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

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          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.

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          Most cited references23

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          Six steps in quality intervention development (6SQuID)

          Improving the effectiveness of public health interventions relies as much on the attention paid to their design and feasibility as to their evaluation. Yet, compared to the vast literature on how to evaluate interventions, there is little to guide researchers or practitioners on how best to develop such interventions in practical, logical, evidence based ways to maximise likely effectiveness. Existing models for the development of public health interventions tend to have a strong social-psychological, individual behaviour change orientation and some take years to implement. This paper presents a pragmatic guide to six essential Steps for Quality Intervention Development (6SQuID). The focus is on public health interventions but the model should have wider applicability. Once a problem has been identified as needing intervention, the process of designing an intervention can be broken down into six crucial steps: (1) defining and understanding the problem and its causes; (2) identifying which causal or contextual factors are modifiable: which have the greatest scope for change and who would benefit most; (3) deciding on the mechanisms of change; (4) clarifying how these will be delivered; (5) testing and adapting the intervention; and (6) collecting sufficient evidence of effectiveness to proceed to a rigorous evaluation. If each of these steps is carefully addressed, better use will be made of scarce public resources by avoiding the costly evaluation, or implementation, of unpromising interventions.
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            Environmental and societal factors affect food choice and physical activity: rationale, influences, and leverage points.

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              Developmental origins of noncommunicable disease: population and public health implications.

              Noncommunicable diseases (NCDs), including cardiovascular disease, diabetes, chronic lung disease, allergy, some forms of cancer, cognitive decline, osteoporosis, sarcopenia, and affective disorders, are the world's biggest killers. Eighty percent of these deaths occur in low- and middle-income countries, especially as these countries undergo socioeconomic improvement after reductions in infectious disease. The World Health Organization predicts a global increase of 17% in NCDs over the next decade. NCDs are preventable, but new initiatives are needed to institute such prevention, especially in early life. In this article, we emphasize that all children are affected by their early developmental conditions, not just children exposed to a very deficient environment, and that this has long-term consequences for their predisposition to NCDs. We highlight the biomedical implications of this developmental origins of health and disease (DOHaD) concept of NCDs and discuss the implications for health policy.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Healthcare (Basel)
                Healthcare (Basel)
                healthcare
                Healthcare
                MDPI
                2227-9032
                20 March 2017
                March 2017
                : 5
                : 1
                : 17
                Affiliations
                [1 ]MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; jb@ 123456mrc.soton.ac.uk (J.B.); cv@ 123456mrc.soton.ac.uk (C.V.); ss@ 123456mrc.soton.ac.uk (S.S.); tr@ 123456mrc.soton.ac.uk (T.R.); hmi@ 123456mrc.soton.ac.uk (H.I.); cc@ 123456mrc.soton.ac.uk (C.C.); wtl@ 123456mrc.soton.ac.uk (W.L.)
                [2 ]NIHR Nutrition Biomedical Research Centre, Southampton Centre for Biomedical Research, Southampton General Hospital, Southampton SO16 6YD, UK
                [3 ]NIHR Dissemination Centre, University of Southampton, Alpha House, Enterprise Road, Southampton SO16 7NS, UK; t.tinati@ 123456soton.ac.uk
                [4 ]Formerly of NIHR Nutrition Biomedical Research Centre, Southampton Centre for Biomedical Research, Southampton General Hospital, Southampton SO16 6YD, UK; rb@ 123456mrc.soton.ac.uk
                [5 ]Li Ka Shing Centre for Health Research Innovation, Department of Agriculture, Food and Nutritional Science, University of Alberta, Edmonton, AB T7X 5A1, Canada; jarman@ 123456ualberta.ca
                [6 ]Formerly of Southampton City Council Public Health Team, Southampton City Council, Civic Centre, Southampton SO14 7LY, UK; Daviesj.1370@ 123456gmail.com
                [7 ]Commissioner, Integrated Commissioning Unit, Southampton City Council, Civic Centre, Southampton SO14 7LY, UK; susan.thompson@ 123456southampton.gov.uk
                [8 ]Former Senior Commissioning Manager for NHS Southampton, NHS Southampton HQ, Oakley Road, Millbrook, Southampton SO16 4GX, UK; liz.taylor@ 123456southampton.gov.uk
                [9 ]Sydney Medical School, Edward Ford Building A27, The University of Sydney, Sydney, NSW 2006, Australia; don.nutbeam@ 123456sydney.edu.au
                Author notes
                [* ]Correspondence: meb@ 123456mrc.soton.ac.uk
                Article
                healthcare-05-00017
                10.3390/healthcare5010017
                5371923
                28335519
                ca17b2ae-e055-46ee-9e7d-162c6e5e18ad
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 31 October 2016
                : 14 March 2017
                Categories
                Essay

                behaviour change,developmental origins,diet,maternal nutrition,disadvantage

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