The U.S. Public Health Service recommends multivitamins or another daily supplement that contains folic acid for all women who may become pregnant. Folic acid has been shown to reduce the occurrence of neural tube defects, which affect about 4,000 pregnancies and 2,500 to 3,000 births in the United States each year.
"But most women of childbearing age in the United States do not take a vitamin containing folic acid regularly," say Jean M. Lawrence, Sc.D., M.P.H., M.S.S.A., of Kaiser Permanente Southern California and colleagues, who carried out the study in a group of 3,438 Kaiser Permanente members.
One intervention relied on physicians and other health care professionals to discuss the importance of taking a multivitamin with their patients and to distribute educational pamphlets about the benefits of folic acid. In the second intervention, 50,000 women were mailed a "starter kit" of 100 multivitamins and an educational pamphlet, and pharmacies in their area offered a free refrigerator magnet with the women's' next vitamin purchase.
There was no significant long-term change in vitamin use in either group, although the women who received the multivitamins directly did briefly increase their vitamin use for a short period during the study.
However, the researchers did a follow-up survey of the participating health care professionals and found little support for the interventions, suggesting that they may not have been fully implemented.
"Despite extensive training of staff and repeated reminders from a full-time intervention coordinator to implement the interventions, half of the physicians and other health care professionals who responded to the survey said that they rarely or never gave out the study brochure or
Contact: Mike Byrne
Center for the Advancement of Health