Background:
Up to 70 percent of neural tube defects could be prevented with adequate folic acid intake in the pre- and periconception period. Data sources suggest that most women do not have an adequate level of folic acid in their body and that most do not take a folic acid or multivitamin supplement. Young women, particularly underserved women, are the least likely to take a multivitamin. In January 2005, the March of Dimes Florida Chapter and the Florida Department of Health implemented a three-year initiative to advance pre/interconceptional health education and multivitamin use among underserved women of childbearing age. The effort was supported by a 2 million dollar grant from the State Attorney General's office and over 500,000 bottles of vitamins were distributed. Over 250 organizations participated in the project.

Objectives:
This presentation discusses the successes and challenges of implementing a statewide folic acid education and vitamin distribution project monitored by ongoing tracking and evaluation. By the end of this presentation, participants will:
• Be aware of factors that may influence the effectiveness of a particular setting (i.e. WIC, Family Planning, home visiting etc.) in incorporating multivitamin distribution and preconception health education
• Identify successful strategies for implementing a statewide preconception health and folic acid campaign


Methods:
Partnerships in the campaign were established with a variety of organizations, including WIC, community health centers, universities, faith-based organizations, migrant health centers and home visiting providers. Each partner furnished data to support evaluation of the success of the individual site in implementing the project. This data, coupled with information gathered at the state-level, provided the basis for assessing overall project implementation success.

Results:
Some project sites met with more success implementing the project than others. A variety of factors contributed to individual success.

Conclusion and implications for practice:
In considering a statewide effort to promote preconception health among underserved women, efforts must be made to minimize impact of challenges to implementation. Some types of sites may be more appropriate for providing preconception health resources.