Maternal lifestyle and conditions such as gestational diabetes affect pregnancy outcomes as well as the risk of T2D of the women as well as their off-spring. Thus, interventions during these periods could have a powerful influence in reducing the incidence of NCDs.
However, there is not much evidence on how to engage the couples and design interventions that successfully achieve pre-conception behaviour change. The Malaysian Jom Mama project takes the pre-pregnancy period as a window of opportunity for health promotion. The project aimed at developing, implementing and evaluating a prevention programme addressing risk factors such as obesity among young couples.
Jom Mama was also unique in the sense that it was a public-private partnership comprising MoH Malaysia, research institutions including SDCC as well as a private pharma company (Novo Nordisk A/S). The collaboration went very smoothly utilising the unique skill sets of each partner institution.
The overall aim was to optimise women's health status prior to and during pregnancy, in order to improve birth outcomes and reduce risk of the next generation to develop T2D. The effects on the next generation are caused by epigenetic mechanisms, i.e. influences on the foetus in utero for instance due to gestational diabetes that have long term effects such as increased risk of later developing T2D.
A tailored intervention combining behaviour change communication and an e-health platform was developed using intervention mapping based on extensive pre-studies. A randomised, controlled trial evaluated the comprehensive intervention comprising six contact points over a period of eight months. In parallel an extensive process evaluation explored the fidelity and dynamics of the intervention. The project has come to an end, and the final papers are being written.
Funding and collaborators
JOM MAMA was funded by Ministry of Health, Malaysia & Novo Nordisk A/S. In addition, the partners involved contribute with their own resources.
- Steno Diabetes Center Copenhagen
- Malaysian Ministry of Health
- University of Southampton
- University of Witwatersrand
- Novo Nordisk A/S
Links Mohammed, Hamid Jan B. Jan & Yap, Roseline Wai Kuan & Loy, See Ling & Norris, Shane A. & Biesma, Regien & Aagaard-Hansen, Jens: Prevalence and Determinants of Overweight, Obesity, and Type 2 Diabetes Mellitus in Adults in Malaysia. Asia-Pacific Journal of Public Health, 2015, vol.27, no.2, pp.123-135. DOI: 10.1177/1010539514562447.
Skau, Jutta KH & Nordin, Awatef Binti Amer & Cheah, Julius CH & Ali, Roslinah & Zainal, Ramli & Aris, Tahir & Ali, Zainudin Mohd & Matzen, Priya & Biesma, Regien & Aagaard-Hansen, Jens & Hanson, Mark A & Norris, Shane A: A complex behavioural change intervention to reduce the risk of diabetes and prediabetes in the pre-conception period in Malaysia: study protocol for a randomised controlled trial. Trials, 2016, vol.17, no.215, pp.1-12. DOI 10.1186/s13063-016-1345-x.
Norris, Shane A. & Ho, Julius C.C. & Rashed, A.A. & Vinding, Vibeke & Skau, Jutta K.H. & Biesma, Regien & Aagaard-Hansen, Jens & Hanson, Mark & Matzen, Priya: Pre-pregnancy community-based intervention for couples in Malaysia: application of intervention mapping. BMC Public Health, 2016, vol.16, p.1167. DOI 10.1186/s12889-016-3827-x.