Interventions to Increase Multivitamin Use Among Women in the Interconception Period: An IMPLICIT Network Study

Area of Science:

• Maternal and Child Health
• Public Health Interventions
• Preventive Medicine

Background:

• Congenital anomalies affect 3% of US infants annually, with neural tube defects being a significant concern.
• Multivitamins (MVIs) with folic acid are proven to reduce birth defects, yet many women have suboptimal intake.
• The interconception period presents a critical window for improving maternal health behaviors.

Purpose of the Study:

• To evaluate the effectiveness of the IMPLICIT ICC model in promoting MVI use among mothers.
• To identify interventions that increase MVI adherence in women of reproductive age.
• To leverage well child visits (WCVs) for maternal health risk screening and intervention.

Main Methods:

• The IMPLICIT ICC model was used to screen mothers attending WCVs for children aged 0-24 months.
• Mothers were assessed for behavioral risks, including MVI and family planning use.
• A mixed-effects logistic regression analyzed the odds of behavior change in MVI use post-intervention.

Main Results:

• 37.7% of mothers reported not using MVIs during WCVs.
• Interventions were provided to 64.0% of mothers to improve MVI use.
• Receiving MVI samples (OR 3.09) or provider advice (OR 1.64) increased MVI use at subsequent visits.

Conclusions:

• Pediatric WCVs offer a valuable opportunity for maternal counseling and behavioral change.
• Direct provision of MVIs is more effective than provider advice in increasing reported MVI use.
• Targeted interventions during WCVs can improve MVI adherence in at-risk women.