Neural tube defects (NTDs) are among the most serious birth defects affecting approximately 4,000 pregnancies in the United States each year. More than one third of these pregnancies are spontaneously aborted. Thus, about 2,500 infants per year are born with an NTD. Research spanning two decades has shown that women who consume folic acid- containing supplements have 50% to 75% fewer infants with NTDs than women who do not consume folic acid supplements. Despite the empirical evidence in the literature, the message about folic acid is not getting across to the general public. This quasi-experimental pretest-posttest study examined the impact of a multifaceted educational intervention on the knowledge levels of college students concerning folic acid. The study was guided by one null hypothesis: There will be no significant difference in knowledge levels among college students before and after exposure to a folic acid educational intervention. The theoretical framework for this research was the Neuman Systems Model. The setting was a community college in a rural southeastern state. The sample was one of 1 1 1 convenience, utilizing five randomly selected 8:00 a.m. classes (N = 114), consisting of male and female students between the ages of 18 and 45 years. Data were compiled from a pretest questionnaire, establishing a baseline knowledge level. A fourfold educational intervention that extended over 3 weeks was initiated: E-mail messages were sent daily, posters were placed in strategic places on campus, television public service announcements rotated hourly, and displays with folic acid brochures were placed throughout the campus. At the completion of the intervention, a posttest was given. Data were analyzed using the dependent t test. A significant increase in knowledge levels (p = .15) of folic acid emerged. Therefore, knowledge levels were impacted by the educational intervention, and the null hypothesis was rejected. It was noted that the facet of the intervention most frequently received was the television public service announcements, and the least frequently received method was the E-mail messages. The implication for nurse practitioners involves the role of educator. As primary care providers, it is the responsibility of the nurse practitioner to promote general and reproductive health during every health encounter. This includes increasing IV awareness of patients concerning folic acid and its role in the prevention of NTDs. A recommendation for future research includes replication of this study with a sample group comprised of childbearing age women who are in the workforce and have not had formal education beyond high school. Additionally, a similar study excluding students with a health-related academic major would yield a more accurate assessment of the average college student. A further recommendation is to investigate the lack of behavioral change regarding intake of folic acid among college students despite their increase in knowledge.


Master of Science in Nursing (MSN)


Graduate Nursing

Degree Date


Publication Number


First Advisor

Dr. Lynn Chilton

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Included in

Nursing Commons