A Framework to Address Challenges in Communicating the Developmental Origins of Health and Disease
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Findings from the field of Developmental Origins of Health and Disease (DOHaD) suggest that some of the most pressing public health problems facing communities today may begin much earlier than previously understood. In particular, this body of work provides evidence that social, physical, chemical, environmental, and behavioral influences in early life play a significant role in establishing vulnerabilities for chronic disease later in life. Further, because this work points to the importance of adverse environmental exposures that cluster in population groups, it suggests that existing opportunities to intervene at a population level may need to refocus their efforts “upstream” to sufficiently combat the fundamental causes of disease. To translate these findings into improved public health, however, the distance between scientific discovery and population application will need to be bridged by conversations across a breadth of disciplines and social roles. And importantly, those involved will likely begin without a shared vocabulary or conceptual starting point. The purpose of this paper is to support and inform the translation of DOHaD findings from the bench to population-level health promotion and disease prevention, by: (1) discussing the unique communication challenges inherent to translation of DOHaD for broad audiences, (2) introducing the First-hit/Second-hit Framework with an epidemiologic planning matrix as a model for conceptualizing and structuring communication around DOHaD, and (3) discussing the ways in which patterns of communicating DOHaD findings can expand the range of solutions considered and encourage discussion of population-level solutions in relation to one another, rather than in isolation.
KeywordsDevelopmental Origins of Health and Disease (DOHaD) Epigenetics Message framing Mother-blame Community-blame First-hit/Second-hit Framework
The project described was supported in part by the National Institute of Diabetes and Digestive and Kidney Diseases, award number K01 DK102857-02 (JBH).
We would like to thank Ms. Jocelyn Wegman for her thoughtful review of earlier drafts.
Compliance with Ethical Standards
Conflict of Interest
Liana Winett, Lawrence Wallack, Dawn Richardson, Janne Boone-Heinonen, and Lynne Messer declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not report any new studies with human or animal subjects performed by any of the authors.
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