Noncommunicable diseases (NCDs), including type 2 diabetes and cardiovascular disease, represent a significant and growing global health burden. To date, a primary focus has been on treatment approaches to NCDs once manifested rather than strategies aimed at prevention. In this context, there is clear evidence that a range of adverse early life exposures can predispose individuals towards a greater risk of developing NCDs across the lifecourse. These risk factors can be passed to future generations, thus perpetuating a cycle of disease. This concept, preferentially termed “developmental programming”, forms the basis of the Developmental Origins of Health and Disease (DOHaD) framework. To date, DOHaD has focused on preconception, pregnancy, lactation and, more recently, paternal health at the time of conception. However, it is becoming increasingly clear that investment in the window of adolescence is perhaps the most critical developmental window. Adolescence is a period where lifestyle behaviours become entrained. Therefore, a focus on adolescent behaviours, health literacy and emotional development may afford the best opportunity to break the cycle of NCDs. As the next generation of parents, adolescents should therefore be considered a priority group in advancing appropriate and informed actions aimed at reducing NCD risk factors across the lifecourse. This advancement requires a more comprehensive community understanding and uptake of DOHaD knowledge and concepts. NCD prevention strategies have typically entailed siloed (and often disease-specific) approaches with limited efficacy in curbing NCD prevalence and breaking the transgenerational transmission of disease traits. Recent findings across various disciplines have highlighted that a lifecourse systems approach is required to establish a comprehensive and sustainable framework for NCD intervention. A whole community approach with a particular focus on adolescents as potential agents of change is necessary to break the disease cycle.

Background/Objectives: Rheumatic fever is preventable and can be treated successfully; however, a lack of understanding of the disease and barriers to timely healthcare can impact outcomes. Pacific people in Aotearoa New Zealand experience inequitable burdens, and a Pacific community group and health professional network are working together to co-design education initiatives. This descriptive, mixed-methods study aimed to (1) explore Pacific people’s awareness and understanding of rheumatic fever, (2) describe where Pacific people access health information. Methods: An online survey co-developed with Pacific community members was run from December 2024 to February 2025. Questions related to sore throats, rheumatic fever, medication adherence, long-term outcomes and where Pacific people access health information. Quantitative data was analyzed descriptively using SPSS version 28 and open-ended qualitative responses were analyzed using an inductive content analysis approach. Results: A total of 400 Pacific respondents were included: 34% were aged 16–24 years and 66% were female. Based on the analysis, 71% of Pacific participants knew that a sore throat should always be checked by a health professional and 65.3% had heard of rheumatic fever. Fever and sore throats were commonly identified as symptoms of rheumatic fever, with joint pain, body aches and chest pain mentioned less. Barriers to health services such as cost, long waiting times and cultural factors were discussed as reasons why many Pacific people often utilize social media and online forums for health information. Conclusions: This study highlights gaps in rheumatic fever knowledge and thus opportunities for health education initiatives for Pacific communities, potentially utilizing social media and online platforms.

Background/Objectives: Pacific peoples in Aotearoa, New Zealand experience the highest burden of gout globally, yet there is still a lack of awareness and understanding of the disease. A Pacific community group and Pacific health professional network co-designed Pacific gout resources to improve understanding. The aim of this study is to identify and discuss the current state and perceptions of Pacific gout education, and explore health professionals’ views on Pacific co-designed resources and their usefulness in clinical settings. Methods: The Fa’afaletui model was utilised to conduct semi-structured Talanga interviews with 14 health professionals in Auckland, New Zealand who work in primary care clinics. The interview explored their views on providing gout education and on the feasibility of the Pacific co-designed gout resources. Talanga interviews were audio recorded and thematically analysed. Results: Overall, health professionals responded positively to the co-designed resources, identifying the benefits of supporting primary care consultations and improving Pacific patients’ understanding of gout. The key findings were summarised in five main themes: (1) health system barriers to gout education, (2) misleading information, (3) health professionals’ experiences of providing health education, (4) general impressions of Pacific co-designed resources, and (5) the feasibility of Pacific co-designed educational resources in a clinical setting. Conclusions: This study presents the views of health professionals in providing health education related to gout and on the feasibility of Pacific co-designed educational resources. It reinforces the significance of involving communities in the design and implementation of interventions to ensure they are culturally safe, relevant, and have long-term impacts on gout management.

This study aims to explore what types of gout content are presented on the social media platform TikTok and assess their association with user engagement. The top 200 TikTok videos captured using the search term ‘gout’ were collected. Two independent researchers coded the videos into eight main categories: account type, presenter, audio, video type, purpose, tone, overall connotation and gout content. Descriptive and inferential analyses were conducted to examine the distribution of variables and examine the association between gout content and engagement. Quotations were selected to reinforce some of the findings. In total, 116 TikTok videos were included in the final analysis after excluding 84 non-relevant videos. The total number of views of the videos was ≈426.6 million, with the majority belonging to content creators from the USA. The most common presenters were patients with gout or close family members (27%). Approximately 38% of videos had negative connotations, with the most common purpose of videos being health advice (38%). The main content categories coded were management strategies (79%) and risk factors (45%), focusing overwhelmingly on diet. A significant difference in engagement was evident between gout medical sequelae and gout management (P < 0.05) only. This analysis found that there is a wide range of information being promoted on TikTok that may be misleading or inconsistent with rheumatology guidelines. Future public health strategies and health professionals have an opportunity to utilise TikTok as a platform to create content, counteract misinformation and improve public understanding of gout.

The Developmental Origins of Health and Disease (DOHaD) framework has highlighted the role of maternal and paternal health on disease risk in offspring and across generations. Although adolescence is increasingly recognised as a key DOHaD window where interventions may have the greatest impact in breaking the cycle of non-communicable diseases, data around the recognition of this concept in adolescents remain limited. Previous work by our group found that the understanding of DOHaD-related concepts among adolescents in New Zealand was low, including some adolescents showing disagreement with key DOHaD concepts. This qualitative study aimed to explore DOHaD perspectives and understandings among a group of adolescents who responded to the survey using semi-structured focus groups and interviews (n = 12). Four core themes were identified: 1. knowledge of DOHaD and DOHaD-related terminology; 2. understanding different life course windows for DOHaD interventions; 3. recognising that DOHaD-related information needs to be accessible for adolescents; and 4. the importance of developing context-specific resources for adolescents. Adolescents in this study indicated that they had not heard of DOHaD or related terminology. Although the majority recognised that there were many important life stages for potential interventions, there was a strong emphasis on adolescence as a key window of opportunity. Adolescents suggested that more could be done in schools to help promote awareness and understanding of DOHaD-related concepts during the later years of schooling. The development of future resources needs to be contextually specific for adolescents to ensure increased uptake of information during this important developmental window.