James Joseph Newham

Systematic reviews of smoking, alcohol, diet and physical activity (PA) behaviour change interventions in pregnancy have high heterogeneity in effectiveness estimates for maternal behaviours and pregnancy outcomes, and it is unclear which features of interventions are integral to promoting effectiveness. This systematic review of reviews aimed to compare findings to identify any shared behaviour change techniques (BCTs), content, or delivery of interventions that may be associated with effectiveness across diet, physical activity, smoking and alcohol behaviours, and to identify intervention features showing promise in targeting one behaviour but have yet to be tested in addressing other behaviours. The search strategy covered reviews published between 2013 and 2025 and identified 66 reviews (9 smoking, 6 alcohol, 50 diet/PA, 1 smoking, diet, and/or PA). Diet/PA interventions should begin in the first trimester, run for a longer duration, and entail frequent engagement via a range of modalities in a supervised format (ideally from a specialist provider). Smoking intervention effectiveness was consistently associated with incentives and counselling. Brief interventions were consistently reported as effective interventions for alcohol use but there was a lack of standardisation in delivery. BCTs from the "goals and planning" and "feedback and monitoring" domains were routinely associated with effectiveness. Further research is required to explore intervention features that have shown promise in one behaviour but have yet to be tested for other behaviours, such as incentives in alcohol interventions.

Background Early intervention for unmet needs is essential to improve health. Clear inequalities in healthcare use and outcomes exist. The Children and Young People’s Health Partnership (CYPHP) model of care uses population health management methods to (1) identify and proactively reach children with asthma, eczema and constipation (tracer conditions); (2) engage these families, with CYPHP, by sending invitations to complete an online biopsychosocial Healthcheck Questionnaire; and (3) offer early intervention care to those children found to have unmet health needs. We aimed to understand this model’s effectiveness to improve equitable access to care. Methods We used primary care and CYPHP service-linked records and applied the same methods as the CYPHP’s population health management process to identify children aged Results Among 129 412 children, registered with 70 GP practices, 15% (19 773) had a tracer condition and 24% (4719) engaged with CYPHP’s population health management system. Children in the most deprived, compared with least deprived communities, had 26% lower odds of engagement (OR 0.74; 95% CI 0.62 to 0.87). Children of Asian or black ethnicity had 31% lower odds of engaging, compared with white children (0.69 (0.59 to 0.81) and 0.69 (0.62 to 0.76), respectively). However, once engaged with the population health management system, black children had 43% higher odds of receiving care, compared with white children (1.43 (1.15 to 1.78)), and children from the most compared with least deprived communities had 50% higher odds of receiving care (1.50 (1.01 to 2.22)). Conclusion Detection of unmet needs is possible using population health management methods and increases access to care for children from priority populations with the highest needs. Further health system strengthening is needed to improve engagement and enhance proportionate universalist access to healthcare. Trial registration number ClinicalTrials.gov Registry (NCT03461848).

Background and aim: Parental substance use is a major public health and safeguarding concern. There have been a number of trials examining interventions targeting this risk factor. We aimed to estimate the effectiveness of psychosocial interventions at reducing parental substance use.Design: We used systematic methods to identify trials; pooling data using a random‐effects model. Moderator analyses examined influence of parent gender, presence of child in treatment and intervention type.Setting: No restrictions on setting.Participants: Substance using parents of children below the age of 21 years.Interventions: Psychosocial interventions including those that targeted drug and alcohol use only, and drug and alcohol use in combination with associated issues.Measurements: Frequency of alcohol use and frequency of drug use.Findings: We included eight unique studies with a total of 703 participants. Psychosocial interventions were more effective at reducing the frequency of parental alcohol use than comparison conditions at 6‐month [standardized mean difference (SMD) = – 0.32, 95% confidence interval (CI) = –0.51 to −0.13, P = 0.001] and 12‐month follow‐up (SMD = –0.25, 95% CI = –0.47 to −0.03, P = 0.02) and frequency of parental drug use at 12 months only (SMD = –0.21, 95% CI = –0.41 to −0.01, P = 0.04). Integrated interventions which combined both parenting and substance use targeted components were effective at reducing the frequency of alcohol use (6 months: SMD = –0.56, 95% CI = –0.96 to −0.016, P = 0.006; 12 months: SMD = –0.42, 95% CI = –0.82 to −0.03, P = 0.04) and drug use (6 months: SMD = –0.39, 95% CI = –0.75 to −0.03, P = 0.04; 12 months: SMD = –0.43, 95% CI = –0.80 to −0.07, P = 0.02). Interventions targeting only substance use or parenting skills were not effective at reducing frequency of alcohol or drug use at either time‐point.Conclusion: Psychosocial interventions should target both parenting and substance use in an integrated intervention.

Diet, physical activity, smoking and alcohol behaviour-change interventions delivered in pregnancy aim to prevent adverse pregnancy outcomes. This review reports a synthesis of evidence from meta-analyses on the effectiveness of interventions at reducing risk of adverse health outcomes. Sixty-five systematic reviews (63 diet and physical activity; 2 smoking) reporting 602 meta-analyses, published since 2011, were identified; no data were identified for alcohol interventions. A wide range of outcomes were reported, including gestational weight gain, hypertensive disorders, gestational diabetes (GDM) and fetal growth. There was consistent evidence from diet and physical activity interventions for a significantly reduced mean gestational weight gain (ranging from −0.21 kg (95% confidence interval −0.34, −0.08) to −5.77 kg (95% CI −9.34, −2.21). There was evidence from larger diet and physical activity meta-analyses for a significant reduction in postnatal weight retention, caesarean delivery, preeclampsia, hypertension, GDM and preterm delivery, and for smoking interventions to significantly increase birth weight. There was no statistically significant evidence of interventions having an effect on low or high birthweight, neonatal intensive care unit admission, Apgar score or mortality outcomes. Priority areas for future research to capitalise on pregnancy as an opportunity to improve the lifelong wellbeing of women and their children are highlighted.

Many countries have universal child health services as part of an early intervention strategy to promote long-term developmental and physical health outcomes. These services are delivered with rema...

Physical activity is known to decline during pregnancy and the postnatal period, yet physical activity is recommended during this time due to the significant health benefits for mothers and their offspring. As a result of the COVID-19 pandemic and the restrictions imposed to reduce infection rates, pregnant and postnatal women have experienced disruption not just to their daily lives but also to their pregnancy healthcare experience and their motherhood journey with their new infant. This has included substantial changes in how, when and why they have engaged with physical activity. While some of these changes undoubtedly increased the challenge of being sufficiently active as a pregnant or postnatal woman, they have also revealed new opportunities to reach and support women and their families. This commentary details these challenges and opportunities, and highlights how researchers and practitioners can, and arguably must, harness these short-term changes for long-term benefit. This includes a call for a fresh focus on how we can engage and support those individuals and groups who are both hardest hit by COVID-19 and have previously been under-represented and under-served by antenatal and postnatal physical activity research and interventions.