Flores Alina L, Isenburg Jennifer, Hillard Christina L, deRosset Leslie, Colen Lisa, Bush Troy, Mai Cara T
1 Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities , Atlanta, Georgia .
2 Carter Consulting, Inc. , Atlanta, Georgia .
J Womens Health (Larchmt). 2017 Feb;26(2):186-194. doi: 10.1089/jwh.2016.6116. Epub 2017 Jan 9.
Although rates of neural tube defects (NTDs) have declined in the United States since fortification, disparities still exist with Hispanic women having the highest risk of giving birth to a baby with a NTD. The Promotora de Salud model using community lay health workers has been shown to be an effective tool for reaching Hispanics for a variety of health topics; however, literature on its effectiveness in folic acid interventions is limited.
An intervention using the Promotora de Salud model was implemented in four U.S. counties with large populations of Hispanic women. The study comprised the following: (1) a written pretest survey to establish baseline levels of folic acid awareness, knowledge, and consumption; (2) a small group education intervention along with a 90-day supply of multivitamins; and (3) a postintervention (posttest) assessment conducted 4 months following the intervention.
Statistically significant differences in pre- and posttests were observed for general awareness about folic acid and vitamins and specific knowledge about the benefits of folic acid. Statistically significant changes were also seen in vitamin consumption and multivitamin consumption. Folic acid supplement consumption increased dramatically by the end of the study.
The Promotora de Salud model relies on interpersonal connections forged between promotoras and the communities they serve to help drive positive health behaviors. The findings underscore the positive impact that these interpersonal connections can have on increasing awareness, knowledge, and consumption of folic acid. Utilizing the Promotora de Salud model to reach targeted populations might help organizations successfully implement their programs in a culturally appropriate manner.
尽管自食品强化以来美国神经管缺陷(NTDs)的发生率有所下降,但差异仍然存在,西班牙裔女性生育患有NTDs婴儿的风险最高。使用社区非专业健康工作者的健康促进者模式已被证明是针对西班牙裔人群开展各种健康主题宣传的有效工具;然而,关于其在叶酸干预方面有效性的文献有限。
在美国四个有大量西班牙裔女性人口的县实施了一项采用健康促进者模式的干预措施。该研究包括以下内容:(1)一份书面的预测试调查,以确定叶酸意识、知识和摄入量的基线水平;(2)小组教育干预以及90天的多种维生素供应;(3)在干预后4个月进行的干预后(后测试)评估。
在叶酸和维生素的总体意识以及叶酸益处的具体知识方面,预测试和后测试之间存在统计学上的显著差异。在维生素摄入量和多种维生素摄入量方面也观察到了统计学上的显著变化。到研究结束时,叶酸补充剂的摄入量大幅增加。
健康促进者模式依赖于健康促进者与其所服务社区之间建立的人际关系,以帮助推动积极的健康行为。研究结果强调了这些人际关系对提高叶酸意识、知识和摄入量可能产生的积极影响。利用健康促进者模式覆盖目标人群可能有助于组织以符合文化习惯的方式成功实施其项目。