Lack of awareness of the importance of folic acid.

Socioeconomic and cultural factors influencing diet, pregnancy planning and vitamin use.  For example, among Latinas, vitamin consumption tends to be perceived negatively as a potential cause of weight gain.  However, young Latinas respond well to the message that vitamins promote overall health and beauty, and Latinas overall are very willing to make behavior changes for the health of future babies.

Financial issues affecting purchase of folic acid supplements and enriched foods. 

Familial behaviors and attitudes affect diet, pregnancy planning and vitamin use. Support and willingness from one’s partner to use contraception is needed in planning a pregnancy.  In addition, vitamin use and diet are greatly influenced by parental habits, partner support, and children.

Individual beliefs, behaviors and attitudes affect diet, pregnancy planning and vitamin use.  Individual beliefs that vitamins cause weight gain inhibit the use of vitamins.