1,720,987 research outputs found
Preconception health and the life course approach to prevention of non-communicable diseases: Implications for informing policy and practice
No full textThe life course approach and developmental origins of health and disease (DOHaD) concepts suggest that early intervention in critical periods reduces the risk of developing non-communicable diseases (NCDs) in later life and prevents the intergenerational transmission of this risk. The preconception period is increasingly cited as a platform for preventive interventions, however, while international health organisations have recognised the importance of such early prevention, specific recommendations have not been made. This mixed-methods thesis aimed to explore the use of evidence from life course epidemiology in policy-making and health care practice, with a focus on the preconception period to prevent NCDs in later life and the transmission of risk across generations. The two main streams of implementation that underpinned this thesis were clinical practice and policy.For the clinical stream, a narrative review of reviews of preconception interventions highlighted that intervening in the preconception period can potentially prevent the intergenerational passage of risk of NCDs. In contrast, a rapid review of published and grey literature showed that most studies and policies adopting the life course approach targeted the pregnancy or early childhood periods. Additionally, there was a need for better measurement strategies as a range of indicators have been proposed to measure health outcomes for different life stages or diseases risks, but with no clear guidelines on how the life course approach can be operationalised through interventions or programmes.These reviews above informed the development of three subsequent studies. First, a qualitative study of obstetricians and midwives explored their understanding of DOHaD concepts and identified barriers and opportunities for intervening through routine clinical care for NCD prevention. Though understanding of the scientific findings from the field of DOHaD was high, practical factors such as lack of time, practitioners’ views on their role in preconception care and a lack of resources hindered translation in routine care. The second study comprised an online survey to test the acceptability of i.) a nutritional risk assessment tool and ii.) the routine discussion of nutrition and pregnancy intention between reproductive-aged women and healthcare practitioners in the UK. Results showed high acceptability for the tool. The discussion of nutrition and pregnancy intention was considered important, provided that the reasons for doing so were communicated clearly, in a non-stigmatising manner. Finally, a document analysis of meeting minutes and observations of five advocacy groups in the field of DOHaD showed that policy translation has been affected by the lack of a clear message on what needs to be done when communicating to the public and policy-makers. The study also revealed insights into several opportunities with recommendations on framing messages, key stakeholders, and the need to acknowledge the influence of wider determinants of health e.g., economic policies and the environment.Overall, the findings contribute to the understanding of how opportunities before and during pregnancy can be harnessed to prevent NCDs, improve women’s health and wellbeing and provide a better start to life for the next generation. A framework for implementing the life course approach is discussed and along with an overview of future work needed to address evidence gaps and improve the translation of evidence to policy and practice
Implications of the Developmental Origins of Health and Disease concept for policy-making
No full textWith the rising burden of noncommunicable diseases (NCDs) globally and recognition that NCD risk can be transmitted across generations, there is an increasing reason for the Developmental Origins of Health and Disease concept to inform international policies and guidelines. However, the concept has not yet been widely adopted in national policies and health care settings. Appropriate dissemination of evidence and possible solutions to the challenge of NCDs is needed to build awareness among stakeholders and policy-makers. In this article, we consider the key messages from the field of developmental origins of health and disease and how they are communicated to stakeholders and policy-makers, emphasising the need for population-level interventions to be communicated in a socially just and nonstigmatising manner.</p
Test, Trace and Learn: lessons about COVID-19 from young people.: Testare, tracciare e imparare: lezioni sul COVID-19 dai giovani
No full textThe preconception period as a platform for preventing diabetes and non-communicable diseases
No full textIncreasing evidence suggests that parental risk factors for non-communicable diseases (NCDs) in the period before conception could affect their lifelong health and increase the risk of NCDs in the offspring. While many of these risks such as obesity, smoking and dietary patterns are influenced by wider socio-economic factors, screening and identification of risk factors can be conducted in the clinical setting to provide appropriate preventive interventions. This article discusses the role of health care practitioners in preventing the risk of NCDs and opportunities for action in the preconception period
Acceptability of the FIGO Nutrition Checklist in Preconception and Early Pregnancy to Assess Nutritional Status and Prevent Excess Gestational Weight Gain: A Study of Women and Healthcare Practitioners in the UK
No full textOptimum nutrition and weight before and during pregnancy are associated with a lower risk of conditions such as pre-eclampsia and gestational diabetes. There is a lack of user-friendly tools in most clinical settings to support healthcare practitioners (HCPs) in implementing them. This study aimed to evaluate the acceptability of (1) using a nutrition checklist designed by the International Federation of Gynecology and Obstetrics (FIGO) for nutritional screening of women in the preconception and early pregnancy period and (2) routine discussion of nutrition and weight in clinical care. An online cross-sectional survey was conducted with women (aged 18–45) and HCPs (e.g., general practitioners, obstetricians, and midwives). Quantitative statistical analysis and qualitative content analysis were performed. The concept and content of the checklist were acceptable to women (n = 251) and HCPs (n = 47) (over 80% in both groups). Several barriers exist to implementation such as lack of time, training for HCPs, and the need for sensitive and non-stigmatizing communication. Routine discussion of nutrition was considered important by both groups; however, results suggest that nutrition is not regularly discussed in perinatal visits in the UK. The FIGO nutrition checklist presents a valuable resource for use in clinical practice, offering long-term and intergenerational benefits for both mother and baby
HCP’s and women’s survey data in support of the Southampton doctoral thesis 'Preconception health and the life course approach to prevention of non-communicable diseases: Implications for informing policy and practice'
No full textDataset with HCP's survey data, women's survey data and data used for qualitative content analysis (anonymised). This informed the PhD thesis entitled "Preconception Health and the Life Course Approach to Prevention of Non-Communicable Diseases: Implications for Informing Policy and Practice". The data was collected through two online surveys in 2021and contains quantitative and qualitative data.
Dataset available to bone fide researchers only - to request the data please complete the attached request form.</span
What quantitative and qualitative methods have been developed to measure the implementation of a life-course approach in public health policies at the national level?
No full textA life-course approach to health and well-being has become a pillar in health policy-making; for example, Member States of the WHO European Region in the 2015 Minsk Declaration resolved to make greater use of a life-course approach in health policies. However, strategies for implementation of a life-course approach, and a plan for monitoring and evaluating this implementation, are lacking. This scoping review identified a lack of literature with a focus on measurement of the implementation of a life-course approach. The report provides suggestions from research on a life-course approach in public health interventions and national-level strategies that could aid policy-makers in developing a measurement framework. For example, Member States using a life-course approach in policy at a population level could report on existing interventions in key stages of the life-course using existing survey platforms and routinely collected quantitative data. Ideally, a monitoring and evaluation framework collecting data longitudinally across different life stages over time should be created for Member States
Narrative review of reviews of preconceptional interventions to prevent increased risk of obesity and non-communicable diseases in children
No full textEvidence for the effect of preconception and periconceptional risk factors on childhood outcomes such as obesity and other non‐communicable diseases (NCDs) in later life is growing. Issues such as maternal malnutrition need to be addressed before pregnancy, to prevent a transgenerational passage of risk of NCDs. The aim of this review was to evidence for preconception interventions to prevent obesity and other risk factors for NCDs in children. A search for systematic reviews of interventions in the preconception period published between 2006 and 2018 was conducted on academic databases. Fifteen reviews were included, two of the reviews also included pregnant women. None of the reviews directly reported on obesity or NCD outcomes in children. Results suggest that exercise‐ and diet‐based interventions significantly reduced maternal weight postpartum, weight gain during pregnancy, and improved prevention and control of gestational diabetes. Balanced protein energy supplementation during and before pregnancy was associated with an increase in mean birth weight and a reduction of low birth weight babies. There is a dearth of evidence for preconception programmes that follow up on childhood outcomes related to a risk of NCDs. Nevertheless, results suggest that women who received preconception interventions were more likely to have improved pregnancy‐related and behavioural outcomes
The importance of a life-course approach to health: Chronic disease risk from preconception through adolescence and adulthood: White paper
No full textNon-communicable diseases (NCDs) including obesity, diabetes and cardiovascular disease, musculoskeletal, mental and neurological disorders have been identified as the ‘world’s largest killers’, and multiple major international organizations have stressed the importance of adopting a life course approach to address them. This paper summarizes existing models that explore the influences of the life cycle on chronic disease, and presents a review of risk factors of NCDs through the life course, highlighting issues in key life stages, with a special focus on the adolescent age group
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