Perceptions of preconception health messaging and responsibility

Engaging with ‘health helpers’ in the Healthy Life Trajectories Initiative-South Africa trial

Dados Bibliográficos

ID21342847
AutoresCaitlin Victoria Gardiner (0000-0002-7867-4051, King's College London, autor correspondente), Lerato Mohlomi (University of the Witwatersrand), Catherine E Draper (0000-0002-2885-437X, University of the Witwatersrand), Tsakani Hlungwani (University of the Witwatersrand), Stephen J Lye (0000-0002-3305-4406, Lunenfeld-Tanenbaum Research Institute), Shane A Norri (0000-0001-7124-3788, University of the Witwatersrand), Shane A Norris (University of the Witwatersrand), Noreth Muller‐kluit (0000-0003-1337-2199, University of the Witwatersrand), Neusa Torres (0000-0001-7568-9971, University of the Witwatersrand), Daniella Watson (0000-0001-6353-7495, King's College London), Michelle Pentecost (0000-0001-8647-6533, King's College London)
Ano2025
Volume57
Fascículo4
Páginas486-505
Data de publicação2025-07-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoJournal of Biosocial Science (JOURNAL)
Identificadores do periódicoISSN: 0021-9320 • E-ISSN: 1469-7599
EditoraCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s0021932025100345
PMID40552452
OpenAlexW4411610925
IdiomaEN
Referências citadas82

Premised on the Developmental Origins of Health and Disease theory and on the limited effectiveness of antenatal interventions, interventions in the preconception period are being conducted to potentially improve intergenerational health and non-communicable disease burdens. The Healthy Life Trajectories Initiative (HeLTI) is an international health research consortium primarily investigating the intergenerational effects of behavioural interventions on obesity via a complex four-phase intervention initiated preconceptionally, through pregnancy, and into early childhood. HeLTI, in partnership with the World Health Organization, aims to generate evidence that will shape health policy focused on preconception as part of a life course approach to population health. It is necessary to ensure that a renewed public health focus on preconception prioritises justice and equity in its framing. This article presents collaborative interdisciplinary work with HeLTI-South Africa. It applies a feminist bioethics methodology, which is empirical, situated, intersectional, and fundamentally concerned with justice, to investigate what South African HeLTI community health workers, or ‘Health Helpers’, who deliver the complex behavioural intervention, think about preconception health and responsibility. Seven semi-structured interviews were conducted with HeLTI-SA Health Helpers, and data were analysed using reflexive thematic analysis. Our findings show that Health Helpers’ perceptions of preconception health and related responsibility were significantly gendered, heteronormative, and concerned with child-bearing intentionality and desires. These themes were inflected with Health Helpers’ perceptions about how attributions of responsibility are shaped by culture, demonstrating the situated nature of epistemologies. Their ideas also highlight how preconception health knowledge can distribute responsibility unjustly. Understanding the contextual impact and relevance of values around responsibility is critical to prospectively design preconception health interventions that promote equity and fairness. This understanding can then be used for effective policy translation, with the goal that public health policy is founded upon contextual responsivity and justice for the public it aims to serve

Environmental health · Health coaching · Health equity · Health promotion · Intervention (counseling) · Political science · Population · Psychological intervention · Public health · Public relations · Qualitative research · Reproductive health · Social science · Sociology · Thematic analysis · Birth, Development, and Health · Child and Adolescent Health · Child Nutrition and Water Access · Medicine · Nursing · Psychology · Health Policy