"The fathers? Does that really matter?" A qualitative study exploring Norwegian university students’ awareness of the preconception health concept and the relevance of preconception diet for health in the next generation

Abstract Background This study is part of the Skills for life project, which aims to develop, test, and evaluate a practical university dietary life skills course to foster students’ food literacy and a healthy diet. The Developmental Origins of Health and Disease (DOHaD) framework emphasises the importance of preconception health (PCH), including dietary health, in shaping pregnancy outcomes and reducing the risk of chronic diseases. Approximately 70% of Norwegian students are below the average age for first-time parenthood, making students a critical target group for establishing healthy behaviours before parenthood. Despite growing global recognition, DOHaD-related topics are absent from curricula in Norway and internationally, and research on students’ awareness of PCH remains limited. This study aimed to explore Norwegian university students’ awareness of the PCH concept and the relevance of preconception diet for health in the next generation. Methods A qualitative design using semi-structured focus group discussions was employed. Four focus groups with 16 students in total (10 women, 6 men; aged 18–40) were conducted in 2019. Data were audio-recorded, transcribed, and analysed using systematic text condensation. Results Three main themes were identified. In theme 1, Students’ initial reflections on how parental health influences the next generation, the students did not discuss PCH, but emphasised parental role modelling, food culture, and the home food environment. Theme 2, Students’ perceived PCH awareness and knowledge , demonstrated low awareness and limited PCH knowledge until being introduced to it, particularly regarding paternal impact. They expressed uncertainty about biological mechanisms but reasoned around genetics and sperm quality. In theme 3, The perceived need for PCH knowledge and how it should be communicated , students highlighted a need for improved PCH knowledge and suggested integrating it into educational institutions and public health initiatives. Greater awareness was perceived as motivating for healthy dietary behaviours and they emphasised the need for evidence-based, engaging communication. Conclusions Limited awareness of PCH among Norwegian university students indicates a need for educational PCH initiatives. Integrating DOHaD-related knowledge and practical dietary skills into curricula may equip students to make informed choices benefiting their own health and that of future children, thus promoting public health.