4.0 Article

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

Journal

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S2040174420000483

Keywords

Developmental Origins of Health and Disease; qualitative; counselling; knowledge translation

Funding

  1. CIHR/IHDCYH/SOGC Clinician-Investigator Teams in Obstetrics & Maternal-Fetal Medicine [MFM-146443]
  2. Western University [R3948A11]
  3. Children's Health Research Institute [R3948A12]
  4. Women's Development Council (LHSC) [R3948A13]
  5. Department of Obstetrics and Gynaecology

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This study found that healthcare providers recognize the importance of DOHaD and are excited about the potential health benefits of counselling on it, but also identified barriers to knowledge translation and concerns about how to introduce the concept to patients. They called for the development of practice guidelines, framing counselling on DOHaD in an empowering way, and emphasized the need for more interaction and collaboration to support knowledge translation.
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.

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