Folic Acid for Healthy Babies
The National Folic Acid Campaign

The CDC, the March of Dimes, and the National Council on Folic Acid have organized the National Folic Acid Campaign to promote the use of folic acid to prevent the serious birth defects spina bifida and anencephaly. The goal of the campaign is to educate all women who could possibly become pregnant to consume 400 micrograms (400 mcg) of synthetic folic acid daily from vitamin supplements and/or fortified foods in addition to eating food folate in a healthful diet.

How will the campaign educate these audiences? CDC has used extensive health communications research to develop the messages and materials for the campaign. The materials and the implementation plan will be provided to all partners who wish to participate in the campaign. Channels and strategies for distributing those materials have been developed with input from women and community partners. Partners will be able to reprint any materials using their own logo and name. The messages were tested and reactions from the target audiences were very positive. The messages will be available as television, radio, and print PSAs, as well as posters and brochures for health care provider offices and other locations.

Who does the campaign target? The campaign will target all women of reproductive age, health care professionals who serve these women, and community advocacy groups. Among women of reproductive age, the research identified two primary target groups for the initial campaign: women planning a pregnancy (labeled "contemplators") and those not planning a pregnancy (labeled "non-contemplators"). 

The "contemplators"generally fall in the 18-35 year old range and are planning a pregnancy sometime in the next year or so. They would seriously consider behavior changes that would improve pregnancy outcomes. The biggest barrier for these women appears to be lack of knowledge–they do not know when folic acid is needed to be effective. Therefore, education about the importance of folic acid prior to conception and in the first few months is the objective. The timing of taking folic acid will be emphasized in the message to contemplators. As a group, Hispanic women reported more openness than other groups to the possibility of becoming pregnant, even if they are not actively planning pregnancy at the time. Since Hispanics are at increased risk for spina bifida and anencephaly, a concurrent campaign for Hispanic women uses materials developed specially for that group, and takes the contemplators target group strategy.

The pregnancy"non-contemplators" are harder to reach. These young women are usually 18-24 and are not planning to become pregnant. Because non-contemplators do not intend to become pregnant, they are more resistant than contemplators to behaviors that improve pregnancy outcomes. However, the average age for pregnancy is 21, and 50% of all pregnancies are unplanned. Women in this group understand that while they are not planning a pregnancy, they are biologically capable. Therefore, it is important to raise their awareness to take multivitamins now in order to reduce the risk for some serious birth defects in the future. The tone for messages to this group will be "hip", youthful, energetic, and will address some of the issues that made this message personal for them. The message for non-contemplators will emphasize that your body is ready for pregnancy even if you’re not planning a pregnancy now.

How will the campaign reach a national audience? The National Council on Folic Acid (NCFA) is a coalition of diverse organizations that interact with national consumer, professional, and multi-cultural constituencies and are committed to a campaign to promote folic acid to prevent birth defects. Each member organization of NCFA will contribute to the campaign in a manner that will maximize their distribution resources and best educate their constituents. NCFA is also recruiting additional partners from the fields of public health, education, and business to help implement and evaluate the campaign. Leadership and staff for NCFA is being provided by the National March of Dimes Birth Defects Foundation.

The CDC has published a Folic Acid Resource Guide to provide user-friendly technical assistance for our partners, local organizations, health departments, and community members to conduct local folic acid education campaigns that will compliment the national effort. The Resource Guide is available to all who request it.

CDC, the March of Dimes, and the National Council on Folic Acid will provide materials and training to all partners who wish to help in the campaign. Materials include television, radio, and print PSAs, media kits, posters and brochures. These campaign materials can be used to plan new state and local campaigns or to integrate into current public health efforts. They can be ordered by calling CDC toll-free at 1-888-232-6789.

March 1999
NCEH Pub No. 99-0128B
Order# 099-6066