This project measured population salt intake in Samoa by integrating urinary sodium analysis into the World Health Organization's (WHO's) STEPwise approach to surveillance of noncommunicable disease risk factors (STEPS). A subsample of the Samoan Ministry of Health's 2013 STEPS Survey collected 24‐hour and spot urine samples and completed questions on salt‐related behaviors. Complete urine samples were available for 293 participants. Overall, weighted mean population 24‐hour urine excretion of salt was 7.09 g (standard error 0.19) to 7.63 g (standard error 0.27) for men and 6.39 g (standard error 0.14) for women (P=.0014). Salt intake increased with body mass index (P=.0004), and people who added salt at the table had 1.5 g higher salt intakes than those who did not add salt (P=.0422). A total of 70% of the population had urinary excretion values above the 5 g/d cutoff recommended by the WHO. A reduction of 30% (2 g) would reduce average population salt intake to 5 g/d, in line with WHO recommendations. While challenging, integration of salt monitoring into STEPS provides clear logistical and cost benefits and the lessons communicated here can help inform future programs.

Re-use of this article is permitted in accordance with the Terms and Conditions set out at http://wileyonlinelibrary.com/ onlineopen#OnlineOpen_Terms SummaryThe Living 4 Life study was a youth-led, school-based intervention to reduce obesity in New Zealand. The study design was quasi-experimental, with comparisons made by two cross-sectional samples within schools. Student data were collected at baseline (n = 1634) and at the end of the 3-year intervention (n = 1612). A random-effects mixed model was used to test for changes in primary outcomes (e.g. anthropometry and obesity-related behaviours) between intervention and comparison schools. There were no significant differences in changes in anthropometry or behaviours between intervention and comparison schools. The prevalence of obesity in intervention schools was 32% at baseline and 35% at follow-up and in comparison schools was 29% and 30%, respectively. Withinschool improvements in obesity-related behaviours were observed in three intervention schools and one comparison school. One intervention school observed several negative changes in student behaviours. In conclusion, there were no significant improvements to anthropometry; this may reflect the intervention's lack of intensity, insufficient duration, or that by adolescence changes in anthropometry and related behaviours are difficult to achieve. School-based obesity prevention interventions that actively involve young people in the design of interventions may result in improvements in student behaviours, but require active support from leaders within their schools.

BackgroundEnsuring a good life for all parts of the population, including children, is high on the public health agenda in most countries around the world. Information about children's perception of their health-related quality of life (HRQoL) and its socio-demographic distribution is, however, limited and almost exclusively reliant on data from Western higher income countries.ObjectivesTo investigate HRQoL in schoolchildren in Tonga, a lower income South Pacific Island country, and to compare this to HRQoL of children in other countries, including Tongan children living in New Zealand, a high-income country in the same region.DesignA cross-sectional study from Tonga addressing all secondary schoolchildren (11–18 years old) on the outer island of Vava'u and in three districts of the main island of Tongatapu (2,164 participants). A comparison group drawn from the literature comprised children in 18 higher income and one lower income country (Fiji). A specific New Zealand comparison group involved all children of Tongan descendent at six South Auckland secondary schools (830 participants). HRQoL was assessed by the self-report Pediatric Quality of Life Inventory 4.0.ResultsHRQoL in Tonga was overall similar in girls and boys, but somewhat lower in children below 15 years of age. The children in Tonga experienced lower HRQoL than the children in all of the 19 comparison countries, with a large difference between children in Tonga and the higher income countries (Cohen's d 1.0) and a small difference between Tonga and the lower income country Fiji (Cohen's d 0.3). The children in Tonga also experienced lower HRQoL than Tongan children living in New Zealand (Cohen's d 0.6).ConclusionThe results reveal worrisome low HRQoL in children in Tonga and point towards a potential general pattern of low HRQoL in children living in lower income countries, or, alternatively, in the South Pacific Island countries.

This paper provides insights from a community-centre intervention study that was co-designed by youth, health providers and researchers. The aims of the paper were to highlight the effectiveness of a co-designed community centred diabetes prevention intervention, and to determine whether a culturally tailored approach was successful. The study participants (n = 26) were at risk of developing prediabetes and represented the working age group of Pasifika peoples in NZ (25-44-year olds). The community-centre intervention consisted of 8 weeks of community physical activity organised and led by the local youth, a community facilitator, and the community provider. Semi-structured interviews with each of the intervention participants using a Pasifika narrative approach (talanoa) was carried out. Each interview was transcribed, coded and analysed and compared using thematic analyses. The study highlights four major themes illuminating positive successes of the community-centre intervention programme, and conclude that co-designing interventions for Pasifika peoples, should be culturally tailored to meet the realities of the communities and require strong support from associated community providers.

Objectives: The Pasifika Prediabetes Youth Empowerment Programme (PPYEP) was a community‐based research project that aimed to investigate empowerment and co‐design modules to build the capacity of Pasifika youth to develop community interventions for preventing prediabetes. Methods: This paper reports findings from a formative evaluation process of the programme using thematic analysis. It emphasises the adoption, perceptions and application of empowerment and co‐design based on the youth and community providers’ experiences. Results: We found that the programme fostered a safe space, increased youth's knowledge about health and healthy lifestyles, developed their leadership and social change capacities, and provided a tool to develop and refine culturally centred prediabetes‐prevention programmes. These themes emerged non‐linearly and synergistically throughout the programme. Conclusions: Our research emphasises that empowerment and co‐design are complementary in building youth capacity in community‐based partnerships in health promotion. Implications for public health: Empowerment and co‐design are effective tools to develop and implement culturally tailored health promotion programmes for Pasifika peoples. Future research is needed to explore the programme within different Pasifika contexts, health issues and Indigenous groups.