The Pacific Science for Health Literacy Project: Indicators of success in the development and testing of curriculum-linked education programs supporting adolescents as agents of primary NCD risk prevention in the Cook Islands

Jacquie Bay^1,2, Karen Tairea³, Delaney Yaqona⁴, Mark Vickers^1,2, Tania Morgan⁵, Celeste Barrett-Watson⁵, Jackson Martin⁵, Gaylyn Lockington⁶, Upokoina Herrmann⁷

1. Liggins Institute, University of Auckland, New Zealand; 2. Gravida: National Centre for Growth and Development, New Zealand; 3. Ministry of Health, Cook Islands; 4. Nukutere College, Cook Islands; 5. Tereora College, Cook Islands; 6. Titikaveka College, Cook Islands; 7. Ministry of Education, Cook Islands.

Purpose: To explore the potential for adaptation of the Healthy Start to Life Education for Adolescents Project (HSLEAP) to support reduction in risk factors for NCDs in adolescents and their future offspring in Small Island Developing States (SIDS).

Methods: HSLEAP, a curriculum-based education program facilitating the development of scientific and health literacy in the context of life course NCD risk reduction (Developmental Origins of Health and Disease, DOHaD). Proven effective in New Zealand, the program was adapted for use in Pacific SIDS using Rarotonga and Tongatapu as initial test sites. Evaluation via matched pre/post questionnaires and interviews with participants, teachers and families is planned in these two contrasting SIDS, to 24-months post-intervention. We present here data from testing in the Cook Islands.

Results: In the Cook Islands, adolescents in all schools on the island of Rarotonga (population 12,000, adult obesity 50%, adult diabetes 25%) will be exposed to the education programs over two years. Validation phase evidence shows major changes in understanding of the importance of nutrition before and during pregnancy for the infant (Strongly agree (SA) pre-to-post 36% to 70%) and adult (13% to 36%) (n=69). In post-intervention interviews (n=30) 80% of participating adolescents offered examples of communication with family and behavior change that if continued will support long-tern NCD risk reduction.

Conclusion: SIDS are burdened with isolation, costs associated with small populations, poverty, high rates of obesity and related disease. Utilizing data from WHO-STEPS, and School-Health Surveys, alongside DOHAD evidence and modern pedagogical strategies, we have demonstrated that HSLEAP has potential to support schools and the Ministry of Health to collaboratively facilitate adolescents to develop scientific and health literacy and become positive NCD risk change-agents in their families and community.

Bay, J.L., Tairea, K., Yaqona, D., Vickers, M.H., Morgan, T., Barrett-Watson, C., Martin, J., Lockington, G., & Herrmann, U. (2015). The Pacific Science for Health Literacy Project: Indicators of success in the development and testing of curriculum-linked education programs supporting adolescents as agents of primary NCD risk prevention in the Cook Islands. The Annual Cook Islands Health Conference 2015, Rarotonga, Cook Islands.