On this page
- Factors
- Interview Strategies
- Barriers
- Related Info
HCET Home > On-line Training > Folic Acid: Getting the Word Out > 4. Factors, Barriers & Strategies for Delivering the Folic Acid Message
4. Factors, Barriers & Strategies for Delivering the Folic Acid Message Use the following table to choose a strategy for "delivering the folic acid message" that works best for your clinic and your clients.| Factors | Barriers | Strategies |
|---|---|---|
| Clinic
Factors |
Lack of Time | Use a brief, standardized message. |
| Information Overload | Have short well-written educational handouts, clinic posters, and video clips in the waiting room. | |
| Client
|
Pregnancy Contemplators | “You need to take folic acid BEFORE you know you’re pregnant to prevent certain birth defects.” |
| Pregnancy Non-contemplators | “Your body’s preparing for pregnancy, even if you are
not. It’s not too soon to take folic acid today, and
everyday.” “FOLIC ACID NOW – so your body’s ready when you are.” |
|
| Age – Young Women | Emphasize that teens can be actively involved in the
solution for NTD risk reduction. Focus on informing young women about other health benefits of folic acid. |
|
| Age – Older Women | Focus on health benefits of folic acid, such as potentially
lowering risk for cardiovascular disease and cancer. Focus on body’s need for folic acid to maintain healthy tissues, thus emphasizing a daily need for folic acid and overall health and vitality. |
|
| Low Income | Consider low-income level when recommending certain
foods and vitamin supplements. Make clients aware of WIC eligible foods that are fortified with folic acid or are rich in folate. Reluctance to take vitamins and supplements (see table below). |
|
| Low Literacy Level | Focus on picture representations in handouts. | |
| Cultural Differences | Learn about your client’s background from available
resources. Ask your clients about their cultural health beliefs, practices and customs. Look for non-verbal clues to indicate whether your client is comfortable with the interaction. Identify educational materials in client’s native language. |
- Reviewing the client’s history
- Measuring vital statistics
- The client asks a question about nutrition, multivitamins, supplements or general preventive health measures
- The individual expresses the desire to become pregnant
(see slide #39). - What do you know about folic acid?
- Do you currently take any vitamin or mineral supplements? Which ones? How often?
- Has had a prior NTD-affected pregnancy;
- Has diabetes, epilepsy, or history in family of pregnancy resulting in NTDs or other birth defects;
- Has had a miscarriage;
- Is planning to become pregnant
- Has barriers that prevent her from taking folic acid/or eating a health diet
During a client visit, when should a clinician discuss folic acid intake with a client?
Starting a conversation about folic acid can begin with a few simple questions:
It is important to determine the client’s history before providing a recommendation; determine if she:
While folate vitamin supplements are the only proven way to prevent NTDs, many women prefer are reluctant to take vitamins. The following table illustrates barriers to taking vitamins as well as suggestions for overcoming those barriers.
| Barriers to Taking Vitamins | Suggestions and Motivators for Overcoming Barriers |
| Swallowing pills is difficult | To ease swallowing, try folic acid supplements (they are smaller) or chewable/dissolvable vitamins. |
| Increase appetite, weight gain | There is no evidence to suggest vitamins cause weight gain. |
| Nausea | To reduce nausea, take a vitamin after eating a meal or take only a supplement. |
| Cost | To reduce cost, select store brand vitamins or take only a supplement. |
| Forget to take them | To aid in remembering, place vitamins near something that is used everyday, like near a toothbrush. |
