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Updated: Jun 11, 2026

Modifying Levels of Maternal Dietary Folic Acid or Choline to Study the Impact of Deficiencies on Offspring Health Outcomes
Published on: June 28, 2024
Impact of a stage-tailored, web-based intervention on folic acid-containing multivitamin use by college women
Julie E Milan1, Adrienne A White
1Department of Food Science and Human Nutrition, University of Maine, Orono, ME 04469-5735, USA. julie_milan@umit.maine.edu
Purpose:
To examine effectiveness of a Web-based, stage-tailored folic acid intervention compared to non-stage-tailored education to promote folic acid-containing multivitamin use among college women.
Design:
Pretest/posttest with random assignment to groups.
Setting:
Internet-based on college campus.
Participants:
Female college students (n = 408; mean age +/- SD = 20.8 +/- 2.6; range 18-29 years).
Intervention:
Transtheoretical Model-based folic acid modules delivered over 4 weeks. Traditional brochure formatted online for nontailored group.
Measures:
Questionnaire assessing stage of change, self-efficacy, and decisional balance.
Analysis:
Chi-square test and logistic regression. Results Of the participants who reported not taking a multivitamin at pretest, a greater proportion of participants in the tailored group (32.6%; n = 47) reported taking a multivitamin at posttest than in the nontailored group (19.9%; n = 27), chi(2)(1, n = 280) = 5.9, p = .015. At posttest tailored intervention participants were 2.5 times more likely to be in a later stage of change (odds ratio [OR] = 2.45; 95% confidence interval [CI] = 1.52, 3.99; p = .0003) and 2.3 times more likely to be in action (OR = 2.27; 95% CI = 1.28, 4.01; p = .005) than nontailored participants. They also had greater increases in self-efficacy and pros. Movement from precontemplation to a later stage occurred significantly more often in the tailored than in the nontailored group. Conclusion Stage-tailored vs. traditional folic acid education was more effective in improving stage of readiness to consume a folic acid-containing multivitamin. The Internet was a successful medium for targeting college females for preconception health care education.
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