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[Joint Media Release] Health & Education: Pacific obesity circuit-breaker gets major boost

An international project that empowers teenagers to use scientific evidence and community and cultural knowledge to lift their own and their family’s health has received a significant funding boost from the New Zealand government.

The Pacific Science for Health Literacy Project (PSHLP) is a partnership between the Cook Islands Ministries of Health and Education and the University of Auckland-based Liggins Institute. A pilot project ran from 2013 to 2017, funded by NZAid. It involved the development of student-centred programmes that link into national curricula, which were put into action in three secondary schools in Rarotonga.

Now, a five-year Partnerships for International Development grant, from the New Zealand Ministry of Foreign Affairs and Trade has enabled the team to launch Phase 2.

“We are hugely grateful for this funding,” says Dr Jacquie Bay, a senior lecturer at the Liggins Institute. “The pilot study showed promising results, and we’re now excited to transform the pilot into a nationally sustainable practice in the Cook Islands. The project team will work with the community to achieve this. The ultimate aim is to realise long-term social and economic benefits associated with lowering the non-communicable disease risk among adolescents.”

Non-communicable diseases, or NCDs, include diseases such as obesity, type 2 diabetes and heart disease. They represent a major disease burden in the Cook Islands, which has one of the highest levels of overweight and obesity in the world.

At the heart of the project is the recognition that teenagers are ideally placed to break the intergenerational cycle of NCDs.

“There is a growing body of evidence that the diet and health of parents, even before conception, has long-term consequences for the disease risks of their future children,” says Dr Bay.

“If we can empower young people to explore the evidence and use it to make decisions about their own lifestyle, the benefits will not only enrich them, but flow through to the next generation.”

Cook Islands Secretary of Education, Danielle Cochrane, says she looks forward to watching project participants “lead change across all schools and communities”.

“Our Health and Education sectors already engage significantly, but Phase 2 will allow us to work in a manner that enables the benefits realised in the pilot to continue and evolve,” she says.

Dr Bay and the project team plan to publish findings from the pilot study in 2020. Feedback from student participants and teachers has been overwhelmingly positive.

“My family didn’t believe me when I said that we were number one [for obesity] because I think my Dad still believes that Cook Islanders are still all fit. So you have to show them the data,” said one Year 11 student.

“Obesity can come from eating too much and not enough physical activity…but it is also about your family – the way they eat now and the way they ate when your mum was pregnant with you. If mums cannot get a good diet then, the baby could be at higher risk for diabetes or heart disease when it is older,” said another 15-year-old student.

“This project opened my eyes to how my teaching was confined to the classroom,” said one teacher. “I saw that I had to take their [students’] thinking outside of the classroom and into society… I heard about story telling in the project... so I started with my story, and we built on it with all the students’ stories, other teachers’ stories… and then the stories from the learning resources... This has totally changed the way I teach… it has connected learning to the family.”

The project has also opened up many postgraduate study opportunities for current and future Cook Islands students.

“The relationship and support of schools, government ministries and community leaders developed through this project have been instrumental to the successful completion of a master’s degree and my current PhD work,” says Heimata Herman, a Cook Islands postgraduate student at the Liggins Institute.

“Doing postgraduate study has not only helped my career but more importantly has supported me to do research with local communities that offers meaningful value to the health and wellbeing of Cook Islanders.”

Dr Neti Tamarua-Herman, who was involved in the pilot project, is now a member of the phase 2 project team, helping to support the postgraduate students in their research associated with PSHLP. Dr Tamarua-Herman says “NCD’s can be passed trans generationally via both the maternal and paternal lineage. Therefore breaking this cycle requires an understanding of the mechanisms involved and this includes the need to move from interventions focused on adult lifestyle behaviours to strategies that include early life interventions, using a multisectoral approach”.

Dr Bay: “A strength of this project is that it involves both the Ministries of Health and Education – a recognition that the problem of NCDs goes far beyond individuals or families; it involves issues of food security, affordability, accessibility and sustainability, which are affected by wider forces such as economics, marketing and cultural norms. We need a whole-of-society approach to shift these forces.”