Health in Preconception, Pregnancy and Postpartum Global Alliance: International Network Preconception Research Priorities for the Prevention of Maternal Obesity and Related Pregnancy and Long-Term Complications
2.2. Phase I. Inputs
2.2.1. Identification of Forum Participants: Experts and Consumer Representatives
2.2.2. Research Priority Areas
2.2.3. Priority Setting Framework
2.3. Phase II. Ranking
2.3.1. Round 1: Pre-Workshop Ranking
2.3.2. Rounds 2 and 3: Workshop Group Discussion and Independent Voting
2.4. Phase III. Output
2.4.1. Consensus Development of Priorities
2.4.2. Post Workshop Consultation and Collaboration
3.1. Phase I. Inputs
3.1.2. Research Priority Areas
3.2. Phase II. Ranking
3.2.1. Round 1: Pre-Workshop Ranking
3.2.2. Round 2: Workshop Sense-Making, Group Discussion and Independent Voting
- Healthy diet and nutrition, including
- Folic acid supplementation
- Food security
- Weight management
- Physical activity
- Planned pregnancy including awareness and optimising fertility
- Physical, mental and psychosocial health, including
- Chronic disease including diabetes, hypertension
- Pre-existing pregnancy conditions
- Context of broader preconception/antenatal care priorities
- Social determinants of health
- Health of families
- Cultural considerations
3.2.3. Round 3: Workshop Group Discussion and Independent Voting
3.3. Phase III. Ouput
3.3.1. Consensus Development of Priorities
3.3.2. Post-Workshop Consultation and Collaboration
- Establishment of Katie’s Team, a women’s health research patient and public advisory group for East London.
- Publication of a 2018 Lancet series that described the different contexts in which we can address nutrition and lifestyle preconception .
- Validation of the London Measure of Unplanned Pregnancy in the Australian context and cultural adaptation and validation in Brazilian Portuguese (http://www.lmup.com/).
- Development and evaluation of eHealth platforms for preconception health and care:
- The virtual conversational agent, Gabby, which screens for 100 risk factors in preconception care, and has been designed to meet the gap between the number and availability of clinicians and what is needed in preconception care in the US .
- A Canadian preconception health risk assessment tool intended to be used in the primary care setting to improve preconception care, adapted from Gabby (wdgpublichealth.ca/preconception-health). Both the US and Canadian programs are context specific and are undergoing evaluation.
- Development of the Dutch Preparing for Pregnancy website, which offers an internet questionnaire for risk assessment in preconception care .
- The mHealth ‘Smarter Pregnancy’ platform, a personal online coaching program for couples contemplating pregnancy .
- Publication of our first paper as an Alliance for the HiPPP Global Alliance, highlighting that we now have a clear and imperative call to action to consolidate and advance current evidence into practice and policy for the prevention of maternal obesity .
- Further defining the preconception population (beyond the definitions presented in Stephenson et al. ) and deepening our understanding of the lifestyle behaviours and mental health of women before pregnancy.
- Understanding the social determinants and disparities in perinatal health, which, for example, contribute to worse outcomes for pre-term delivery, small-for-gestational age and stillbirth .
- Conducting an intervention trial aiming to better understand the effect of preconception multiple micronutrient supplementation and life-skills-based education compared to the standard of care, among adolescent and young women in rural Pakistan. Outcomes will capture the health of both those who do and do not become pregnant within the context of the trial [40,41].
- Conducting an intervention to evaluate whether training health professionals on preconception health will improve delivery of preconception services in primary health care facilities in Sao Paulo, Brazil.
- In pregnancy, collaborative work of individual patient data meta-analysis and comprehensive systematic reviews of lifestyle intervention to reduce gestational weight gain have highlighted that generation of evidence needs to move from randomised controlled trials to pragmatic implementation trials sooner ; lessons learned in this space will be applied preconception.
- Applying our recent work developing our understanding of intervention strategies, behaviour change techniques, and implementation characteristics in lifestyle interventions for postpartum  women to preconception applications.
- Conducting an updated review of preconception and pregnancy guidelines for lifestyle modification in pregnancy.
Conflicts of Interest
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|Criteria 1. Prevalence or burden attributable to the proposed problem||Consider the prevalence or attributable burden of the problem and its implications/complications. Is the problem a significant issue for the community, health system and key stakeholders?|
|Criteria 2: Prevention||Is there potential to prevent the problem, including complications or secondary impacts, in the general population or in a specific vulnerable target cohort?|
|Criteria 3: Position||Consider the geographical issues around the problem and the location of services/expertise. Are there inequities that can be improved through this initiative? Is there potential to improve health outcomes for the general population and/or regional populations and/or specific vulnerable target cohorts?|
|Criteria 4: Provision||Does the current approach or system align with evidence-based best practice? Is the current approach designed to deliver the best possible community health outcomes and health care system? Is there a clear gap to address in the area proposed?|
|Criteria 5: Potential||Is there a strong rationale/evidence base for the potential for improvement in patient outcomes and health system advancement through this initiative?|
|Criteria 6: Participation||Is a collaborative approach critical to success? Are there clear drivers for stakeholders to engage and collaborate? Are there existing relationships between stakeholders that can be leveraged to drive improvement and change?|
|Criteria 7: Policy||Does the problem or the potential solution align with current policy directions at a local, state, national or international level?|
|Criteria 8: Proposed Strategy||Does the proposal align with the purpose of the Health in Preconception, Pregnancy and Postpartum strategic alliance?|
|Criteria 9: Proposed Transformation||Will addressing this problem or taking this approach collaboratively support the development of an improved health system and health outcomes?|
|Round 1||Round 2||Round 3|
|Healthy diet and nutrition
||1, 8 †||1||1||1.6|
|Planned Pregnancy—awareness and optimising and fertility||5, 10 †||4||4||4.4|
|Pre-existing medical conditions *
||4, 12 †||5||5||4.5|
|Substance use (including alcohol and tobacco)||6||7||6||6.4|
|Mental health *||7||6||7||5.6|
||9, 11 †||9 ^||8||8.6|
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Hill, B.; Skouteris, H.; Teede, H.J.; Bailey, C.; Baxter, J.-A.B.; Bergmeier, H.J.; Borges, A.L.V.; Harrison, C.L.; Jack, B.; Jorgensen, L.; Lim, S.; Montanaro, C.; Redman, L.; Steegers, E.; Stephenson, J.; Sundseth, H.; Thangaratinam, S.; Walker, R.; Boyle, J.A. Health in Preconception, Pregnancy and Postpartum Global Alliance: International Network Preconception Research Priorities for the Prevention of Maternal Obesity and Related Pregnancy and Long-Term Complications. J. Clin. Med. 2019, 8, 2119. https://doi.org/10.3390/jcm8122119
Hill B, Skouteris H, Teede HJ, Bailey C, Baxter J-AB, Bergmeier HJ, Borges ALV, Harrison CL, Jack B, Jorgensen L, Lim S, Montanaro C, Redman L, Steegers E, Stephenson J, Sundseth H, Thangaratinam S, Walker R, Boyle JA. Health in Preconception, Pregnancy and Postpartum Global Alliance: International Network Preconception Research Priorities for the Prevention of Maternal Obesity and Related Pregnancy and Long-Term Complications. Journal of Clinical Medicine. 2019; 8(12):2119. https://doi.org/10.3390/jcm8122119Chicago/Turabian Style
Hill, Briony, Helen Skouteris, Helena J Teede, Cate Bailey, Jo-Anna B Baxter, Heidi J Bergmeier, Ana Luiza Vilela Borges, Cheryce L Harrison, Brian Jack, Laura Jorgensen, Siew Lim, Cynthia Montanaro, Leanne Redman, Eric Steegers, Judith Stephenson, Hildrun Sundseth, Shakila Thangaratinam, Ruth Walker, and Jacqueline A Boyle. 2019. "Health in Preconception, Pregnancy and Postpartum Global Alliance: International Network Preconception Research Priorities for the Prevention of Maternal Obesity and Related Pregnancy and Long-Term Complications" Journal of Clinical Medicine 8, no. 12: 2119. https://doi.org/10.3390/jcm8122119