Liggins Institute, University of Auckland, Auckland, New Zealand.
Te Marae Ora, Ministry of Health, Avarua, Cook Islands.
J Dev Orig Health Dis. 2020 Dec;11(6):564-572. doi: 10.1017/S2040174420000252. Epub 2020 Jul 7.
Developmental origins of health and disease research have cemented relationships between the early-life environment and later risk of non-communicable diseases (NCDs). However, there is limited translation of this knowledge in developing-economy nations, such as the Cook Islands, that carry exceptionally high NCD burdens. Considering the evidence, Cook Islands leaders identified a need for increased community awareness of the importance of early-life nutrition. Using a community-based participatory research approach, this study aimed to engage Cook Islands community representatives in the co-construction of a contextually relevant early-life nutrition resource. A booklet distributed to mothers in Australia and New Zealand was used as a starting point. Ten semi-structured focus groups (n = 60) explored views regarding the existing resource and options for contextual adaptation. Three core themes were identified: knowledge of the importance of early-life nutrition, recognition of the need for an early-life nutrition resource and the importance of resources being context specific. A draft booklet was created based on these discussions. Participants were invited to give feedback via a second round of focus groups. This confirmed that the voice of the community was represented in the draft booklet. Suggestions for additional material not included in the original resource were also identified. We report on the process and outcomes of the co-construction with community representatives of a resource that has the potential to be used to stimulate community-level discussion about the importance of early-life nutrition. It is crucial that communities have an active voice in research and in making decisions about interventions for their population.
健康与疾病起源研究已经巩固了生命早期环境与非传染性疾病（NCD）后期风险之间的关系。然而，在发展中经济体国家，如 NCD 负担极高的库克群岛，这种知识的转化有限。考虑到这一证据，库克群岛领导人认识到需要提高社区对生命早期营养重要性的认识。本研究采用基于社区的参与式研究方法，旨在让库克群岛的社区代表共同构建一个与当地情况相关的生命早期营养资源。一本分发给澳大利亚和新西兰母亲的小册子被用作起点。十个半结构化焦点小组（n=60）探讨了对现有资源的看法以及进行背景调整的选择。确定了三个核心主题：了解生命早期营养的重要性、认识到需要生命早期营养资源以及资源具有特定背景的重要性。根据这些讨论创建了一本草案小册子。邀请参与者通过第二轮焦点小组提供反馈。这证实了草案小册子中体现了社区的声音。还确定了原始资源中未包含的其他材料的建议。我们报告了与社区代表共同构建资源的过程和结果，该资源有可能用于激发社区层面关于生命早期营养重要性的讨论。社区在研究和决策干预其人口方面拥有积极的发言权至关重要。
