N ational C ouncil on F olic A cid National Meeting June 29, 2009 Take Home Messages The National Council on Folic Acid is managed by the Spina Bifida Association, 4590 MacArthur Blvd., NW, Suite 250 Washington, DC , x13,

N ational C ouncil on F olic A cid Take Home Messages: State of Science on Folic Acid The data on preventing NTDs is solid and there is a need to continue educating about the importance of 400 mcg folic acid for women of childbearing age. Data from NHANES: 72% of the population consume 400 mcg 4% get > 1,000 mcg If the amount of folic acid fortification was doubled: 50% would get >400mcg 6% would get >1,000 mcg This is still within range of the upper level allowed by FDA The National Council on Folic Acid is managed by the Spina Bifida Association, 4590 MacArthur Blvd., NW, Suite 250 Washington, DC , x13,

N ational C ouncil on F olic A cid Take Home Messages: State of Science on Folic Acid Supplements are main contributors to high intakes and 75% of seniors take supplements with folic acid. Cole article (JAME 2007) is a supplement study. Multicenter study for 3 years New adenomas had no change in 3 years at 6 years a 2.3 risk of adenomas Logan (UK) 500 mcg 3 year study no increase in colorectal adenomas Media reports about increase of colorectal cancer in relation to fortification is not biological Accentuate the positive – the science supporting the connection between birth defects prevention and folic acid is strong The National Council on Folic Acid is managed by the Spina Bifida Association, 4590 MacArthur Blvd., NW, Suite 250 Washington, DC , x13,

N ational C ouncil on F olic A cid Take Home Messages: Success Stories NC Folic Acid Council: -rates of NTDs have decreased more than 70% in Western NC since the campaign -have coordinated preconception folic acid message with obesity campaign, thus increasing chance of sustainability CT Folic Acid Council: -take minutes of meetings and keep on file (no records from council from 1990s) The National Council on Folic Acid is managed by the Spina Bifida Association, 4590 MacArthur Blvd., NW, Suite 250 Washington, DC , x13,

N ational C ouncil on F olic A cid Take Home Messages: Success Stories CT Folic Acid Council: -emphasize role of male in influencing significant other as an intervention Western Regional NC Folic Acid Campaign: -Significant behavior change was accomplished with a relatively inexpensive tool, a 3 month supply of multivitamins costing only $1.15 a bottle The National Council on Folic Acid is managed by the Spina Bifida Association, 4590 MacArthur Blvd., NW, Suite 250 Washington, DC , x13,

N ational C ouncil on F olic A cid Take Home Messages: Success Stories Migrant Health Promotion: -successful interventions included placing an ongoing show at a Christian radio station utilizing community leaders that they trained -grocery stores got involved and gave out free prenatal vitamins and multivitamins to women at half price The National Council on Folic Acid is managed by the Spina Bifida Association, 4590 MacArthur Blvd., NW, Suite 250 Washington, DC , x13,

N ational C ouncil on F olic A cid Take Home Messages: Coalition I – Organizing and Sustaining -The path between starting and maintaining a coalition is seldom straight or level. -There are 4 stages of coalition development: forming, storming, norming, performing -The coalition coordinator/leader is the catalyst. Constant communication is key! -Make sure your coalition represents those whom you serve (diversity). -Stay fresh in how your coalition thinks or looks. Be willing to “re- package.” -Always look back at your accomplishments and decide where to go next. The National Council on Folic Acid is managed by the Spina Bifida Association, 4590 MacArthur Blvd., NW, Suite 250 Washington, DC , x13,

N ational C ouncil on F olic A cid Take Home Messages: Coalition II – Cultural Competency -Cultural competency is a life-long process, both developmental and emotional. It matters because of the diversity in the US. -“Iceberg concept” refers to some things being apparent (on the surface) and some things not (below the surface) - Communication is key. There may be differences in perception and differences in learning styles. -Culture has implications and several factors should be considered with regard to Hispanic outreach: respeto, familismo, language, fatalism, personalismo -Sources of possible miscommunication includes verbal and nonverbal communication, preconceptions and stereotypes. -Becoming more culturally competent is a process with ourselves, as we interact with others, and within coalitions. The National Council on Folic Acid is managed by the Spina Bifida Association, 4590 MacArthur Blvd., NW, Suite 250 Washington, DC , x13,

N ational C ouncil on F olic A cid Take Home Messages: Hispanic Outreach and Media Tool Kit Training -Latinos are everywhere: About 40% are Hispanic -Many opportunities for folic acid outreach to Latinos: 50% are childbearing age, times more likely to have a baby with NTDs -Barriers to health care include access, sociocultural factors, structural factors. -Focus on what we can do and develop in concert with other efforts, eg diabetes awareness -A combination of media and community outreach works in fostering behavior change -Practice media sound bites. For the media, everything is on the record! -Use sample press releases and articles rather than reinventing the wheel. -Spanish language media feel responsibility to educate the Latino community and will want to hear your issue. They have bilingual staff, so you do not need to be fluent in Spanish. The National Council on Folic Acid is managed by the Spina Bifida Association, 4590 MacArthur Blvd., NW, Suite 250 Washington, DC , x13,