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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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