Lay summary
Non-communicable diseases (NCD) rates are rising steadily and now account for approximately two-thirds of all annual deaths globally. In the Cook Islands, prevalence of NCDs and related metabolic disorders are particularly high, with a recent report by the World Health Organization (WHO) estimating that NCDs contribute to 74% of all deaths. This translates to a very high premature mortality rate. Current NCD interventions typically focus on adult lifestyle behaviours but evidence to date suggests such approaches at later life stages are largely ineffectual and early life interventions may have the greatest efficacy. This project has two primary goals. Our approach will encompass both identification of early life determinants (i.e. maternal factors) of later health risk and also potential for early life intervention strategies aimed at breaking the NCD cycle in the Cook Islands via better understanding and self-awareness by adolescents of factors underpinning their own health, behaviour and environment.