Translating Developmental Origins: Improving the Health of Women and Their Children Using a Sustainable Approach to Behaviour Change

Abstract

Theories of the developmental origins of health and disease imply that optimising the growth and development of babies is an essential route to improving the health of populations. A key factor in the growth of babies is the nutritional status of their mothers. Since women from more disadvantaged backgrounds have poorer quality diets and the worst pregnancy outcomes, they need to be a particular focus. The behavioural sciences have made a substantial contribution to the development of interventions to support dietary changes in disadvantaged women. Translation of such interventions into routine practice is an ideal that is rarely achieved, however. This paper illustrates how re-orientating health and social care services towards an empowerment approach to behaviour change might underpin a new developmental focus to improving long-term health, using learning from a community-based intervention to improve the diets and lifestyles of disadvantaged women. The Southampton Initiative for Health aimed to improve the diets and lifestyles of women of child-bearing age through training health and social care practitioners in skills to support behaviour change. Analysis illustrates the necessary steps in mounting such an intervention: building trust; matching agendas and changing culture. The Southampton Initiative for Health demonstrates that developing sustainable; workable interventions and effective community partnerships; requires commitment beginning long before intervention delivery but is key to the translation of developmental origins research into improvements in human health.

Knowledge about the Developmental Origins of Health and Disease is independently associated with variation in diet quality during pregnancy

“…Our initial hypothesis that inequities in health literacy are likely to drive inequities in familiarity with DOHaD‐related concepts offers a compelling explanation for our findings that DOHaD KNOWLEDGE score varies with SEP and age. This is consistent with the handful of previous studies that have assessed DOHaD KNOWLEDGE translation, which show that people living in lower SEP contexts tend to have lower health knowledge and literacy generally, have little self‐efficacy with which to make use of health knowledge, and are more distrustful of health service provision (Barker et al, ; Sørensen et al, ). Fortunately, the available literature also suggests that these kinds of barriers can be overcome.…”

“…Indeed, influential stakeholders and institutions in several nations with strong DOHaD‐oriented research communities are beginning to direct efforts towards DOHaD knowledge translation (Baird, Cooper, Margetts, Barker, & Inskip, ; Barker et al, ; Bay, Mora, Sloboda, & Morton, , 2017b; McMullan et al, ; MacNab & Mukisa, ; Mckerracher et al, ; Oyamada, Lim, Dixon, Wall, & Bay, ; Woods‐Townsend et al, ; Perreault et al, ). What remains unclear is the extent to which DOHaD findings are effectively reaching populations and organizations best positioned to make use of DOHaD‐related research findings.…”

“…Non-communicable diseases (NCDs) related to obesity and metabolic function (e.g., cardiovascular disease and type 2 diabetes mellitus) represent leading causes of illness and death globally (World Health Organization, 2017). Although these diseases manifest mainly in adulthood, abundant evidence indicates that the main risk factors for metabolism-related NCDs are established during the peri-conceptional and foetal stages of development (Barker et al, 2017;Fleming et al, 2018;Stephenson et al, 2018). The idea that early lifeespecially prenatal-environments shape developmental trajectories, which then affect later-life disease risk (Barker & Osmond, 1986), is now most widely referred to as the Developmental Origins of Health and Disease (DOHaD) hypothesis (Barnes, Heaton, Coates, & Packer, 2016).…”

“…Furthermore, models derived from the DOHaD hypothesis indicate that strategies for reducing the burden of metabolic disease should focus on intervening in the earliest stages of life (Garmendia, Corvalan, & Uauy, 2014;Godfrey et al, 2017;Hanson & Gluckman, 2015;Low, Gluckman, & Hanson, 2018;Stephenson et al, 2018;Victora et al, 2016). As such, over the last decade, there has been an increasing push to translate key findings from DOHaD-related research into social and public health policy and guidelines as well as into clinical practice (Anon., 2011;Barker et al, 2017;Mckerracher, Moffat, Barker, Williams, & Sloboda, 2019).…”

“…Indeed, influential stakeholders and institutions in several nations with strong DOHaD-oriented research communities are beginning to direct efforts towards DOHaD knowledge translation (Baird, Cooper, Margetts, Barker, & Inskip, 2009;Barker et al, 2017;Bay, Mora, Sloboda, & Morton, 2012, 2017bMcMullan et al, 2017;MacNab & Mukisa, 2017;Mckerracher et al, 2019;Oyamada, Lim, Dixon, Wall, & Bay, 2018;Woods-Townsend et al, 2018;Perreault et al, 2016).…”