title: Pre-pregnancy community-based intervention for couples in Malaysia: application of intervention mapping.
abstract: Malaysia is experiencing a nutrition transition with burgeoning obesity, particularly in women, and a growing prevalence of non-communicable disease. These health burdens have severe implications not only for adult health but also across generations. Pre-conception health promotion could address the intergenerational risk of metabolic disease. This paper describes the development of the "Jom Mama" intervention using Intervention Mapping (IM). The Jom Mama intervention aims to improve the health of young adult couples in Malaysia prior to conception.
  
  
  
  IM comprises of five steps prior to the last one, which involves the evaluation of the intervention. We used the five steps to develop the Jom Mama intervention.
  
  
  
  Both the process and evidence is documented providing the rationale to the selection of the key objectives of the intervention: (i) increasing healthy dietary practice; (ii) increasing physical activity levels, (iii) reducing sedentary activity; and (iv) improving social support to offset stressful lifestyles. From the IM process, Jom Mama will be health-system centred approach that uniquely combines both community health promoters and an electronic-health platform to deliver the complex intervention.
  
  
  
  IM is an iterative process that systematically gathers "best" evidence, selects appropriate theories of behaviour change, and facilitates formative research so as to develop a complex intervention. Though the IM process is time consuming, complex, and costly, it has enriched the Jom Mama intervention with a number of notable advantages: (i) intervention fashioned on formative work with stakeholders and in the target group; (ii) intervention combines research evidence with theory; (iii) intervention acknowledges multiple dynamics of influence; and (iv) intervention is embedded within health service priorities in Malaysia for greater scale-up possibility.
authors.affiliation: MRC Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. shane.norris@wits.ac.za.
authors.forename: Shane A
authors.initials: SA
authors.lastname: Norris
authors.affiliation: School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 46150, Bandar Sunway, Selangor, Malaysia.
authors.forename: Julius Cheah Chee
authors.initials: JC
authors.lastname: Ho
authors.affiliation: Nutrition Unit, Cardiovascular, Diabetes and Nutrition Research Center, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, 50588, Kuala Lumpur, Malaysia.
authors.forename: Aswir Abd
authors.initials: AA
authors.lastname: Rashed
authors.affiliation: IT University of Copenhagen, Rued Langgaards Vej 7, 2300, Copenhagen, Denmark.
authors.forename: Vibeke
authors.initials: V
authors.lastname: Vinding
authors.affiliation: MRC Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Jutta K H
authors.initials: JK
authors.lastname: Skau
authors.affiliation: Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, 123 Saint Stephen's Green, Dublin 2, Ireland.|Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.
authors.forename: Regien
authors.initials: R
authors.lastname: Biesma
authors.affiliation: MRC Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.|Health Promotion Research, Steno Diabetes Center, Niels Steensens Vej 6, 2820, Gentofte, Copenhagen, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Aagaard-Hansen
authors.affiliation: Institute of Developmental Sciences, British Heart Foundation, Cardiovascular Sciences Faculty of Medicine, University of Southampton Mailpoint 887, Southampton General Hospital Tremona Road, Southampton, SO16 6YD, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Hanson
authors.affiliation: Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.
authors.forename: Priya
authors.initials: P
authors.lastname: Matzen
mesh_terms: D000328:Adult; D003153:Community Health Services; D003695:Delivery of Health Care; D004032:Diet; D015444:Exercise; D005191:Family Characteristics; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008296:Malaysia; D008659:Metabolic Diseases / Q000209:etiology / Q000517:prevention & control*; D009765:Obesity / Q000209:etiology / Q000517:prevention & control*; D010290:Parents; D016742:Preconception Care; D011247:Pregnancy; D015397:Program Evaluation; D012107:Research Design; D012307:Risk Factors; D012944:Social Support; D055815:Young Adult
keywords: Gestational diabetes mellitus; Intervention mapping; Malaysia; Metabolic disease risk; Reproductive health