Pilot intervention with adolescents to increase knowledge and consumption of folate‐rich foods based on the Health Belief Model

Folate is important in the prevention of birth defects and in the maintenance of general health. Even after mandatory fortification, many people are still not consuming the recommended dietary allowance (RDA) of 400 mcg folate/day. Consuming a diet rich in naturally high‐folate foods, as opposed to supplementation, may offer additional health benefits and promote an overall healthy diet. The purpose of this pilot study was to test the hypothesis that a learner‐centred educational intervention based on the Health Belief Model (HBM) will successfully increase knowledge and consumption of folate‐rich foods, while increasing positive beliefs about folate and health in adolescents. A two‐group parallel control trial was conducted in two schools in Nebraska. Pre‐ and post‐study questionnaires included a folate‐based food frequency questionnaire, a HBM questionnaire and a folate knowledge test. Participants in the intervention group completed a post‐study evaluation. The intervention consisted of three 30‐min lessons followed by participant creation of podcasts. One podcast was viewed each week for 8 weeks following the lessons. Data were analysed using t‐tests to measure simple effects within the intervention and control groups, and analysis of variance to measure within‐subject effects between the groups. Folate consumption decreased in both the intervention and control groups, but these differences were not significant (P > 0.05). Significant increases (P = 0.000) in folate knowledge occurred in the intervention group. This difference remained significant (P = 0.001) when compared to the control group. Average HBM rankings significantly decreased (P < 0.05) towards ‘strongly agree’ (Likert scale of 1–6) in the intervention group (P < 0.05) for all constructs except cues to action. However, when compared to the control group, these differences were only significant for self‐efficacy and perceived susceptibility. Creating and viewing podcasts may be helpful for the retention of knowledge over time, but did not appear to be an effective cue to action for increased folate‐rich foods in this pilot study.