A life-course approach to reduction of risk of non-communicable diseases (NCD) suggests that early-life interventions may be more effective than lifestyle modifications in middle age. Knowledge translation to develop understanding of the Developmental Origins of Health and Disease (DOHaD) within the community offers the potential to encourage informed diet and lifestyle choices supporting reduction of NCD risk in current and future generations. Many women do not make sustained dietary change before or during pregnancy, therefore appropriate nutritional behaviours need to be established prior to adulthood. This makes adolescence an appropriate stage for interventions to establish suitable dietary and lifestyle behaviours. Therefore, we engaged adolescents in a school-based educational intervention, and assessed the value of this in development of understanding of DOHaD concepts to support behaviour change that could lead to NCD risk reduction in the next generation. Modules of course work were written for 11-14 year olds and trialled in nine schools. Matched pre- and post-intervention questionnaire responses from 238 students and 99 parents, and post-intervention interviews evaluated the intervention. Understanding of a link between maternal diet during pregnancy and the health of the foetus in adulthood increased from 46% to 76% following intervention. Post-intervention evidence suggests the programme facilitated discussion of diet, lifestyle and DOHaD concepts in most families. The intervention was effective in improving understanding of DOHaD concepts and in some cases led to appropriate behaviour change. However, the sustainability of these changes remains to be determined through on-going evaluation of attitudes and behaviour within this cohort.

Background: Scientific literacy development is widely emphasized as the overarching goal of science education. It encompasses development of understanding of the nature of science as well as knowledge, attitudes, and values that contribute to empowering adolescents to engage with and make evidence-based decisions about socioscientific issues. Scientific literacy development is enhanced when learning is contextualized in exploration of socioscientific issues. Noncommunicable diseases (NCDs) associated with a combination of obesity and adverse environmental exposures are examples of pressing health-related SSIs facing the world today. Evidence emerging from the field of Developmental Origins of Health and Disease (DOHaD) has identified adolescence as a key life-phase where population-wide education-based interventions that empower teens to engage in science-based health-promoting behaviors could significantly change the course of this epidemic. To achieve this, learning resources that support scientific and health literacy development contextualized in issues linking NCD risk and DOHaD are required. The Healthy Start to Life Education for Adolescents Project is a school-university partnership program designed to support scientific and health literacy development, knowledge translation, and participant-led actions relating to NCD risk prevention. This study assesses the impact of program participation in a cohort of 11-14-year-olds in New Zealand. Evaluation comprised analysis of individually matched questionnaires, pre-, 3 months, and 12 months postintervention (n = 201) and 6 months post-intervention interviews (n = 40). Results: Positive engagement in science learning occurred. Positive changes in health-related awareness and attitudes 3 months post-intervention were sustained to 12 months. Adolescents reporting pre-intervention dietary behaviors associated with increased obesity risk reported sustained positive behavior changes (p < .001). Qualitative evidence revealed that these changes resulted from application of scientific and health literacy. This has the potential to improve long-term health outcomes for adolescents and their future offspring. Furthermore, feedback from parents demonstrated that adolescents became science communicators within their families. Conclusions: We demonstrated that contextualized learning promoting scientific and health literacy development facilitated knowledge translation. This allowed adolescents to decide if, and how, to use scientific evidence in relation to their current and future wellbeing. Exploration of the transferability of scientific and health literacy capabilities, and impacts on future health would enhance understanding of the value of the intervention.

Evidence from the field of Developmental Origins of Health and Disease (DOHaD) demonstrates that early life environmental exposures impact later-life risk of non-communicable diseases (NCDs). This has revealed the transgenerational nature of NCD risk, thus demonstrating that interventions to improve environmental exposures during early life offer important potential for primary prevention of DOHaD-related NCDs. Based on this evidence, the prospect of multi-sectoral approaches to enable primary NCD risk reduction has been highlighted in major international reports. It is agreed that pregnancy, lactation and early childhood offer significant intervention opportunities. However, the importance of interventions that establish positive behaviors impacting nutritional and non-nutritional environmental exposures in the pre-conceptual period in both males and females, thus capturing the full potential of DOHaD, must not be overlooked. Adolescence, a period where life-long health-related behaviors are established, is therefore an important life-stage for DOHaD-informed intervention. DOHaD evidence underpinning this potential is well documented. However, there is a gap in the literature with respect to combined application of theoretical evidence from science, education and public health to inform intervention design. This paper addresses this gap, presenting a review of evidence informing theoretical frameworks for adolescent DOHaD interventions that is accessible collectively to all relevant sectors.

Adolescence is a critical time point in the lifecourse. LifeLab is an educational intervention engaging adolescents in understanding Developmental Origins of Health and Disease (DOHaD) concepts and the impact of the early life environment on future health, benefitting both their long-term health and that of the next generation. We aimed to assess whether engaging adolescents with DOHaD concepts improves scientific literacy and whether engagement alone improves health behaviours.Six schools were randomized, three to intervention and three to control. Outcome measures were changed in knowledge, and intended and actual behaviour in relation to diet and lifestyle. A total of 333 students completed baseline and follow-up questionnaires. At 12 months, intervention students showed greater understanding of DOHaD concepts. No sustained changes in behaviours were identified.Adolescents' engagement with DOHaD concepts can be improved and maintained over 12 months. Such engagement does not itself translate into behaviour change. The intervention has consequently been revised to include additional components beyond engagement alone.

Evidence in support of the Developmental Origins of Health and Disease (DOHaD) hypothesis has reached the level where it can appropriately be used to inform practice. DOHaD informed interventions supporting primary noncommunicable disease risk reduction should target the pre- and periconceptional periods, pregnancy, lactation, childhood and adolescence. Such interventions are dependent on a health workforce (including dietitians, nurses, midwives, doctors, and nutrition teachers), that has a deep understanding of DOHaD concepts. This study assessed development of awareness of DOHaD concepts during undergraduate health professional training programs. Using a cross-sectional design, a standardized questionnaire was completed by Year 1-4 undergraduate students studying nutrition in Japan (n=309) and Year 1-3 nursing students in New Zealand (n=151). On entry to undergraduate study, most students had no awareness of the terms 'DOHaD' or 'First 1000 Days'. While awareness reached 60% by Year 3 in courses that included DOHaD-related teaching, this remains inadequate. More than 95% of Year 1 undergraduates in both countries demonstrated an appreciation of associations between maternal nutrition and fetal health. However, awareness of associations between parental health status and/or nutritional environment and later-life health was low. While levels of awareness increased across program years, overall awareness was less than optimal. These results indicate evidence of some focus on DOHaD-related content in curricula. We argue that DOHaD principles should be one pillar around which health training curricula are built. This study indicates a need for the DOHaD community to engage with faculties in curriculum development.