Nurse-Led Educational Intervention to Promote Knowledge and Attitude of Folic Acid Intake among Reproductive-Age Women
DOI:
https://doi.org/10.5281/zenodo.21411716Keywords:
Folic Acid; Neural Tube Defects; Health Knowledge; Attitude; Reproductive Age; Nursing Education; PakistanAbstract
Background: Pakistan continues to report a high prevalence of neural tube defects (NTDs), yet awareness of periconceptional folic acid (FA) and the adoption of a positive stance toward its use are alarmingly low. This study evaluated the effectiveness of a nurse-led educational intervention on FA knowledge and attitudes among reproductive-age women in a peri-urban community in Karachi.
Methods: A quasi-experimental (pre-test/post-test) study was conducted from March to November 2024 in Sachal Goath, Karachi. Using purposive sampling, 260 married women aged 15–40 years with a history of pregnancy were enrolled. A validated questionnaire comprising two sections (1) a knowledge section adapted from the CDC folic acid quiz and (2) a five-item attitude scale adapted from Sadiq and Hussein (2022) was administered before, immediately after, and six weeks following a 20-minute doorstep teaching session. Overall, 60 women (23.1%) dropped out, leaving 200 for final analysis. Primary outcomes were correct knowledge (timing, dose, preventive role) and a positive attitude (score ≥3 on the attitude scale). McNemar’s test and Spearman’s rank correlation were used.
Results: Among the 200 participants, baseline FA awareness was 33.0%. Correct timing knowledge increased from 28.5% to 86.0% post-intervention (p < 0.001), and correct dose knowledge from 18.0% to 80.5% (p < 0.001). Good or excellent knowledge rose from 13.0% to 87.5% immediately and remained at 78.0% at six weeks. Positive attitude increased from 31.0% at baseline to 79.5% post-intervention (p < 0.001). A significant correlation was found between post-intervention knowledge and attitude (Spearman’s rho = 0.64, p < 0.001).
Conclusion: A single nurse-led session significantly enhanced FA knowledge and favorable attitudes in reproductive-age women, sustained at six weeks. Expanding this through community health workers holds potential to reduce NTDs across Pakistan.
