ArticleHealth promotion international2025
Evolution of a sustained health promotion programme exploring adolescent metabolic health in the Cook Islands.
Article in Health promotion international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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.
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