A Framework to Address Challenges in Communicating the Developmental Origins of Health and Disease.
A Framework to Address Challenges in Communicating the Developmental Origins of Health and Disease.
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DOI：
10.1007/s40572-016-0102-3
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发表时间：
2016-09
影响因子：
7.9
通讯作者：
Messer L
中科院分区：
文献类型：
--
作者：
Winett L;Wallack L;Richardson D;Boone-Heinonen J;Messer L
健康与疾病发展起源 (DOHaD) 领域的研究结果表明，当今社区面临的一些最紧迫的公共卫生问题可能比以前理解的要早得多。特别是，这项工作提供的证据表明，早期生活中的社会、物理、化学、环境和行为影响在确定晚年慢性疾病的脆弱性方面发挥着重要作用。此外，由于这项工作指出了人群中聚集的不利环境暴露的重要性，因此它表明在人群层面进行干预的现有机会可能需要重新集中精力“上游”，以充分对抗疾病的根本原因。然而，为了将这些发现转化为改善的公共卫生，科学发现和人口应用之间的距离需要通过跨学科和社会角色的对话来弥合。重要的是，相关人员可能会在没有共享词汇或概念起点的情况下开始。本文的目的是通过以下方式支持和指导将 DOHaD 研究结果从实验室转化为人口层面的健康促进和疾病预防：1) 讨论向广大受众翻译 DOHaD 所固有的独特沟通挑战，2) 引入带有流行病学规划矩阵的首次打击/二次打击框架，作为围绕 DOHaD 概念化和构建沟通的模型，以及 3) 讨论 DOHaD 沟通模式的方式研究结果可以扩大考虑的解决方案的范围，并鼓励对人口层面的解决方案进行相互关联的讨论，而不是孤立地讨论。
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.