Date of Award
Level of Access Assigned by Author
Doctor of Philosophy (PhD)
Food and Nutrition Sciences
Adrienne A. White
Second Committee Member
Richard A. Cook
Third Committee Member
Most college-age women fail to consume the recommended 400 micrograms of folic acid, the B vitamin needed to prevent birth defects affecting the neural tube in unborn babies. The study objective was to examine the effectiveness of a web-based, stage-tailored folic acid intervention based on the Transtheoretical Model (TTM) compared to non-stage tailored folic acid education. Subjects were drawn from a random sample of female college students (n=408), (mean age±SD=20.8 ± 2.58, ranging from 18-29 years). Using a pre-/post-test, interventionlcontrol design, subjects were randomly assigned to either 1) the non-tailoredcontrol group, who received non-stage tailored folic acid education; or 2) the tailored treatment group, who received stage-tailored folic acid education. To evaluate the intervention, TTM-based instruments were administered at baseline (week one) and at post-test (week six). Subjects were assessed for 1) stage of change for readiness to consume a multivitamin containing folic acid; 2) self-efficacy; 3) decisional balance, the pros and cons of changing behavior; and 4) dietary folate intake, based on a food frequency questionnaire. Of the 99% who completed the study, significantly more of the staged-tailored group advanced in stage at post-test compared to the non-tailored group (OR=2.45; 95% CI=1.52, 3.99; p=.0003). Movement from precontemplation to a later stage occurred significantly more often in the tailored group than in the non-tailored group (OR=2.48; 95% CI=1.33,4.63; p=.004). Among subjects who were not taking a multivitamin at pretest, therefore staged in pre-action, the tailored group was significantly more likely to be taking a multivitamin at post-test, therefore staged in action, compared to the non-tailored group (0R32.27; 95% CI=1.28,4.01; p=.005). The stage-tailored group also had greater increases in self-efficacy and pros, from pre- to post-intervention, than the non-tailored group (p<.05). Regardless of group, most subjects did not meet recommended levels for dietary folate at pre- or post intervention, nor did intake differ by stage of change for multivitamin intake. Web-based, stage-tailored folic acid education was a successful means of improving college women's stage of readiness to consume the recommended amount of folic acid from a multivitamin. Funding was provided by the Maine State Chapter of the March of Dimes.
Milan, Julie E., "The Women's Folate Study: A Stage-Tailored, Web-Based Intervention for College Women" (2004). Electronic Theses and Dissertations. 1262.
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