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Technical Report
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This paper synthesises what is known about that factors that affect development during the first 1000 days (the period from conception to the end of the second year), how these factors have their impact, and what are the long-term effects of early exposures and experiences. Further details can be found on the Centre for Community Child Health websi...

Contexts in source publication

Context 1
... are the caps at the end of each of our chromosomes, and can be likened to the plastic tips at the end of shoelaces (Blackburn & Epel, 2012Blackburn, Epel & Lin, 2015;Prescott, 2015) (See figure 1). ...
Context 2
... breastfeeding has been shown to at least modestly protect against excessive early infant gain and later obesity, an effect that may result from differences in composition of weight gain between breast-fed and formula-fed infants (Young et al., 2012). Moreover, the method of infant feeding (i.e. ...

Citations

... Establishing optimal nutrition and movement behaviors (physical activity and sedentary behavior) in early life is critical for achieving health and wellbeing benefits that track into adulthood, including preventing overweight and obesity (1,2). Family and parental-child influences are important for establishing healthy early life nutrition and movement behaviors (2)(3)(4)(5). ...
... Establishing optimal nutrition and movement behaviors (physical activity and sedentary behavior) in early life is critical for achieving health and wellbeing benefits that track into adulthood, including preventing overweight and obesity (1,2). Family and parental-child influences are important for establishing healthy early life nutrition and movement behaviors (2)(3)(4)(5). Early childhood family-based behavior change interventions are an important avenue for supporting optimal nutrition and movement behaviors; such interventions have been shown to reduce obesity risk behaviors in children aged 0-5 years (6)(7)(8). ...
Article
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Introduction Early life parent-focused interventions can effectively improve infant and child nutrition and movement (physical activity and sedentary behavior) as well as parents' health behaviors. Scale-up of such interventions to real-world settings is essential for population-wide benefits. When progressing to scale-up, intervention components may be modified to reflect contextual factors and promote feasibility of scale-up. The INFANT program, an efficacious early life nutrition and movement behavioral intervention began as a randomized controlled trial (RCT), was modified after a small-scale translation, and is currently being scaled-up in Victoria, Australia. This study mapped and compared discrete intervention components of both the original RCT and the scaled-up version of INFANT to examine modifications for scaling up. Methods Discrete intervention components, specifically the target behaviors (child-related and parent-related behaviors), delivery features and behavior change techniques (BCTs) from the RCT and the scaled-up program were coded and mapped using established frameworks and taxonomies. Publications and unpublished materials (e.g., facilitator notes, handouts, videos, app) were coded. Coding was performed independently in duplicate, with final coding validated in a meeting with interventionists. Interventionists reported the rationale for modifications made. Results The INFANT RCT and scaled-up version targeted the same obesity prevention-related nutrition and movement behaviors. Key modified delivery features at scale-up included reduced number of sessions, a broader range of professionals facilitating groups, the addition of a mobile app for parents replacing hard-copy materials and tangible tools (e.g., pedometers), and broadening of content (e.g., early feeding, updated 24-h movement guidelines). BCTs used across the RCT and scale-up sessions were unchanged. However, the BCTs identified in the between-session support materials were almost double for the scale-up compared with the RCT, primarily due to the reduced number of sessions and the app's capacity to include more content. Conclusions INFANT is one of few early life nutrition and movement behavioral interventions being delivered at scale. With INFANT as an example, this study provides critical understanding about what and why intervention components were altered as the RCT was scaled-up. Unpacking these intervention modifications provides important insights for scale-up feasibility, outcome effects, and how to optimize implementation strategies for population-level benefits.
... The importance of addressing inequities in health and social outcomes, while imperative across the lifespan, is never more critical than in the early years of a child's life (Moore et al., 2017). Research highlights the impact of such inequities on early brain development and the lifelong trajectory of the child into adulthood (Gerlach and Varcoe, 2021;Jeong et al., 2020). ...
Article
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The impact of health service access disparities has significant implications for society. The importance of addressing health and social inequities is never more critical than in the early years of a child’s life. Despite advances in healthcare implementation, there is a lack of an evidence-based framework to specifically guide the adaptation of child and family health (CFH) service models for different community contexts. This paper describes the development of a framework for the adaptation of community-based CFH service models. Drawing on the findings of an integrative review and Delphi study, Participatory Action Research was used to test the framework, resulting in the Framework for Collaborative Adaptation of Service Models for Child and Family Health in Diverse Settings (CASCADES). The Framework uses the analogy of a waterfall to represent the iterative process of collecting information to inform each step. The framework supports a collaborative co-design approach to build a comprehensive understanding of the target community to inform the adaptation and evaluation of evidence-based interventions appropriate to the local context. The ultimate aim is to enable the delivery of services that are contextually relevant for local communities and provide greater access to effective, accessible services to support children and their families.
... The phrase 'the first 1000 days', a period spanning conception to 3 years of age, is one increasingly seen in policy documents relating to child health. 1 The phrase has its origins in the work of Professor David Barker, a physician and epidemiologist, whose trio of seminal articles published in the Lancet between 1986 and 1993 prompted the development of the 'foetal origins hypothesis'. [2][3][4][5] A fundamental concept in Barker's work was developmental plasticity, formally defined as 'the ability of a single genotype to produce more than one alternative form of structure, physiological state, or behaviour in response to environmental conditions'. ...
Article
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The application of machine learning (ML) to address population health challenges has received much less attention than its application in the clinical setting. One such challenge is addressing disparities in early childhood cognitive development—a complex public health issue rooted in the social determinants of health, exacerbated by inequity, characterised by intergenerational transmission, and which will continue unabated without novel approaches to address it. Early life, the period of optimal neuroplasticity, presents a window of opportunity for early intervention to improve cognitive development. Unfortunately for many, this window will be missed, and intervention may never occur or occur only when overt signs of cognitive delay manifest. In this review, we explore the potential value of ML and big data analysis in the early identification of children at risk for poor cognitive outcome, an area where there is an apparent dearth of research. We compare and contrast traditional statistical methods with ML approaches, provide examples of how ML has been used to date in the field of neurodevelopmental disorders, and present a discussion of the opportunities and risks associated with its use at a population level. The review concludes by highlighting potential directions for future research in this area. Impact To date, the application of machine learning to address population health challenges in paediatrics lags behind other clinical applications. This review provides an overview of the public health challenge we face in addressing disparities in childhood cognitive development and focuses on the cornerstone of early intervention. Recent advances in our ability to collect large volumes of data, and in analytic capabilities, provide a potential opportunity to improve current practices in this field. This review explores the potential role of machine learning and big data analysis in the early identification of children at risk for poor cognitive outcomes.
... As widely stated, the relevance of familial and socio relationships as environments for early socio-personality development is crucial [38] and, during the pandemic, confinement measures have led to an important social deprivation. The first 1,000 days of a child's life represent a highly sensitive moment for child development and growth [42] and our findings highlighted that there are specific areas of a child's development that are more vulnerable than others when infants are affected by confinement measures. ...
Article
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Objectives: The study aimed to assess and compare the global development in six-month-old infants before and during the pandemic restrictive social distancing measures. Methods: This cross-sectional nested study involved infants assessed through the Griffiths Scales of Child Development (GSCD) between September 2019 and April 2021. Infants were classified in a pre-COVID or a COVID group, considering the evaluation date and the restrictive measures in place. GSCD subscales and General Development Scores (GDS) were calculated and compared. Results: One hundred and four healthy term-born infants were evaluated. GDS in the COVID group (n:70; median: 94; IQR: 90–100) appeared significantly lower than in the pre-COVID group (n:34; median: 98; IQR: 97–103; p < 0.001). Language and personal-social-emotional subareas scores appeared the most affected. A decreasing trend of GDS along with the severity of restriction was observed. Conclusion: A reduction in infant development scores was observed during pandemic social distancing. Further studies are needed to systematize these findings and to address effective public health policies for infants and families during long-term forced isolation periods.
... The healthy development of children and young people is directly related to the nature and quality of caregiving by parents or guardians (hereafter referred to as parenting) that they receive (Moore et al., 2017; National Scientific Council on the Developing Child, 2004Child, , 2007Rioseco et al., 2020;Sanders, 2012;Stewart-Brown & Schrader-McMillan, 2011). Interventions which promote positive, caring and consistent parenting practices are repeatedly reported as critical in attempts to reduce the incidence of adverse childhood experiences (ACEs) and consequent poor health outcomes (Barth, 2009;Chen & Chan, 2016;Havighurst et al., 2004;National Scientific Council on the Developing Child, 2007;Sanders, 2012;Sanders & Turner, 2005). ...
Article
Research indicates that healthy development of children and young people is directly related to the nature and quality of parenting/ caregiving they receive. Parenting support interventions have potential to support healthy child development and mental health. While many parenting programs, in controlled research settings, have demonstrated efficacy in improving child mental health outcomes, there are numerous challenges in translating these programs to real-world settings. The aim of this review was to systematically identify and synthesise existing qualitative research on the barriers and facilitators that influence the implementation of parenting programs in real-world settings. Four key electronic databases (PsycInfo, Medline, Family and Society Studies Worldwide and CINAHL) were searched. A modified population, intervention, control, and outcome (PICO) inclusion/ exclusion criteria framework determined the inclusion of fourteen articles in the review. All identified studies were double-screened, and data were extracted independently by two authors. Included studies were synthesised using framework synthesis methods and were quality appraised. The results from the synthesis revealed six themes and sixteen subthemes related to implementation barriers and facilitators. The overarching themes were: system level factors, provider characteristics, program characteristics, organisational characteristics, prevention support system factors, and client factors. Provider, program, and organisational characteristics were the most frequently reported. The findings highlight the importance of considering these factors from the initial stages of development and implementation of parenting programs into real-world settings.
... The 'first 1,000 days from conception' is guiding investment in programmes in preventive and early intervention child health programmes in Australia as elsewhere (Moore et al, 2017). This is shifting, however, with increasing recognition of the need for sustaining intervention beyond age two years to school entry (first 2,000 days) (Black et al, 2017). ...
Article
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Background: Risk-taking behaviours are a major contributor to youth morbidity and mortality. Vulnerability to these negative outcomes is constructed from individual behaviour including risk-taking, and from social context, ecological determinants, early life experience, developmental capacity and mental health, contributing to a state of higher risk. However, although risk-taking is part of normal adolescent development, there is no systematic way to distinguish young people with a high probability of serious adverse outcomes, hindering the capacity to screen and intervene. This study aims to explore the association between risk behaviours/states in adolescence and negative health, social and economic outcomes through young adulthood. Methods: The Raine Study is a prospective cohort study which recruited pregnant women in 1989-91, in Perth, Western Australia. The offspring cohort (N = 2,868) was followed up at regular intervals from 1 to 27 years of age. These data will be linked to State government health and welfare administrative data. We will empirically examine relationships across multiple domains of risk (for example, substance use, sexual behaviour, driving) with health and social outcomes (for instance, road-crash injury, educational underachievement). Microsimulation models will measure the impact of risk-taking on educational attainment and labour force outcomes. Discussion: Comprehensive preventive child health programmes and policy prioritise a healthy start to life. This is the first linkage study focusing on adolescence to adopt a multi-domain approach, and to integrate health economic modelling. This approach captures a more complete picture of health and social impacts of risk behaviour/ states in adolescence and young adulthood.
... The first 1000 days of life is recognized as an important window to nurture child health and development [1]. An increasing body of evidence indicates that a compromised microbiome in early life is a risk factor for the development of non-communicable diseases [2][3][4][5][6][7][8][9][10]. ...
Article
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Background The compromised gut microbiome that results from C-section birth has been hypothesized as a risk factor for the development of non-communicable diseases (NCD). In a double-blind randomized controlled study, 153 infants born by elective C-section received an infant formula supplemented with either synbiotic, prebiotics, or unsupplemented from birth until 4 months old. Vaginally born infants were included as a reference group. Stool samples were collected from day 3 till week 22. Multi-omics were deployed to investigate the impact of mode of delivery and nutrition on the development of the infant gut microbiome, and uncover putative biological mechanisms underlying the role of a compromised microbiome as a risk factor for NCD. Results As early as day 3, infants born vaginally presented a hypoxic and acidic gut environment characterized by an enrichment of strict anaerobes (Bifidobacteriaceae). Infants born by C-section presented the hallmark of a compromised microbiome driven by an enrichment of Enterobacteriaceae. This was associated with meta-omics signatures characteristic of a microbiome adapted to a more oxygen-rich gut environment, enriched with genes associated with reactive oxygen species metabolism and lipopolysaccharide biosynthesis, and depleted in genes involved in the metabolism of milk carbohydrates. The synbiotic formula modulated expression of microbial genes involved in (oligo)saccharide metabolism, which emulates the eco-physiological gut environment observed in vaginally born infants. The resulting hypoxic and acidic milieu prevented the establishment of a compromised microbiome. Conclusions This study deciphers the putative functional hallmarks of a compromised microbiome acquired during C-section birth, and the impact of nutrition that may counteract disturbed microbiome development. Trial registration The study was registered in the Dutch Trial Register (Number: 2838 ) on 4th April 2011.
... The prevention of obesity in early life is a key priority identified by the World Health Organization (1). The dietary and activity (energy-balance) behaviours associated with overweight and obesity begin in and track from early childhood (2). In Australia, a minority of children meet dietary, physical activity or sedentary behaviour guidelines (3). ...
Article
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Introduction Promoting healthy eating and active play in early life is critical, however few interventions have been delivered or sustained at scale. The evaluation of interventions at scale is a crucial, yet under-researched aspect of modifying population-level health behaviours. INFANT is an evidence-based early childhood healthy lifestyle intervention that aims to improve parents’ knowledge and skills around promoting optimal energy balance-related behaviours that, in turn, influence children’s diet, activity and adiposity. It consists of: 1) Four group sessions delivered via first time parent groups across the first 12 months of life; 2) access to the My Baby Now app from birth to 18 months of age. This research aims to assess real-world implementation, effectiveness and cost-effectiveness of INFANT when delivered at scale across Victoria, Australia. Methods and Analysis A hybrid type II implementation-effectiveness trial applying a mixed methods design will be conducted. INFANT will be implemented in collaboration with practice and policy partners including maternal and child health services, population health and Aboriginal health, targeting all local government areas (n=79) in Victoria, Australia. Evaluation is based on criteria from the ‘Outcomes for Implementation Research’ and ‘RE-AIM’ frameworks. Implementation outcomes will be assessed using descriptive quantitative surveys and qualitative interviews with those involved in implementation, and include intervention reach, organisational acceptability, adoption, appropriateness, cost, feasibility, penetration and sustainability. Process measures include organizational readiness, fidelity, and adaptation. Effectiveness outcomes will be assessed using a sample of INFANT participants and a non-randomized comparison group receiving usual care (1,500 infants in each group), recruited within the same communities. Eligible participants will be first time primary caregivers of an infant aged 0-3 months, owning a personal mobile phone and able to communicate in English. Effectiveness outcomes include infant lifestyle behaviours and BMIz at 12 and 18 months of age. Impact This is the first known study to evaluate the scale up of an evidence based early childhood obesity prevention intervention under real world conditions. This study has the potential to provide generalisable implementation, effectiveness and cost-effectiveness evidence to inform the future scale up of public health interventions both in Australia and internationally. Clinical Trial Registration Australian and New Zealand Clinical Trial Registry https://www.anzctr.org.au/ , identifier ACTRN12620000670976.
... As mental health difficulties early in life have a significant impact on the future health trajectory of an individual, it is essential to build the foundations of good mental health during this critical period (Lewis et al., 2014;Moore et al., 2017). In this review, we consider interventions offered at the earliest opportunity spanning from the perinatal period to 3 years of age aimed at preventing mental health difficulties in childhood. ...
... There is international consensus that the first 1,000 days of life -the period of development from conception to age tworepresent a crucial period of rapid physical, psychological and neurological growth (Moore et al., 2017). During this time there is an increased likelihood that detrimental experiences such as early trauma or deprivation will be especially harmful and greatly impact future development, with adverse effects potentially going on to develop into lifelong consequences (Shonkoff et al., 2012;Lyons-Ruth et al., 2017;Moore et al., 2017). ...
... There is international consensus that the first 1,000 days of life -the period of development from conception to age tworepresent a crucial period of rapid physical, psychological and neurological growth (Moore et al., 2017). During this time there is an increased likelihood that detrimental experiences such as early trauma or deprivation will be especially harmful and greatly impact future development, with adverse effects potentially going on to develop into lifelong consequences (Shonkoff et al., 2012;Lyons-Ruth et al., 2017;Moore et al., 2017). ...
Article
Full-text available
The period of infancy and early childhood is a critical time for interventions to prevent future mental health problems. The first signs of mental health difficulties can be manifest in infancy, emphasizing the importance of understanding and identifying both protective and risk factors in pregnancy and the early postnatal period. Parents are at a higher risk of developing mental health problems during the perinatal period. An understanding of the evidence around prevention and intervention for parental anxiety and depression is vital to the process of prevention of early mental health disorders in infants and young children. Here we review the existing prevention and treatment interventions in the early years focusing on the period from conception to 3 years – the majority targeting parents in order to improve their mental health, and that of their infants. Elements of successful programs for parents include psychoeducation and practical skills training, as well as work on the co-parenting relationship, developing secure attachment, and enhancing parental reflective functioning. While both targeted and universal programs have produced strong effect sizes, universal programs have the added benefit of reaching people who may otherwise not have sought treatment. In synthesizing this information, our goal is to inform the development of integrated models for prevention and novel early intervention programs as early in life as possible.
... It is widely agreed that the thousand-day period encompassing the 9 months of pregnancy plus the first 2 years of an infant's life is a window of opportunity for interventions, precisely because nutritional well-being at this critical time will impact the child for the rest of his or her life (Beluska-Turkan et al., 2019;Moore, Arefadib, Deery, & West, 2017;Schwarzenberg & Georgieff, 2018). ...
... Insufficient nutrition during this period can lead to a plethora of health and development risks including stunting, wasting, brain underdevelopment and death (Kabaran, 2018;Moore, Arefadib, Deery, & West, 2017). ...
Article
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In Nepal, an at‐scale, multisectoral programme—Suaahara (2011–2023)—aims to improve nutrition behaviours. Suaahara II (2016–2023) transitioned from a mother/child dyad focus to explicitly targeting all family members. Evidence is scant, however, regarding how exposure by men to social and behaviour change interventions relates to nutrition outcomes. This study uses a 2019 cross‐sectional monitoring dataset to test associations between maternal and male household head exposure to Suaahara II interventions (interacting with a frontline worker, participating in a community event or listening to the Bhanchhin Aama radio programme) and adoption of three infant and young child feeding practices: minimum dietary diversity, minimum acceptable diet and sick child feeding, in households with a child under 2 years (n = 1827). Maternal exposure to Suaahara II had a positive association with minimum dietary diversity (OR: 1.71, 95% CI [1.27, 2.28], P < 0.001), minimum acceptable diet (OR: 1.60, 95% CI [1.19, 2.14], P = 0.002) and increased feeding to a sick child (OR: 2.11, 95% CI [1.41, 3.17], P < 0.001). Male household head exposure was only associated with increased feeding to a sick child (OR: 2.21, 95% CI [1.27, 3.84], P = 0.005). Among households with an exposed mother, having an exposed male household head nearly tripled the odds of appropriate sick child feeding (OR: 2.90, 95% CI [1.57, 5.34], P = 0.001) but was not significantly associated with the other two outcomes. These findings suggest that the relationships between exposure to nutrition programmes and outcomes are complex and further research is needed to understand variation by family member, behavioural outcome and context.