title: School-based primary NCD risk reduction: education and public health perspectives.
abstract: The rising global burden of noncommunicable diseases (NCDs) has heightened awareness of the necessity for primary risk prevention programmes. These aim to facilitate long-term behaviour changes in children and adolescents that can reduce NCD risk factors and disease onset in later-life. School-based programmes designed to improve childhood and adolescent health behaviours and wellbeing contribute to this; however, design and impact assessment of these is complex. These programmes should be multidisciplinary, utilizing both educational and health expertise. Health outcomes may not be evident in the short term, but may occur with learning-related behaviour modifications, highly effective when sustained over a lifetime. Thus assessment must analyse short-term learning and behaviour impacts as well as long-term capability, behaviour and health outcomes.The focus of assessment measures in the health and education sectors differs and often lacks depth in one or other area. Educators generally focus on identifying evidence of learning related to capability, attitude and/or behaviour changes, while public health practitioners typically focus on health measures (e.g. body mass index (BMI), mental health, or risk behaviours).We argue that multidisciplinary approaches incorporating education and health viewpoints clarify issues relating to the potential value of schools as a setting to facilitate primary NCD risk reduction. To demonstrate this, we need to: 1) build stronger understandings of the features of effective learning for behavioural change and the best way to evaluate these, and 2) convincingly correlate these measures with long-term metabolic health indicators by tracking learner behaviour and health over time.
authors.affiliation: Liggins Institute, University of Auckland, Auckland, New Zealand.|Gravida: National Centre for Growth and Development, New Zealand.
authors.forename: Jacquie L
authors.initials: JL
authors.lastname: Bay
authors.affiliation: New Zealand Council for Educational Research, Wellington, New Zealand.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Hipkins
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Kamran
authors.initials: K
authors.lastname: Siddiqi
authors.affiliation: Department of Economics, University of Dhaka, Dhaka, Bangladesh.
authors.forename: Rumana
authors.initials: R
authors.lastname: Huque
authors.affiliation: Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: Robyn
authors.initials: R
authors.lastname: Dixon
authors.affiliation: Faculty of Health Sciences, University of Sydney, Sydney, Australia.
authors.forename: Debra
authors.initials: D
authors.lastname: Shirley
authors.affiliation: Cook Islands Ministry of Health, Te Marae Ora, Rarotonga, Cook Islands.
authors.forename: Karen
authors.initials: K
authors.lastname: Tairea
authors.affiliation: Nukutere College Rarotonga, Cook Islands.
authors.forename: Delaney
authors.initials: D
authors.lastname: Yaqona
authors.affiliation: Department of Health Sciences, University of York, York, UK.|Adolescent Health Research Unit, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
authors.forename: Amanda
authors.initials: A
authors.lastname: Mason-Jones
authors.affiliation: Liggins Institute, University of Auckland, Auckland, New Zealand.|Gravida: National Centre for Growth and Development, New Zealand.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Vickers
mesh_terms: D000293:Adolescent; D002908:Chronic Disease / Q000517:prevention & control; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D011322:Primary Prevention / Q000379:methods*; D011634:Public Health / Q000193:education*; D040242:Risk Reduction Behavior; D012574:Schools
keywords: adolescent; education; evaluation; multisectorial; non communicable disease