The influences of health-related knowledge, attitudes and behaviours on the health and wellbeing of Rarotongan adolescents

Abstract

This baseline study aimed to examine the associations between anthropometric data and health-related knowledge, attitudes and behaviours (KAB) among Rarotongan Year 9 students, prior to participating in the Pacific Science for Health Literacy Project in 2016. A cross-sectional design was used to examine associations between anthropometric measures and health-related KAB data from 133 students. Firstly, this study identified high rates of non-communicable disease (NCD) risk factors among the study participants: 64.4% were classified as overweight/obese, 58.1% were at risk of high blood pressure and 32.6% were centrally obese. In terms of the KAB data, students overall demonstrated a good level of knowledge regarding nutrition and had positive attitudes towards nutrition. However, their responses also demonstrated poor self-reported food and meal consumption patterns. Key results from the comparison between anthropometric and KAB data showed that obese and severely obese students were 2.7 times more likely to consume fizzy drinks nearly every day compared with healthy weight students (p = 0.058). Furthermore, students with raised blood pressure (BP) were 2.6 times less likely to eat fruit (p = 0.010) than students with normal BP. This highlights that students with anthropometric risk factors were more likely to have poorer dietary patterns. Interestingly, this study also found that overweight students were 2.6 times more likely to rate what they eat matters compared with their healthy weight counterparts (p = 0.026). Additionally, students with raised BP were 4.6 times more likely to strongly agree that it is important to eat healthy food now (p = 0.020). This shows that relationships were also found linking adolescents with anthropometric risk factors to healthy attitudes. Additionally, there were associations which did not show significant differences. This study acknowledges that while several associations show that KAB does impact the health of adolescents, there might also be several other factors affecting adolescent health status. This study showed that NCD primary prevention programmes in the Cook Islands need to focus earlier in the life-course. The findings from this study may inform future research, programmes and policy, indicating that focusing on addressing adolescent health prior to becoming parents can help protect the health of the future generations essentially reducing the high burden of NCD in the Cook Islands.