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Translating developmental origins of health and disease in practice: health care providers’ perspectives

Published online by Cambridge University Press:  23 June 2020

Monica L. Molinaro Open the ORCID record for Monica L. Molinaro [Opens in a new window] ,
Marilyn Evans ,
Timothy R.H. Regnault  and
Barbra de Vrijer
Monica L. Molinaro
Affiliation:
Graduate Program in Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
Marilyn Evans
Affiliation:
Department of Nursing, Western University, London, Ontario, Canada
Timothy R.H. Regnault
Affiliation:
Department of Physiology and Pharmacology, Western University, London, Ontario, Canada Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada Children’s Health Research Institute, London, Ontario, Canada
Barbra de Vrijer*
Affiliation:
Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada Children’s Health Research Institute, London, Ontario, Canada Lawson Health Research Institute, London, Ontario, Canada
*
Address for correspondence: Barbra de Vrijer MD, FRCSC, Maternal Fetal Medicine Consultant, Associate Professor, Western University, Associate Scientist, Children's Health Research Institute, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, London Health Sciences Centre, Victoria Hospital, 800 Commissioner's Road E, Room B2-412, London, Ontario N6A 3B4, Canada. Tel: 519 6858500, Ext: 64052; Fax: 519 6466213. Email: Barbra.deVrijer@lhsc.on.ca
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Abstract

Currently, there is limited knowledge on how health care providers perceive and understand the Developmental Origins of Health and Disease (DOHaD), which may impact how they inform patients and their families throughout the perinatal period. This qualitative descriptive study explored if and how health care providers counsel on in utero programming and future health outcomes with parents, both preconception and during pregnancy. One-on-one, semi-structured interviews were conducted with 23 health care providers from varying health disciplines including obstetrics and gynaecology, midwifery, paediatrics, endocrinology and internal medicine. Audiotaped interviews were transcribed verbatim and analysed using inductive thematic analysis. Three themes were identified: Knowledge about DOHaD, Counselling on DOHaD in Practice Settings and Impact of DOHaD on Health. Health care providers not only expressed excitement over the potential health benefits of DOHaD counselling but also indicated barriers to knowledge translation, including a lack of knowledge among providers and a disconnect between basic scientists and practitioners. All health care providers expressed concerns on how and when to introduce the concept of DOHaD when counselling patients and called for the development of practice guidelines. Counselling on DOHaD needs to be framed in a way that is empowering, minimising the potential of coercion and guilt. More interaction and collaboration are needed between health care providers and researchers to identify strategies to support knowledge translation generated from DOHaD research into practice settings.

Keywords

Developmental Origins of Health and Diseasequalitativecounsellingknowledge translation
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 12 , Issue 3 , June 2021 , pp. 404 - 410
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Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2020

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References

Balbus, JM, Boxall, AB, Fenske, RA, McKone, TE, Zeise, L. Implications of global climate change for the assessment and management of human health risks of chemicals in the natural environment. Environ Toxicol Chem. 2013; 32(1), 62–78.CrossRefGoogle ScholarPubMed
Gluckman, PD, Hanson, MA, Low, FM. The role of developmental plasticity and epigenetics in human health. Birth Defects Res C Embryo Today. 2011; 93(1), 12–18.CrossRefGoogle ScholarPubMed
Hanson, MA, Gluckman, PD. Developmental origins of health and disease – global public health implications. Best Pract Res Clin Obstet Gynaecol. 2015; 29(1), 24–31.CrossRefGoogle ScholarPubMed
Barker, DJ, Osmond, C. Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales. Lancet. 1986; 1(8489), 1077–1081.CrossRefGoogle ScholarPubMed
Barker, DJ, Osmond, C, Forsen, TJ, Kajantie, E, Eriksson, JG. Trajectories of growth among children who have coronary events as adults. N Engl J Med. 2005; 353(17), 1802–1809.CrossRefGoogle ScholarPubMed
Hales, CN, Barker, DJ, Clark, PM, et al. Fetal and infant growth and impaired glucose tolerance at age 64. BMJ. 1991; 303(6809), 1019–1022.CrossRefGoogle ScholarPubMed
Lumey, LH, Ravelli, AC, Wiessing, LG, Koppe, JG, Treffers, PE, Stein, ZA. The dutch famine birth cohort study: design, validation of exposure, and selected characteristics of subjects after 43 years follow-up. Paediatr Perinat Epidemiol. 1993; 7(4), 354–367.CrossRefGoogle ScholarPubMed
Whincup, PH, Kaye, SJ, Owen, CG, et al. Birth weight and risk of type 2 diabetes: a systematic review. JAMA. 2008; 300(24), 2886–2897.Google ScholarPubMed
Barnes, MD, Heaton, TL, Goates, MC, Packer, JM. Intersystem implications of the developmental origins of health and disease: advancing health promotion in the 21st Century. Healthcare (Basel). 2016; 4(3), 45. doi:10.3390/healthcare4030045.CrossRefGoogle ScholarPubMed
Thiele, DK, Anderson, CM. Developmental origins of health and disease: a challenge for nurses. J Pediatr Nurs. 2016; 31(1), 42–46.CrossRefGoogle ScholarPubMed
CIHR. Knowledge Translation 2016 Available from: http://www.cihr-irsc.gc.ca/e/29418.html.Google Scholar
McKerracher, L, Moffat, T, Barker, M, Williams, D, Sloboda, DM. Translating the developmental origins of health and disease concept to improve the nutritional environment for our next generations: a call for a reflexive, positive, multi-level approach. J Dev Orig Health Dis. 2019; 10(4), 420–428.CrossRefGoogle Scholar
Hanson, M, Gluckman, P. Commentary: developing the future: life course epidemiology, DOHaD and evolutionary medicine. Int J Epidemiol. 2016; 45(4), 993–996.CrossRefGoogle ScholarPubMed
Lown, BA. Difficult conversations: anger in the clinician-patient/family relationship. South Med J. 2007; 100(1), 33–39; quiz 40–42, 62.10.1097/01.smj.0000223950.96273.61CrossRefGoogle ScholarPubMed
Orgel, E, McCarter, R, Jacobs, S. A failing medical educational model: a self-assessment by physicians at all levels of training of ability and comfort to deliver bad news. J Palliat Med. 2010; 13(6), 677–683.CrossRefGoogle ScholarPubMed
Mazor, KM, Ockene, JK, Rogers, HJ, Carlin, MM, Quirk, ME. The relationship between checklist scores on a communication OSCE and analogue patients’ perceptions of communication. Adv Health Sci Educ Theory Pract. 2005; 10(1), 37–51.CrossRefGoogle Scholar
Barker, M, Baird, J, Tinati, T, et al. Translating developmental origins: improving the health of women and their children using a sustainable approach to behaviour change. Healthcare (Basel). 2017; 5(1), 17. doi:10.3390/healthcare5010017.CrossRefGoogle ScholarPubMed
Poskiparta, M, Kasila, K, Kiuru, P. Dietary and physical activity counselling on type 2 diabetes and impaired glucose tolerance by physicians and nurses in primary healthcare in Finland. Scand J Prim Health Care. 2006; 24(4), 206–210.CrossRefGoogle ScholarPubMed
Schindler, BA, Novack, DH, Cohen, DG, et al. The impact of the changing health care environment on the health and well-being of faculty at four medical schools. Acad Med. 2006; 81(1), 27–34.CrossRefGoogle ScholarPubMed
Vears, DF, D’Abramo, F. Health, wealth and behavioural change: an exploration of role responsibilities in the wake of epigenetics. J Community Genet. 2018; 9(2), 153–167.CrossRefGoogle ScholarPubMed
Fortmann, SP, Sallis, JF, Magnus, PM, Farquhar, JW. Attitudes and practices of physicians regarding hypertension and smoking: the stanford five city project. Prev Med. 1985; 14(1), 70–80.CrossRefGoogle ScholarPubMed
Levy, BT, Williamson, PS. Patient perceptions and weight loss of obese adults. J Fam Pract. 1988; 27(3), 285–290.Google ScholarPubMed
Ockene, JK, Quirk, ME, Goldberg, RJ, et al. A residents’ training program for the development of smoking intervention skills. Arch Intern Med. 1988; 148(5), 1039–1045.CrossRefGoogle ScholarPubMed
Jelsma, JG, van Leeuwen, KM, Oostdam, N, et al. Beliefs, barriers, and preferences of European overweight women to adopt a healthier lifestyle in pregnancy to minimize risk of developing gestational diabetes mellitus: an explorative study. J Pregnancy. 2016; 2016, 3435791.CrossRefGoogle ScholarPubMed
Mazza, D, Chapman, A, Michie, S. Barriers to the implementation of preconception care guidelines as perceived by general practitioners: a qualitative study. BMC Health Serv Res. 2013; 13, 36.10.1186/1472-6963-13-36CrossRefGoogle ScholarPubMed
Huepenbecker, SP, Wan, L, Leon, A, et al. Obesity counseling in obstetrics and gynecology: provider perceptions and barriers. Gynecol Oncol Rep. 2019; 27, 31–34.Google Scholar
Leverence, RR, Williams, RL, Sussman, A, Crabtree, BF, Clinicians, RN. Obesity counseling and guidelines in primary care: a qualitative study. Am J Prev Med. 2007; 32(4), 334–339.CrossRefGoogle ScholarPubMed
Straus, SE, Tetroe, J, Graham, I. Defining knowledge translation. CMAJ. 2009; 181(3–4), 165–168.CrossRefGoogle ScholarPubMed
Sandelowski, M. Whatever happened to qualitative description? Res Nurs Health. 2000; 23(4), 334–340.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
Sandelowski, M. What’s in a name? Qualitative description revisited. Res Nurs Health. 2010; 33(1), 77–84.CrossRefGoogle Scholar
Creswell, JW. Qualitative Inquiry & Research Design: Choosing Among the Five Approaches, 2013. Sage Publications, California.Google Scholar
Braun, V, Clarke, V. Using thematic analysis in psychology. Qual Res Psychol. 2006; 3(2), 77–101.CrossRefGoogle Scholar
Morse, JM. The significance of saturation. Qual Health Res. 1995; 5(2), 147–149.CrossRefGoogle Scholar
Lincoln, Y, Guba, EG. Naturalistic Inquiry, 1985. Sage, Newbury Park, CA.CrossRefGoogle Scholar
Tracy, SJ. Qualitative quality: eight ‘Big-Tent’ criteria for excellent qualitative eesearch. Qual Inq. 2010; 16(10), 837–851.CrossRefGoogle Scholar
Davis, D, Evans, M, Jadad, A, et al. The case for knowledge translation: shortening the journey from evidence to effect. BMJ. 2003; 327(7405), 33–35.CrossRefGoogle Scholar
Backer, TE, Liberman, RP, Kuehnel, TG. Dissemination and adoption of innovative psychosocial interventions. J Consult Clin Psychol. 1986; 54(1), 111–118.CrossRefGoogle ScholarPubMed
Henderson, JL, MacKay, S, Peterson-Badali, M. Closing the research-practice gap: factors affecting adoption and implementation of a children’s mental health program. J Clin Child Adolesc Psychol. 2006; 35(1), 2–12.CrossRefGoogle ScholarPubMed
May, C. Agency and implementation: understanding the embedding of healthcare innovations in practice. Soc Sci Med. 2013; 78, 26–33.CrossRefGoogle ScholarPubMed
Painter, RC. Applying developmental programming to clinical obstetrics: my ward round. J Dev Orig Health Dis. 2015; 6(5), 407–414.CrossRefGoogle ScholarPubMed
Sharp, GC, Schellhas, L, Richardson, SS, Lawlor, DA. Time to cut the cord: recognizing and addressing the imbalance of DOHaD research towards the study of maternal pregnancy exposures. J Dev Orig Health Dis. 2019; 11(1), 1–4.Google Scholar
Hedlund, M. Epigenetic responsibility. Mediaev Stud. 2012; 3, 171–183.CrossRefGoogle Scholar
Kenney, M, Müller, R. Of rats and women: narratives of motherhood in environmental epigenetics. BioSocieties. 2016; 12, 1–24.Google Scholar
Richardson, SS, Daniels, CR, Gillman, MW, et al. Society: don’t blame the mothers. Nature. 2014; 512(7513), 131–132.CrossRefGoogle ScholarPubMed
Eriksson, JG. Developmental origins of health and disease – from a small body size at birth to epigenetics. Ann Med. 2016; 48(6), 456–467.CrossRefGoogle ScholarPubMed
Barouki, R, Gluckman, PD, Grandjean, P, Hanson, M, Heindel, JJ. Developmental origins of non-communicable disease: implications for research and public health. Environ Health. 2012; 11, 42.CrossRefGoogle ScholarPubMed
Dupras, C, Ravitsky, V. The ambiguous nature of epigenetic responsibility. J Med Ethics. 2016; 42(8), 534–541.CrossRefGoogle ScholarPubMed
Patel, R. Stuffed and Starved: Markets, Power and the Hidden Battle for the World Food System, 2008. Melville House Publishing, Hoboken, NJ.Google Scholar
Ivers, LC, Cullen, KA. Food insecurity: special considerations for women. Am J Clin Nutr. 2011; 94(6), 1740S–1744S.CrossRefGoogle ScholarPubMed
Tarasuk, VS, Beaton, GH. Household food insecurity and hunger among families using food banks. Can J Public Health. 1999; 90(2), 109–113.CrossRefGoogle ScholarPubMed
Winett, LB, Wulf, AB, Wallack, L. Framing strategies to avoid mother-blame in communicating the origins of chronic disease. Am J Public Health. 2016; 106(8), 1369–1373.CrossRefGoogle ScholarPubMed
Pentecost, M, Ross, FC, Macnab, A. Beyond the dyad: making developmental origins of health and disease (DOHaD) interventions more inclusive. J Dev Orig Health Dis. 2018; 9(1), 10–14.CrossRefGoogle ScholarPubMed
Heindel, JJ, Balbus, J, Birnbaum, L, et al. Developmental origins of health and disease: integrating environmental influences. Endocrinology. 2015; 156(10), 3416–3421.CrossRefGoogle ScholarPubMed
Bay, JL, Morton, SM, Vickers, MH. Realizing the potential of adolescence to prevent transgenerational conditioning of noncommunicable disease risk: multi-sectoral design frameworks. Healthcare (Basel). 2016; 4(3), 39. doi:10.3390/healthcare4030039.CrossRefGoogle ScholarPubMed
Craigie, AM, Lake, AA, Kelly, SA, Adamson, AJ, Mathers, JC. Tracking of obesity-related behaviours from childhood to adulthood: a systematic review. Maturitas. 2011; 70(3), 266–284.CrossRefGoogle ScholarPubMed
Steinberg, L. Cognitive and affective development in adolescence. Trends Cogn Sci. 2005; 9(2), 69–74.CrossRefGoogle ScholarPubMed
Alberga, AS, Sigal, RJ, Goldfield, G, Prud’homme, D, Kenny, GP. Overweight and obese teenagers: why is adolescence a critical period? Pediatr Obes. 2012; 7(4), 261–273.CrossRefGoogle ScholarPubMed
Bay, JL, Vickers, MH. Adolescent education: an opportunity to create a developmental origins of health and disease (DOHaD) circuit breaker. J Dev Orig Health Dis. 2016; 7(5), 501–504.CrossRefGoogle ScholarPubMed
Gore, DM, Kothari, AR. Getting to the root of the problem: health promotion strategies to address the social determinants of health. Can J Public Health. 2013; 104(1), e52–e54.CrossRefGoogle ScholarPubMed
Bay, JL, Mora, HA, Sloboda, DM, Morton, SM, Vickers, MH, Gluckman, PD. Adolescent understanding of DOHaD concepts: a school-based intervention to support knowledge translation and behaviour change. J Dev Orig Health Dis. 2012; 3(6), 469–482.CrossRefGoogle ScholarPubMed
Grace, M, Woods-Townsend, K, Griffiths, J, et al. Developing teenagers’ views on their health and the health of their future children. Health Education. 2012; 112(6), 543–559.CrossRefGoogle Scholar
Bay, JL, Yaqona, D, Tairea, K, et al. The healthy start to life education for adolescents project: indicators of early success in adaptation for use in small Island developing states. J Dev Orig Health Dis. 2015; 6(S2), S77.Google Scholar