77,78,80–91 and four were qualitative 53,65,75,76 . The majority of studies were conducted in high‐income countries (HIC) ( n = 31: United States, 51,54,59,79–89,91 United Kingdom, 75–77 Italy, 56,57,65,66 the Netherlands, 71,72 Australia 53,60 Croatia, 62 Ireland, 64 the Kingdom of Saudi Arabia, 67 Poland, 58 and United Arab Emirates 78 ).…”

“…Thirty‐eight studies were quantitative, 50–52,54–58,60–64,66–74,77,78,80–91 and four were qualitative 53,65,75,76 . The majority of studies were conducted in high‐income countries (HIC) ( n = 31: United States, 51,54,59,79–89,91 United Kingdom, 75–77 Italy, 56,57,65,66 the Netherlands, 71,72 Australia 53,60 Croatia, 62 Ireland, 64 the Kingdom of Saudi Arabia, 67 Poland, 58 and United Arab Emirates 78 ). The remainder were conducted in upper middle‐income countries ( n = 5: Iran, 90 China, 61 Lebanon, 68 Thailand, 74 Jordan 52 ), lower middle‐income countries ( n = 3: Nepal, 69,70 India, 55 Egypt 63 ), and low‐income countries ( n = 2: Ethiopia, 50 Sudan 73 ).…”

“…Studies reported aspects of psychological capability that acted as both enablers (knowledge and timing about supplement use) and barriers (lack of knowledge about taking supplement and its timing) as there was wide variation in the level of participants' knowledge between studies. For example, knowledge of folic acid use before pregnancy ranged from 3% to 95% 50,52,55,60,62,69,92 and the knowledge of timing of supplement intake ranged from 7% to 72% 51,52,55,58,61,63,67–72,74,77,78,80–83,85,86,93 . The proportion of women who were aware of benefits of preconception folic acid supplementation on pregnancy outcome also varied (55–95%) 54,56,57,84 …”

Correlates of knowledge on birth defects and associated factors among antenatal mothers in Galle, Sri Lanka: a cross-sectional analytical study

“…Many researchers have targeted on the awareness and intake of FA [28–30]. The “Promotora de Salud model” which relied on interpersonal connections of the community health workers, has shown an increased awareness and practice of FA among the participants in several studies [28, 29]. Sri Lanka also can practice this method through PHMs.…”

Sociodemographic Factors That Influence the Choice to Pursue Nasoalveolar Molding: One Pediatric Hospital’s Experience

“…This limited research indicates that whereas Caucasian patients receive NAM more than half the time, African American and Latino patients still receive the conventional surgeries up to 7 times more often than NAM (Sischo et al, 2012). Given that Latinos make up one of the largest and fastest growing population groups in Philadelphia and the United States, and the historic health care disparities of African American patients when compared to Caucasians, gaining further insight into disparities in cleft care is vital, both in our community and the country as a whole (Bhopal, 1998; MMWR, 2005; Flores, 2017).…”