The Lancet https://doi.org/10.1016/S0140-6736(18)30313-1 (2018)

Encouraging people to practice healthy lifestyles before pregnancy may ensure the long-term health of their children. However, there is a need to identify which types of interventions will be most effective and by what means they are best delivered at different life stages.

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Mary Barker, of the University of Southampton, and colleagues evaluated 14 published studies that aimed to improve preconception nutrition through nutritional supplementation, cash incentives or behaviour change interventions. They then identified which intervention pathways are most likely to be effective at different stages in people’s lives, in accordance with their changing life motivations. Based on these analyses, the authors advocate a combined strategy of encouraging healthy nutrition in those planning pregnancy, via traditional health services, and informing and supporting the public more broadly, via a mix of channels, to lay the groundwork for healthy pregnancies in future.

Social marketing campaigns that provide only health information have not been effective in improving outcomes for all socioeconomic groups. Instead, the authors argue for a broader social movement that will also provide the resources to enact change and instil the motivation among citizens by making the link between preconception health and children’s life outcomes public knowledge. Tactics from marketing brand development could help to form more effective motivational campaigns. Such campaigns also need to involve industry and leverage its massive influence on consumer behaviour. These goals may be best achieved by establishing an advocacy coalition that will place preconception health on the political agenda.