The Pacific Science for Health Literacy Project: Evidence of sustained positive impacts for Rarotongan adolescents at 12-months post-intervention

Jacquie Bay¹, Karen Tairea², Celeste Barrett-Watson³, Delaney Yaqona⁴, Heimata Herman¹, Mark Vickers¹, Upokoina Herrmann⁵ on behalf of the Cook Islands Pacific Science for Health Literacy Project team

1. Liggins Institute, University of Auckland, New Zealand; 2. Cook Islands Ministry of Health, Cook Islands; 3. Tereora College, Rarotonga, Cook Islands; 4. Nukutere College, Rarotonga, Cook Islands; 5. Cook Islands Ministry of Education, Cook Islands

Background: Adolescence is an important life-stage for establishing health-promoting practices that impact lifelong NCD risk. The Pacific Science for Health Literacy Project is a school-based partnership facilitating action-research examining the NCD crisis with those affected by the issue, for the purpose of education and action to effect change. Programmes link to the Cook Islands national curriculum, focussing on capability development associated with scientific and health literacies. Adolescents examine factors that promote poor environmental exposures, and develop evidence-based actions.

Aim: To assess the potential of learning programmes exploring the NCD crisis in Years 9 and 11 to contribute to education, and primary NCD risk reduction in the Cook Islands.

Methods: An individually matched repeated time-series design supported quantitative and qualitative data collection, recognizing the importance of individual change analysis within community-based interventions. Evaluation of concepts beyond the programme supported assessment of internal validity. Analysis to 12-months post-intervention occurred for 66% of the cohort (n=246).

Results: We observed increased understanding of concepts associated with the NCD crisis, lifecourse NCD risk, and contributors to nutritional environmental exposures, retained at 12-months post-intervention. Application of critical thinking associated with understanding of the intergenerational nature of NCD risk was stronger in 15-year old females (p’=.002) than in males or younger females. At least 50% of students reporting obesity-promoting nutritional behaviours at baseline recorded positive changes in relation to obesity-promoting foods at 12-months post-intervention (e.g. doughnuts, +ve∆=73%, p<.001). However, 2-fruit/3-vegetable consumption remained low at <15%. Focus-group evidence confirmed that: behaviour change was in response to learning; 15-year olds became strongly aware of socioecological challenges associated with fruit/vegetable access; students engaged peers and families in discussion of lifecourse NCD evidence and nutrition.

Conclusions: Participation positively influenced nutritional attitudes and knowledge of evidence. It nudged long-term small, sustainable, behaviour-changes associated with obesity-promoting foods. Development is required within the national NCD strategy to address fruit/vegetable access.

Bay, J.L., Tairea, K., Barrett-Watson, C., Yaqona, D., Morgan, T., Vickers, M.H., & Herrmann, U. (2017). The Pacific Science for Health Literacy Project: Evidence of sustained positive impacts for Rarotongan adolescents at 12-months post-intervention. The Annual Cook Islands Health Conference 2017, Rarotonga, Cook Islands.