Understanding the intention to permanently follow a high folate diet among a sample of low-income pregnant women according to the Health Belief Model

Despite folate fortification of the US food supply beginning January 1, 1998, evidence indicates that a substantial proportion of women of child-bearing age will continue to have folate intakes inadequate for the prevention of neural tube defects (NTDs). Therefore, health education remains an essential component of this public health campaign. The purpose of this study was to determine the applicability of the Health Belief Model (HBM) to understanding the intention to permanently follow a high folate diet among low-income pregnant women. A convenience sample of 251 low-income pregnant women participated in individual 15 min interviews assessing their folate attitudes and beliefs according to the model. Correlations consistent with the HBM were found between the perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy and cues to action constructs, and participants' intention to permanently follow a high folate diet (folate intention). In regression analyses, the perceived benefits construct was consistently the most predictive of folate intention. Participants were generally unfamiliar with and had many misperceptions concerning both folate and NTDs. The HBM may offer an effective foundation for development of tailored educational interventions promoting permanent consumption of a high folate diet among low-income women.