Enabling local evidence to inform school-based programmes supporting NCD risk reduction

Alvina Pauuvale¹, Dorothy Apelu², Soana Pamaka², ‘Anaseini Fehoko³, Mark Vickers¹, Jacquie Bay¹

1. Liggins Institute, University of Auckland, Auckland, New Zealand; 2. Tamaki College, Auckland, New Zealand; 3. Tonga High School, Nuku’alofa, Tonga.

Background: Non-communicable diseases (NCDs) such as diabetes, cardiovascular diseases, and cancers are the leading cause of ill-health globally. They contribute significantly to social inequities. The burden of NCD risk and incidence, and associated socio-economic impacts are disproportionately high in low- and middle-income countries (LMIC), and communities experiencing social and economic deprivation in high-income countries. Although NCDs develop over time, most interventions focus on adult behaviours. School-based interventions offer opportunities to influence environmental exposures affecting future NCD risk. We explored and compared dietary patterns of students and the built-food environment surrounding one school in each of Nuku’alofa and Auckland.

Methods: A questionnaire (n=100 Auckland; n=81 Nuku’alofa) examined dietary practices of 13-year-olds and awareness of the impact of early life environment on later-life NCD risk; spatial mapping explored accessibility and quality of food-stores surrounding each school.

Results: Students in both settings reported poor nutritional practices. Purchasing lunch from on-site and surrounding food-stores was common. Significant differences were observed in the density of food-stores in a 1km radius of each school (n=52 Auckland, n=150 Nuku’alofa). However, contextually, the density of food-stores surrounding both locations was high. Poor-quality foods dominated in food-stores.

Conclusions: This evidence provided schools with a snapshot of adolescent dietary practices and the surrounding built-food environment. Teachers identified that students could benefit from using food-store mapping as a learning activity to stimulate critical thinking. Schools intend to use the protocol to track evidence over time. This enables teacher-designed learning programmes to support adolescents to evaluate NCD risk critically. This study has the potential to be translated into other Pacific Island nations, such as the Cook Islands, where the NCD burden is high, and student empowerment strategies could improve health and wellbeing.

Pauuvale, A., Apelu, D., Pamaka, S., Fehoko, A., Vickers, M.H., & Bay, J.L. (2018). Enabling local evidence to inform school-based programmes supporting NCD risk reduction. The Annual Cook Islands Health Conference 2018, Rarotonga, Cook Islands.