Abstract
BACKGROUND: The 2021 British Medical Research Council framework, outline that effective development of interventions requires engagement of diverse stakeholders. In practice, however, engaging stakeholders in health intervention development often receives insufficient investment. The Mothers to Babies (M2B) Study and its linked Art of Creation (AoC) Intervention Project comprise a joint case study in prioritizing stakeholder engagement. METHODS: From 2016 to 2019, our M2B team dedicated its financial and personnel resources to assessing community health priorities for preventing non-communicable diseases (NCDs) in Hamilton, Canada. Motivated by a “first 1000 days” approach (i.e. health environments through pregnancy and infancy have outsized impacts on NCD risks across a child’s life), we worked with stakeholders to identify acceptable, feasible complex intervention strategies supportive of health behaviours among pregnant Hamiltonians. To this end, we surveyed 434 pregnant people of diverse backgrounds and ran focus groups, interviews, and meetings with 69 stakeholders with diverse orientations to pregnancy and family health provision. RESULTS: M2B’s work indicated two areas actionable through a complex, behavioural intervention: 1) lack of knowledge about the first 1000 days, and 2) need for platforms for peer support and empowerment. These themes were centred in the development and the stakeholder-engaged implementation/evaluation of the ongoing AoC intervention study. AoC uses outreach through local cultural institutions and arts-based workshops to facilitate understanding of the first 1000 days. AoC increases participants’ knowledge of the first 1000 days, supports social relationships among participants and is enjoyable and empowering. CONCLUSIONS: Investing three years and dedicated personnel to stakeholder engagement by M2B yielded the development of AoC, a complex health promotion intervention that fits the diverse priorities of Hamilton communities.