The crucial importance of pre-testing of messages is demonstrated in this issueReference Van der Merwe, Bourne and Marais1. It is just too seldom that this much attention is given to pre-testing of information, material and/or concepts – even though we all should know the hows and whys.
Evaluation of interventions, as well as pre-testing, are both at risk of being cut out as unnecessary parts of projects. But this vitiates intervention results. Craig Lefebvre and June Flora wrote about this almost twenty years ago, in a paper still extremely valuable for training purposesReference Lefebvre and Flora2. They call pre-testing ‘formative evaluation’. I think formative evaluation also involves ensuring a sound evidence base for any kind of information or concept. The paper in this issue nicely describes the process of pre-testing food-based dietary guidelines in a local community setting.
Pre-pregnancy preparation
The other paper that caught the editor's eye this month deals with body mass before pregnancy and how that relates to food habits during pregnancyReference Laraia, Bodnar and Siega-Riz3. Obese pre-pregnant women in particular showed significantly different eating habits, with lower intakes of vegetables as well as whole grains. Furthermore, the proportion of pregravid obese mothers who did not reach the Estimated Average Requirement for folate, as well as iron, was significantly higher. As the authors rightly suggest, the findings, as well as indicating the necessity for more studies, point to the need right now to target obese and overweight pregnant women.
How to reach pre-pregnant women is another story; all pregnancies might not be planned and prepared. The issue of reaching young women before they become overweight or obese and also pregnant is of high importance. Complications include a higher risk for Caesarean delivery, pre-eclampsia and gestational diabetes, as well as an increased risk of birth anomaliesReference Mansour4. Low serum folateReference Mojtabai5 and possibly an increased risk of neural tube defects has also been described in connection with pre-pregnancy overweightReference Ray, Vermeulen, Meier and Wyatt6, Reference Ray, Wyatt, Vermeulen, Meier and Cole7. So, let us make sure that young women get all the support they need before they get pregnant!
