Power Me A2Z Arizona Department of Health Preconception and Folic Acid Media Social Marketing Campaign

Theoretical Background and research questions/hypothesis:  In 2011, the Arizona Department of Health Services (ADHS) initiated a preconception campaign to increase awareness and consumption of folic acid among young women in response to:

• the rate of neural tube birth defects
• the Arizona Behavior Risk Survey that shows five consecutive years of folic acid awareness below 45%
• an established state statute authorizing a program to distribute folic acid to women of childbearing age. 

Hypothesis: The campaign will raise awareness and motivate change by:

• Targeting key populations with culturally and age-appropriate strategies and free products
• Motivating behavior change by creating messages relevant to young women who are not planning a pregnancy (non-planners).
• Grounding campaign messages and strategies in formative research and evaluation
• Creating sustainability through dissemination with key community partnerships

Objectives: Based on in-depth formative research, the target audiences were narrowed to: non-planning young women (18-25); pharmacists; and other healthcare providers.  The campaign aims to (1) increase women’s consumption of vitamins with folic acid, and (2) raise awareness about preconception health behaviors including physical, sexual, and mental health.

Methods:  SUMA designed and implemented the campaign using: audience segmentation; an internal communications assessment to catalogue existing resources within ADHS; formative research with key stakeholders (N=40), non-planning women 18-25 (10 focus groups, 35 in-depth interviews,) a qualitative telephone survey of 400 women in Arizona, and healthcare providers (5 focus groups). Research-Based Campaign Strategy:

• Create sustainability though an innovative distribution and educational partnership with the Arizona Pharmacy Association and their student representatives on key college campuses.
• Design/develop/distribute Power Packs (with 100-day supply of folic acid vitamins, health magazine, campaign collateral).
• Broadened folic acid key messages to include benefits for women and preventing birth defects. Focus group findings support women are more motivated to take folic acid when they learn the personal benefits. This is important since the target audience is non-planning women but 50% of pregnancies are unplanned.
• Up Coming Paid and Earned Media (radio/television/print/web, Spanish/English) to promote www.PowerMeA2Z.org for health information and Power Pack registration.
• Community Outreach through health fairs, cultural celebrations (e.g., Pow Wows) and local partnerships.
• Website Development of www.PowerMeA2Z.org where women complete an interactive 6 questions quiz centered on preconception health behaviors prior to registering for vitamins.  
• Continuing Medical Education workshop for healthcare professionals, featuring nationally-renowned speakers.

Results:  The campaign is in the first months of implementation. Evaluation will include website analytics, continuing education workshop surveys, and an internet survey of women who received the Power Pack.

Conclusions:  Evaluation is on-going using the above mentioned evaluation methods and post surveys later in the year.

Implications for research and/or practice:  This campaign offers a promising national model to follow. It includes two unique campaign elements to promote folic acid 1) a strong statewide partnership with pharmacists 2) reframing the reasons young women of childbearing age should take folic acid. The approach is the foundation for a sustainable campaign to create long-lasting effects on women’s health behaviors and birth outcomes.