Background:
The Utah Birth Defect Network is a statewide birth defect surveillance program that has monitored neural tube defects (NTDs) since 1994, for all pregnancy outcomes. UBDN data has demonstrated that women who have had a pregnancy affected by an NTD were more likely to be multiparous and under 30 years of age. The Utah WIC program serves approximately 50% of women and infants and reflects characteristics of women having babies with NTDs: 85% were under 30 years of age and likely have at least one child. Because maternal characteristics of the WIC clients were similar to the population we wished to target, the education and multivitamin project was piloted in the statewide WIC Program.

Objectives:
A pilot study to assess face-to-face education and intervention with free multivitamins in the WIC population.

Methods:
Educational materials and multivitamins were provided for each WIC clinic and were then given, in face-to-face sessions, to nonpregnant women enrolled in WIC, beginning in 2000. Program evaluation was conducted via the WIC Client Satisfaction Survey.

Results:
3,694 women completed the survey (76% English, 24% Spanish) for a response rate of 88%: mean age was 27 years, 71% were 19-33 years of age, 62% white and 36% Hispanic. Of the 3,007 women who answered the question regarding the WIC Vitamin Project, 626 (21%) stated they received the free bottle of multivitamins with 525 (88%) stating they had taken them: 215 (41%) finished the bottle, 59 (11%) finished the bottle and received another, and 231 (44%) consumed part of the bottle.

Conclusion and implications for practice:
This pilot project was well received by both clinic staff and the women served. Educating on the importance of consuming folic acid may facilitate the consumption of multivitamins for NTD prevention. A multifactorial study design will be necessary to assess whether face-to-face education with and without free multivitamins facilitates behavior change.