DOHaD-community partnership research: Empowering adolescents to interrupt transgenerational NCD risk in Pacific Island nations

Jacquie Bay¹, Delaney Yaqona², Celeste Barrett-Watson³, Karen Tairea⁴, Fehi Fehoko⁵, Oliveti Tovo⁶, Mumui La’akulu⁷, Soana Pamaka⁷, Mark Vickers¹, Upokoina Herrmann⁸, on behalf of the Pacific Science for Health Literacy Project (PSHLP) team

1. Liggins Institute, University of Auckland, Auckland, New Zealand; 2. Nukutere College, Rarotonga, Cook Islands; 3. Tereora College, Rarotonga, Cook Islands; 4. Te Marae Ora, Ministry of Health, Rarotonga, Cook Islands; 5. Tonga High School, Nuku’alofa, Tongatapu, Tonga; 6. Kolisi Tonga ‘Atele, Funga Manamo’ui, Ha’ateiho, Tongatapu, Tonga; 7. Tonga Side School, Nuku’alofa, Tongatapu, Tonga; 8. Tamaki College, Auckland, New Zealand; 9. Maraurau o te Pae Api’I, Ministry of Education, Rarotonga, Cook Islands.

Very high prevalence of overweight, obesity and noncommunicable diseases (NCDs) exists in Small Island Developing States (SIDS), alongside associated public health, social and economic challenges, impacting development. The Cook Islands and Tonga, representative of Pacific SIDS, have 90% adult overweight and obesity, 65% obesity in reproductive-age females, and up to 70% overweight and obesity in adolescent girls, yet only 20-25% overweight in primary school children.

The Liggins Institute, working with communities with high Māori and Pacific populations in Auckland, demonstrated that school-based programmes utilising DOHaD as a learning context can empower adolescents as change-agents, bringing understanding of early-life risk into their homes, and challenging socio-ecological factors placing their families at high-risk of negative early-life exposures.

Liggins shared this DOHaD-partnership journey with communities in Tonga and the Cook Islands, resulting in health and education sectors in both nations deciding to partner with Liggins to bring DOHaD evidence to their communities. The collaborators won a NZAid partnership grant to explore how, within the context of each nation, DOHaD evidence could be integrated with educational and epidemiological evidence to capture the opportunity of adolescence as a DOHaD intervention point.

Talanoa, a research methodology grounded in Pacific thought and culture, integrated with mixed-methods participatory action research has been used to assess baseline health indicators and develop and evaluate education programmes designed to improve adolescent health behaviours, and thus improve periconceptional nutritional and non-nutritional exposures.

This has resulted in integration of DOHaD into health and education sector actions, including national NCD strategy and development of DOHaD/NCD-linked education programmes ranging from science/health to humanities. The pilot teachers are determined proponents of DOHaD translation, for their students, and in community settings, such as male kava groups. We have evidence of positive change in participating students that, if sustained, will positively impact NCD risk for the next generation.

Bay, J.L., Yaqona, D., Barrett-Watson, C., Tairea, K., Fehoko, F., Tovo, O., La’akulu, M., Pamaka, S., Vickers, M.H., & Herrmann, U. (2016). DOHaD-community partnership research: Empowering adolescents to interrupt transgenerational NCD risk in Pacific Island nations. DOHaD ANZ Conference, Adelaide, Australia.