title: A Framework to Address Challenges in Communicating the Developmental Origins of Health and Disease.
abstract: 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.
authors.affiliation: School of Community Health and OHSU/PSU School of Public Health, Portland State University, PO Box 751, Portland, OR, 97201, USA. lwinett@pdx.edu.
authors.forename: Liana
authors.initials: L
authors.lastname: Winett
authors.affiliation: School of Community Health and OHSU/PSU School of Public Health, Portland State University, PO Box 751, Portland, OR, 97201, USA.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Wallack
authors.affiliation: School of Community Health and OHSU/PSU School of Public Health, Portland State University, PO Box 751, Portland, OR, 97201, USA.
authors.forename: Dawn
authors.initials: D
authors.lastname: Richardson
authors.affiliation: Public Health and Preventive Medicine and OHSU/PSU School of Public Health, Oregon Health and Science University, 3181 Sam Jackson Park Road, Portland, OR, 97239, USA.
authors.forename: Janne
authors.initials: J
authors.lastname: Boone-Heinonen
authors.affiliation: School of Community Health and OHSU/PSU School of Public Health, Portland State University, PO Box 751, Portland, OR, 97201, USA.
authors.forename: Lynne
authors.initials: L
authors.lastname: Messer
mesh_terms: D002908:Chronic Disease / Q000453:epidemiology*; D003142:Communication; D004777:Environment; D057890:Epigenomics; D005260:Female; D006801:Humans; D009035:Mothers; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology; D011634:Public Health; D064890:Social Determinants of Health
keywords: Community-blame; Developmental Origins of Health and Disease (DOHaD); Epigenetics; First-hit/Second-hit Framework; Message framing; Mother-blame