Building knowledge, optimising physical and mental health and setting up healthier life trajectories in South African women (Bukhali): a preconception randomised control trial part of the Healthy Life Trajectories Initiative (HeLTI)
IntroductionSouth Africa’s evolving burden of disease is challenging due to a persistent infectious disease, burgeoning obesity, most notably among women and rising rates of non-communicable diseases (NCDs). With two thirds of women presenting at their first antenatal visit either overweight or obes...
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| Published in | BMJ open Vol. 12; no. 4; p. e059914 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
British Medical Journal Publishing Group
21.04.2022
BMJ Publishing Group LTD BMJ Publishing Group |
| Series | Protocol |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2044-6055 2044-6055 |
| DOI | 10.1136/bmjopen-2021-059914 |
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| Abstract | IntroductionSouth Africa’s evolving burden of disease is challenging due to a persistent infectious disease, burgeoning obesity, most notably among women and rising rates of non-communicable diseases (NCDs). With two thirds of women presenting at their first antenatal visit either overweight or obese in urban South Africa (SA), the preconception period is an opportunity to optimise health and offset transgenerational risk of both obesity and NCDs.Methods and analysisBukhali is the first individual randomised controlled trial in Africa to test the efficacy of a complex continuum of care intervention and forms part of the Healthy Life Trajectories Initiative (HeLTI) consortium implementing harmonised trials in Canada, China, India and SA. Starting preconception and continuing through pregnancy, infancy and childhood, the intervention is designed to improve nutrition, physical and mental health and health behaviours of South African women to offset obesity-risk (adiposity) in their offspring. Women aged 18–28 years (n=6800) will be recruited from Soweto, an urban-poor area of Johannesburg. The primary outcome is dual-energy X-ray absorptiometry derived fat mass index (fat mass divided by height2) in the offspring at age 5 years. Community health workers will deliver the intervention randomly to half the cohort by providing health literacy material, dispensing a multimicronutrient supplement, providing health services and feedback, and facilitating behaviour change support sessions to optimise: (1) nutrition, (2) physical and mental health and (3) lay the foundations for healthier pregnancies and early child development.Ethics and disseminationEthical approval has been obtained from the Human Ethics Research Committee University of the Witwatersrand, Johannesburg, South Africa (M1811111), the University of Toronto, Canada (19-0066-E) and the WHO Ethics Committee (ERC.0003328). Data and biological sample sharing policies are consistent with the governance policy of the HeLTI Consortium (https://helti.org) and South African government legislation (POPIA). The recruitment and research team will obtain informed consent.Trial registrationThis trial is registered with the Pan African Clinical Trials Registry (https://pactr.samrc.ac.za) on 25 March 2019 (identifier: PACTR201903750173871).Protocol version20 March 2022 (version #4). Any protocol amendments will be communicated to investigators, Institutional Review Board (IRB)s, trial participants and trial registries. |
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| AbstractList | IntroductionSouth Africa’s evolving burden of disease is challenging due to a persistent infectious disease, burgeoning obesity, most notably among women and rising rates of non-communicable diseases (NCDs). With two thirds of women presenting at their first antenatal visit either overweight or obese in urban South Africa (SA), the preconception period is an opportunity to optimise health and offset transgenerational risk of both obesity and NCDs.Methods and analysisBukhali is the first individual randomised controlled trial in Africa to test the efficacy of a complex continuum of care intervention and forms part of the Healthy Life Trajectories Initiative (HeLTI) consortium implementing harmonised trials in Canada, China, India and SA. Starting preconception and continuing through pregnancy, infancy and childhood, the intervention is designed to improve nutrition, physical and mental health and health behaviours of South African women to offset obesity-risk (adiposity) in their offspring. Women aged 18–28 years (n=6800) will be recruited from Soweto, an urban-poor area of Johannesburg. The primary outcome is dual-energy X-ray absorptiometry derived fat mass index (fat mass divided by height2) in the offspring at age 5 years. Community health workers will deliver the intervention randomly to half the cohort by providing health literacy material, dispensing a multimicronutrient supplement, providing health services and feedback, and facilitating behaviour change support sessions to optimise: (1) nutrition, (2) physical and mental health and (3) lay the foundations for healthier pregnancies and early child development.Ethics and disseminationEthical approval has been obtained from the Human Ethics Research Committee University of the Witwatersrand, Johannesburg, South Africa (M1811111), the University of Toronto, Canada (19-0066-E) and the WHO Ethics Committee (ERC.0003328). Data and biological sample sharing policies are consistent with the governance policy of the HeLTI Consortium (https://helti.org) and South African government legislation (POPIA). The recruitment and research team will obtain informed consent.Trial registrationThis trial is registered with the Pan African Clinical Trials Registry (https://pactr.samrc.ac.za) on 25 March 2019 (identifier: PACTR201903750173871).Protocol version20 March 2022 (version #4). Any protocol amendments will be communicated to investigators, Institutional Review Board (IRB)s, trial participants and trial registries. Introduction South Africa’s evolving burden of disease is challenging due to a persistent infectious disease, burgeoning obesity, most notably among women and rising rates of non-communicable diseases (NCDs). With two thirds of women presenting at their first antenatal visit either overweight or obese in urban South Africa (SA), the preconception period is an opportunity to optimise health and offset transgenerational risk of both obesity and NCDs.Methods and analysis Bukhali is the first individual randomised controlled trial in Africa to test the efficacy of a complex continuum of care intervention and forms part of the Healthy Life Trajectories Initiative (HeLTI) consortium implementing harmonised trials in Canada, China, India and SA. Starting preconception and continuing through pregnancy, infancy and childhood, the intervention is designed to improve nutrition, physical and mental health and health behaviours of South African women to offset obesity-risk (adiposity) in their offspring. Women aged 18–28 years (n=6800) will be recruited from Soweto, an urban-poor area of Johannesburg. The primary outcome is dual-energy X-ray absorptiometry derived fat mass index (fat mass divided by height2) in the offspring at age 5 years. Community health workers will deliver the intervention randomly to half the cohort by providing health literacy material, dispensing a multimicronutrient supplement, providing health services and feedback, and facilitating behaviour change support sessions to optimise: (1) nutrition, (2) physical and mental health and (3) lay the foundations for healthier pregnancies and early child development.Ethics and dissemination Ethical approval has been obtained from the Human Ethics Research Committee University of the Witwatersrand, Johannesburg, South Africa (M1811111), the University of Toronto, Canada (19-0066-E) and the WHO Ethics Committee (ERC.0003328). Data and biological sample sharing policies are consistent with the governance policy of the HeLTI Consortium (https://helti.org) and South African government legislation (POPIA). The recruitment and research team will obtain informed consent.Trial registration This trial is registered with the Pan African Clinical Trials Registry (https://pactr.samrc.ac.za) on 25 March 2019 (identifier: PACTR201903750173871).Protocol version 20 March 2022 (version #4). Any protocol amendments will be communicated to investigators, Institutional Review Board (IRB)s, trial participants and trial registries. South Africa's evolving burden of disease is challenging due to a persistent infectious disease, burgeoning obesity, most notably among women and rising rates of non-communicable diseases (NCDs). With two thirds of women presenting at their first antenatal visit either overweight or obese in urban South Africa (SA), the preconception period is an opportunity to optimise health and offset transgenerational risk of both obesity and NCDs.INTRODUCTIONSouth Africa's evolving burden of disease is challenging due to a persistent infectious disease, burgeoning obesity, most notably among women and rising rates of non-communicable diseases (NCDs). With two thirds of women presenting at their first antenatal visit either overweight or obese in urban South Africa (SA), the preconception period is an opportunity to optimise health and offset transgenerational risk of both obesity and NCDs.Bukhali is the first individual randomised controlled trial in Africa to test the efficacy of a complex continuum of care intervention and forms part of the Healthy Life Trajectories Initiative (HeLTI) consortium implementing harmonised trials in Canada, China, India and SA. Starting preconception and continuing through pregnancy, infancy and childhood, the intervention is designed to improve nutrition, physical and mental health and health behaviours of South African women to offset obesity-risk (adiposity) in their offspring. Women aged 18-28 years (n=6800) will be recruited from Soweto, an urban-poor area of Johannesburg. The primary outcome is dual-energy X-ray absorptiometry derived fat mass index (fat mass divided by height2) in the offspring at age 5 years. Community health workers will deliver the intervention randomly to half the cohort by providing health literacy material, dispensing a multimicronutrient supplement, providing health services and feedback, and facilitating behaviour change support sessions to optimise: (1) nutrition, (2) physical and mental health and (3) lay the foundations for healthier pregnancies and early child development.METHODS AND ANALYSISBukhali is the first individual randomised controlled trial in Africa to test the efficacy of a complex continuum of care intervention and forms part of the Healthy Life Trajectories Initiative (HeLTI) consortium implementing harmonised trials in Canada, China, India and SA. Starting preconception and continuing through pregnancy, infancy and childhood, the intervention is designed to improve nutrition, physical and mental health and health behaviours of South African women to offset obesity-risk (adiposity) in their offspring. Women aged 18-28 years (n=6800) will be recruited from Soweto, an urban-poor area of Johannesburg. The primary outcome is dual-energy X-ray absorptiometry derived fat mass index (fat mass divided by height2) in the offspring at age 5 years. Community health workers will deliver the intervention randomly to half the cohort by providing health literacy material, dispensing a multimicronutrient supplement, providing health services and feedback, and facilitating behaviour change support sessions to optimise: (1) nutrition, (2) physical and mental health and (3) lay the foundations for healthier pregnancies and early child development.Ethical approval has been obtained from the Human Ethics Research Committee University of the Witwatersrand, Johannesburg, South Africa (M1811111), the University of Toronto, Canada (19-0066-E) and the WHO Ethics Committee (ERC.0003328). Data and biological sample sharing policies are consistent with the governance policy of the HeLTI Consortium (https://helti.org) and South African government legislation (POPIA). The recruitment and research team will obtain informed consent.ETHICS AND DISSEMINATIONEthical approval has been obtained from the Human Ethics Research Committee University of the Witwatersrand, Johannesburg, South Africa (M1811111), the University of Toronto, Canada (19-0066-E) and the WHO Ethics Committee (ERC.0003328). Data and biological sample sharing policies are consistent with the governance policy of the HeLTI Consortium (https://helti.org) and South African government legislation (POPIA). The recruitment and research team will obtain informed consent.This trial is registered with the Pan African Clinical Trials Registry (https://pactr.samrc.ac.za) on 25 March 2019 (identifier: PACTR201903750173871).TRIAL REGISTRATIONThis trial is registered with the Pan African Clinical Trials Registry (https://pactr.samrc.ac.za) on 25 March 2019 (identifier: PACTR201903750173871).20 March 2022 (version #4). Any protocol amendments will be communicated to investigators, Institutional Review Board (IRB)s, trial participants and trial registries.PROTOCOL VERSION20 March 2022 (version #4). Any protocol amendments will be communicated to investigators, Institutional Review Board (IRB)s, trial participants and trial registries. South Africa's evolving burden of disease is challenging due to a persistent infectious disease, burgeoning obesity, most notably among women and rising rates of non-communicable diseases (NCDs). With two thirds of women presenting at their first antenatal visit either overweight or obese in urban South Africa (SA), the preconception period is an opportunity to optimise health and offset transgenerational risk of both obesity and NCDs. is the first individual randomised controlled trial in Africa to test the efficacy of a complex continuum of care intervention and forms part of the Healthy Life Trajectories Initiative (HeLTI) consortium implementing harmonised trials in Canada, China, India and SA. Starting preconception and continuing through pregnancy, infancy and childhood, the intervention is designed to improve nutrition, physical and mental health and health behaviours of South African women to offset obesity-risk (adiposity) in their offspring. Women aged 18-28 years (n=6800) will be recruited from Soweto, an urban-poor area of Johannesburg. The primary outcome is dual-energy X-ray absorptiometry derived fat mass index (fat mass divided by height ) in the offspring at age 5 years. Community health workers will deliver the intervention randomly to half the cohort by providing health literacy material, dispensing a multimicronutrient supplement, providing health services and feedback, and facilitating behaviour change support sessions to optimise: (1) nutrition, (2) physical and mental health and (3) lay the foundations for healthier pregnancies and early child development. Ethical approval has been obtained from the Human Ethics Research Committee University of the Witwatersrand, Johannesburg, South Africa (M1811111), the University of Toronto, Canada (19-0066-E) and the WHO Ethics Committee (ERC.0003328). Data and biological sample sharing policies are consistent with the governance policy of the HeLTI Consortium (https://helti.org) and South African government legislation (POPIA). The recruitment and research team will obtain informed consent. This trial is registered with the Pan African Clinical Trials Registry (https://pactr.samrc.ac.za) on 25 March 2019 (identifier: PACTR201903750173871). 20 March 2022 (version #4). Any protocol amendments will be communicated to investigators, Institutional Review Board (IRB)s, trial participants and trial registries. |
| Author | Jaspan, Heather Bassani, D Martin, Marie-Claude Cameron, D William Tollman, Stephen Lye, Stephen Richter, Linda Slemming, Wiedaad Norris, Shane A Jenkins, Jennifer Fallon, B Tough, Suzanne Gray, CM Bhutta, Zulfiqar Scherer, Stephen Ramsay, Michele Prioreschi, Alessandra Briollais, Laurent Chirwa, Tobias Szyf, M Matthews, Stephen G Lambert, Estelle V Levitt, Naomi Hamilton, Jill Draper, Catherine E Awadalla, Philip Kengne, AP Kahn, Kathleen Jamison, J Dennis, CindyLee Sloboda, Deborah Roth, Daniel Sellen, Daniel Smuts, CM Ware, Lisa Jayne Tomlinson, Mark |
| AuthorAffiliation | 28 Department of Biochemistry and Biomedical Sciences , McMaster University , Hamilton , Ontario , Canada 31 Department of Paediatrics , Alberta Children's Hospital Research Institute , Calgary , Alberta , Canada 1 SAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics , University of the Witwatersrand , Johannesburg-Braamfontein , South Africa 10 Medicine, Division of Infectious Diseases , Ottawa Hospital General Campus , Ottawa , Ontario , Canada 9 Lunenfeld-Tanenbaum Research Institute , Toronto , Ontario , Canada 17 Community Services , Red River College , Winnipeg , Manitoba , Canada 11 Ottawa Hospital Research Institute , Ottawa , Ontario , Canada 6 Department of Molecular Genetics, Ontario Institute for Cancer Research , University of Toronto , Toronto , Ontario , Canada 23 Sydney Brenner Institute for Molecular Bioscience , University of the Witwatersrand , Johannesburg , South Africa 21 Division of Exercise Science and Sports Medicine , University of Cape Town |
| AuthorAffiliation_xml | – name: 25 Department of Molecular Genetics , University of Toronto , Toronto , Ontario , Canada – name: 31 Department of Paediatrics , Alberta Children's Hospital Research Institute , Calgary , Alberta , Canada – name: 23 Sydney Brenner Institute for Molecular Bioscience , University of the Witwatersrand , Johannesburg , South Africa – name: 2 Global Health Research Institute, School of Human Development and Health , University of Southampton , Southampton , UK – name: 29 Department of Pharmacology and Therapeutics , McGill University , Montreal , Quebec , Canada – name: 18 Department of Applied Psychology and Human Development , University of Toronto , Toronto , Ontario , Canada – name: 21 Division of Exercise Science and Sports Medicine , University of Cape Town , Rondebosch , South Africa – name: 12 School of Public Health , University of the Witwatersrand , Johannesburg , South Africa – name: 27 Department of Paediatrics , University of the Witwatersrand , Johannesburg-Braamfontein , South Africa – name: 1 SAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics , University of the Witwatersrand , Johannesburg-Braamfontein , South Africa – name: 8 Institute for Global Health and Development , Aga Khan University , Karachi , Pakistan – name: 15 Division of Immunology, Institute of Infectious Disease and Molecular Medicine , University of Cape Town , Rondebosch , South Africa – name: 19 SAMRC Rural Public Health and Health Transitions Research Unit (Agincourt) , Uinversity of the Witwatersrand , Johannesburg , South Africa – name: 5 Lawrence S. Bloomberg Faculty of Nursing , University of Toronto , Toronton , Ontario , Canada – name: 30 Institute for Life Course Health Research , University of Stellenbosch , Cape Town , South Africa – name: 14 Division of Molecular Biology and Human Genetics , University of Stellenbosch , Stellenbosch , South Africa – name: 13 Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada – name: 28 Department of Biochemistry and Biomedical Sciences , McMaster University , Hamilton , Ontario , Canada – name: 3 Centre of Excellence of Nutrition , North-West University , Potchefstroom , South Africa – name: 4 DSI-NRF Centre of Excellence in Human Development , University of the Witwatersrand , Johannesburg , South Africa – name: 9 Lunenfeld-Tanenbaum Research Institute , Toronto , Ontario , Canada – name: 10 Medicine, Division of Infectious Diseases , Ottawa Hospital General Campus , Ottawa , Ontario , Canada – name: 6 Department of Molecular Genetics, Ontario Institute for Cancer Research , University of Toronto , Toronto , Ontario , Canada – name: 7 Centre for Global Child Health , SickKids Research Institute , Toronto , Ontario , Canada – name: 16 Department of Paediatrics , University of Toronto , Toronto , Ontario , Canada – name: 32 Department of Physiology, Obstetrics & Gynaecology and Medicine , University of Toronto , Toronto , Ontario , Canada – name: 17 Community Services , Red River College , Winnipeg , Manitoba , Canada – name: 24 The Hospital for Sick Children , Toronto , Ontario , Canada – name: 20 Non-communicable Diseases Research Unit , South African Medical Research Council , Cape Town , South Africa – name: 26 Department of Nutritional Sciences , University of Toronto , Toronto , Ontario , Canada – name: 11 Ottawa Hospital Research Institute , Ottawa , Ontario , Canada – name: 22 Chronic Diseases Initiative for Africa , University of Cape Town , Cape Town , South Africa |
| Author_xml | – sequence: 1 givenname: Shane A orcidid: 0000-0001-7124-3788 surname: Norris fullname: Norris, Shane A email: shane.norris@wits.ac.za organization: Global Health Research Institute, School of Human Development and Health, University of Southampton, Southampton, UK – sequence: 2 givenname: Catherine E surname: Draper fullname: Draper, Catherine E organization: SAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa – sequence: 3 givenname: Alessandra surname: Prioreschi fullname: Prioreschi, Alessandra organization: SAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa – sequence: 4 givenname: CM surname: Smuts fullname: Smuts, CM organization: Centre of Excellence of Nutrition, North-West University, Potchefstroom, South Africa – sequence: 5 givenname: Lisa Jayne orcidid: 0000-0002-9762-4017 surname: Ware fullname: Ware, Lisa Jayne organization: DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa – sequence: 6 givenname: CindyLee orcidid: 0000-0002-0135-7242 surname: Dennis fullname: Dennis, CindyLee organization: Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronton, Ontario, Canada – sequence: 7 givenname: Philip surname: Awadalla fullname: Awadalla, Philip organization: Department of Molecular Genetics, Ontario Institute for Cancer Research, University of Toronto, Toronto, Ontario, Canada – sequence: 8 givenname: D surname: Bassani fullname: Bassani, D organization: Centre for Global Child Health, SickKids Research Institute, Toronto, Ontario, Canada – sequence: 9 givenname: Zulfiqar orcidid: 0000-0003-0637-599X surname: Bhutta fullname: Bhutta, Zulfiqar organization: Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan – sequence: 10 givenname: Laurent surname: Briollais fullname: Briollais, Laurent organization: Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada – sequence: 11 givenname: D William surname: Cameron fullname: Cameron, D William organization: Ottawa Hospital Research Institute, Ottawa, Ontario, Canada – sequence: 12 givenname: Tobias surname: Chirwa fullname: Chirwa, Tobias organization: School of Public Health, University of the Witwatersrand, Johannesburg, South Africa – sequence: 13 givenname: B surname: Fallon fullname: Fallon, B organization: Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada – sequence: 14 givenname: CM surname: Gray fullname: Gray, CM organization: Division of Immunology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Rondebosch, South Africa – sequence: 15 givenname: Jill orcidid: 0000-0002-1958-2800 surname: Hamilton fullname: Hamilton, Jill organization: Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada – sequence: 16 givenname: J surname: Jamison fullname: Jamison, J organization: Community Services, Red River College, Winnipeg, Manitoba, Canada – sequence: 17 givenname: Heather surname: Jaspan fullname: Jaspan, Heather organization: Division of Immunology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Rondebosch, South Africa – sequence: 18 givenname: Jennifer surname: Jenkins fullname: Jenkins, Jennifer organization: Department of Applied Psychology and Human Development, University of Toronto, Toronto, Ontario, Canada – sequence: 19 givenname: Kathleen surname: Kahn fullname: Kahn, Kathleen organization: SAMRC Rural Public Health and Health Transitions Research Unit (Agincourt), Uinversity of the Witwatersrand, Johannesburg, South Africa – sequence: 20 givenname: AP surname: Kengne fullname: Kengne, AP organization: Non-communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa – sequence: 21 givenname: Estelle V surname: Lambert fullname: Lambert, Estelle V organization: Division of Exercise Science and Sports Medicine, University of Cape Town, Rondebosch, South Africa – sequence: 22 givenname: Naomi surname: Levitt fullname: Levitt, Naomi organization: Chronic Diseases Initiative for Africa, University of Cape Town, Cape Town, South Africa – sequence: 23 givenname: Marie-Claude surname: Martin fullname: Martin, Marie-Claude organization: Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada – sequence: 24 givenname: Michele surname: Ramsay fullname: Ramsay, Michele organization: Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa – sequence: 25 givenname: Daniel surname: Roth fullname: Roth, Daniel organization: The Hospital for Sick Children, Toronto, Ontario, Canada – sequence: 26 givenname: Stephen surname: Scherer fullname: Scherer, Stephen organization: Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada – sequence: 27 givenname: Daniel surname: Sellen fullname: Sellen, Daniel organization: Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada – sequence: 28 givenname: Wiedaad orcidid: 0000-0002-1566-8228 surname: Slemming fullname: Slemming, Wiedaad organization: Department of Paediatrics, University of the Witwatersrand, Johannesburg-Braamfontein, South Africa – sequence: 29 givenname: Deborah surname: Sloboda fullname: Sloboda, Deborah organization: Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada – sequence: 30 givenname: M surname: Szyf fullname: Szyf, M organization: Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada – sequence: 31 givenname: Stephen surname: Tollman fullname: Tollman, Stephen organization: SAMRC Rural Public Health and Health Transitions Research Unit (Agincourt), Uinversity of the Witwatersrand, Johannesburg, South Africa – sequence: 32 givenname: Mark orcidid: 0000-0001-5846-3444 surname: Tomlinson fullname: Tomlinson, Mark organization: Institute for Life Course Health Research, University of Stellenbosch, Cape Town, South Africa – sequence: 33 givenname: Suzanne surname: Tough fullname: Tough, Suzanne organization: Department of Paediatrics, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada – sequence: 34 givenname: Stephen G surname: Matthews fullname: Matthews, Stephen G organization: Department of Physiology, Obstetrics & Gynaecology and Medicine, University of Toronto, Toronto, Ontario, Canada – sequence: 35 givenname: Linda surname: Richter fullname: Richter, Linda organization: DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa – sequence: 36 givenname: Stephen surname: Lye fullname: Lye, Stephen organization: Department of Physiology, Obstetrics & Gynaecology and Medicine, University of Toronto, Toronto, Ontario, Canada |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35450913$$D View this record in MEDLINE/PubMed |
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doi: 10.1186/s12887-020-02321-4 – volume: 24 start-page: 3602 year: 2021 ident: 2022051704551877000_12.4.e059914.23 article-title: Maternal perspectives on infant feeding practices in Soweto, South Africa publication-title: Public Health Nutr doi: 10.1017/S1368980020002451 – volume: 23 year: 2022 ident: 2022051704551877000_12.4.e059914.5 article-title: Does prepregnancy weight change have an effect on subsequent pregnancy health outcomes? 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| Snippet | IntroductionSouth Africa’s evolving burden of disease is challenging due to a persistent infectious disease, burgeoning obesity, most notably among women and... South Africa's evolving burden of disease is challenging due to a persistent infectious disease, burgeoning obesity, most notably among women and rising rates... Introduction South Africa’s evolving burden of disease is challenging due to a persistent infectious disease, burgeoning obesity, most notably among women and... |
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| SubjectTerms | Age Child Child, Preschool Community Health Workers Coronaviruses COVID-19 Data collection Diabetes Female Health Status Humans Infectious diseases Initiatives Intervention Malnutrition Medical research Mental Health nutrition & dietetics Obesity Obesity - prevention & control Overweight Pregnancy Public Health social medicine South Africa Stakeholders Systematic review Womens health |
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| Title | Building knowledge, optimising physical and mental health and setting up healthier life trajectories in South African women (Bukhali): a preconception randomised control trial part of the Healthy Life Trajectories Initiative (HeLTI) |
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