Bay Jacquie L, John Tania, Barrett-Watson Celeste, Ngamata Karen, Renelle Amy, Trask Suzanne A, Bates Metua, Vickers Mark H, Cochrane Danielle Tungane
Liggins Institute, Waipapa Taumata Rau The University of Auckland, Auckland 1142, New Zealand.
Koi Tu: The Centre for Informed Futures, Waipapa Taumata Rau The University of Auckland, Auckland 1142, New Zealand.
Health Promot Int. 2025 May 13;40(3). doi: 10.1093/heapro/daaf069.
The non-communicable disease (NCD) burden in the Cook Islands is severe; 62% of adults 18-69 years live with 3-5 risk factors. Understanding NCD complexity and developing evidence-based actions to mitigate this burden is crucial. This article reports on the evolution of a sustained health promotion programme contributing to understanding adolescent metabolic health in Rarotonga. Ora'anga Tūmanava (established 2013) is a transdisciplinary initiative engaging adolescents in exploring NCD-related challenges through curriculum-linked learning. Community-based participatory research integrated within the Tivaevae framework guides co-design. In 2013, inclusion of health measures within this initiative was considered but rejected. Feedback in 2015 identified that, after examining population-level NCD burdens, adolescents wanted greater access to personal health information. Consequently, inclusion of health measures was revisited and agreed for trial alongside learning about metabolic health within a Year 9 programme. Data from 2016 to 2019 and 2022 to 2023 (n = 783; 65% total cohort; median age 13.8 years) indicated overweight 22.1%; obesity 37.6%; waist-to-height ratio > 0.5, 39.1%; elevated blood cholesterol, 8.1%; and elevated blood glucose, 15.6%. Where all measures were available (n = 321), 27.7% of students were living with ≥ 3 risk factors. Feedback confirmed the programme met student expectations, contributed to school-based health promotion, offered an acceptable strategy for tracking metabolic health indicators and highlighting NCD risk factors in this age-group, and encouraged health-related discussions. Alignment with curriculum-based learning and evidence-sharing has ensured sustained school-level support. This study highlights how transdisciplinary partnerships built via culturally appropriate co-design can support educational and health promotion goals and simultaneously inform public health in small island communities.
库克群岛的非传染性疾病负担严重；18至69岁的成年人中有62%患有3至5种风险因素。了解非传染性疾病的复杂性并制定基于证据的行动来减轻这一负担至关重要。本文报告了一项持续的健康促进计划的演变，该计划有助于了解拉罗汤加青少年的代谢健康。奥拉'anga图马纳瓦（成立于2013年）是一项跨学科倡议，通过与课程相关的学习让青少年参与探索与非传染性疾病相关的挑战。纳入蒂瓦埃瓦框架内的社区参与式研究指导共同设计。2013年，曾考虑在该倡议中纳入健康措施，但被否决。2015年的反馈表明，在研究了人群层面的非传染性疾病负担后，青少年希望能更多地获取个人健康信息。因此，重新考虑了纳入健康措施，并同意在9年级课程中与学习代谢健康一起进行试验。2016年至2019年以及2022年至2023年的数据（n = 783；占总队列的65%；中位年龄13.8岁）显示超重率为22.1%；肥胖率为37.6%；腰高比>0.5，为39.1%；血胆固醇升高，为8.1%；血糖升高，为15.6%。在所有指标都可用的情况下（n = 321），27.7%的学生患有≥3种风险因素。反馈证实该计划达到了学生的期望，有助于学校层面的健康促进，提供了一种可接受的策略来跟踪代谢健康指标并突出该年龄组的非传染性疾病风险因素，并鼓励了与健康相关的讨论。与基于课程的学习和证据共享保持一致确保了学校层面的持续支持。这项研究强调了通过文化上合适的共同设计建立的跨学科伙伴关系如何能够支持教育和健康促进目标，同时为小岛屿社区的公共卫生提供信息。
