McKerracher L, Moffat T, Barker M, Williams D, Sloboda D M
Department of Biochemistry and Biomedical Sciences, McMaster University,Hamilton, ON,Canada.
Department of Anthropology, McMaster University,Hamilton, ON,Canada.
J Dev Orig Health Dis. 2019 Aug;10(4):420-428. doi: 10.1017/S2040174418001034.
Evidence supporting the Developmental Origins of Health and Disease (DOHaD) hypothesis indicates that improving early life environments can reduce non-communicable disease risks and improve health over the lifecourse. A widespread understanding of this evidence may help to reshape structures, guidelines and individual behaviors to better the developmental conditions for the next generations. Yet, few efforts have yet been made to translate the DOHaD concept beyond the research community. To understand why, and to identify priorities for DOHaD Knowledge Translation (KT) programs, we review here a portion of published descriptions of DOHaD KT efforts and critiques thereof. We focus on KT targeting people equipped to apply DOHaD knowledge to their everyday home or work lives. We identified 17 reports of direct-to-public DOHaD KT that met our inclusion criteria. Relevant KT programs have been or are being initiated in nine countries, most focusing on secondary school students or care-workers-in-training; few target parents-to-be. Early indicators suggest that such programs can empower participants. Main critiques of DOHaD KT suggest it may overburden mothers with responsibility for children's health and health environments, minimizing the roles of other people and institutions. Simultaneously, though, many mothers-to-be seek reliable guidance on prenatal health and nutrition, and would likely benefit from engagement with DOHaD KT. We thus recommend emphasizing solidarity, and bringing together people likely to one day become parents (youth), people planning pregnancies, expecting couples, care workers and policymakers into empowering conversation about DOHaD and about the importance and complexity of early life environments.
支持健康与疾病发展起源(DOHaD)假说的证据表明,改善生命早期环境可以降低非传染性疾病风险,并在整个生命过程中改善健康状况。对这一证据的广泛理解可能有助于重塑结构、指南和个人行为,以改善下一代的发育条件。然而,将DOHaD概念转化到研究界之外的努力却很少。为了理解原因,并确定DOHaD知识转化(KT)项目的优先事项,我们在此回顾了一部分已发表的关于DOHaD KT努力及其批评的描述。我们关注的是针对那些有能力将DOHaD知识应用于日常家庭或工作生活的人群的KT。我们确定了17份符合我们纳入标准的直接面向公众的DOHaD KT报告。相关的KT项目已经或正在九个国家启动,大多数项目关注中学生或正在接受培训的护理人员;很少有项目针对准父母。早期指标表明,此类项目可以增强参与者的能力。对DOHaD KT的主要批评表明,它可能会让母亲承担过多儿童健康和健康环境的责任,而将其他人及机构的作用最小化。然而,与此同时,许多准母亲寻求关于产前健康和营养的可靠指导,并且可能会从参与DOHaD KT中受益。因此,我们建议强调团结,并让未来可能成为父母的人(年轻人)、计划怀孕的人、准父母、护理人员和政策制定者共同参与关于DOHaD以及生命早期环境的重要性和复杂性的赋能对话。