Award Date


Degree Type


Degree Name

Doctor of Philosophy in Nursing



Advisor 1

Carolyn Sabo, Committee Co-Chair

Advisor 2

Susan Kowalski, Committee Co-Chair

First Committee Member

Patricia Alpert

Graduate Faculty Representative

Chad Cross

Number of Pages



In 1995, North Carolina (NC) had one of the highest prevalence rates of neural tube defects (NTDs) in the United States. Since the NC Folic Acid Council began focusing their efforts on educating women of childbearing age regarding NTDs in 1994, the prevalence of NTDs has declined overall by 40%; however, NTD prevalence among Hispanics in NC continues to be double the rate of non-Hispanics. Research has found daily consumption of a multivitamin with folic acid significantly decreases NTDs. Healthy People 2010 include in their objectives the need to increase folic acid consumption in women and reduce the NTD rates. It is estimated that 72% of women in the US between the ages of 18-45 do not take a multivitamin fortified with the recommended amount of folic acid regularly. Nurses play a pivotal role in educating women about the importance of folic acid and daily multivitamin use.

The purpose of this study was to determine acute care staff nurses' knowledge levels of folic acid and the relationship between knowledge level, self-efficacy level, and selected sample demographics. Beliefs in the benefits of multivitamin consumption were explored along with the extent to which folic acid benefits are addressed by the acute care staff nurse in client teaching. A socio-demographic survey was administered to randomly selected acute care staff nurses in NC using the online survey platform Survey Monkey. Folic acid knowledge levels were determined using pre-established questions developed by the CDC while self-efficacy in the nurses' relationship with clients was measured using an item assessing confidence. A March of Dimes online video accessed thru YouTube served as the intervention. There were 143 participants, with 84 in the control group and 59 in the experimental group. The average nurse was 43-45 years old, held a BSN degree, and worked in the medical-surgical area of nursing. The hypotheses supported by the statistically significant findings included: confidence, or self-efficacy, played a significant role in how often acute care staff nurses discussed benefits of multivitamins when providing discharge teaching to their clients, and, acute care staff nurses who took part in the educational intervention showed an increase in folic acid knowledge level from the pre-test period to the post-test period. Health care providers play a vital role in disseminating the health benefits of folic acid to the clients they care for. It is critical for every woman of childbearing age to receive teaching on the health benefits of folic acid in an effort to reduce NTD rates, as well as provide potential benefit or prevention for other disease processes and defects. This can certainly be accomplished through the role of the acute care staff nurse.


Child-bearing age women; Folic acid; Multivitamins; Neural tube defects; Nutrition education


Maternal and Child Health | Maternal, Child Health and Neonatal Nursing | Nursing | Public Health Education and Promotion

File Format


Degree Grantor

University of Nevada, Las Vegas




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