The Murcia Twin Registry (MTR) has steadily expanded over two decades and has become a key resource for twin research in the Mediterranean region. The registry currently includes data from 3971 individual twins born between 1940 and 1999, as well as an associated biobank containing samples from 1586 participants. Its primary research focus is on health and health-related behaviors within a public health framework, covering areas such as lifestyle, health promotion, quality of life, and environmental factors. Across multiple waves of data collection, the MTR has compiled extensive and wide-ranging phenotypic data. These data can be further expanded and have strong potential for record linkage with other health databases, particularly those of the regional public health care system, including both primary and inpatient care. Efforts are also underway to establish record linkage with additional sources of information, such as the educational system. In the near future, the registry aims to expand its biobank and continue the collection of longitudinal data, as well as increasing the ability to collect additional data that could enrich the information from participants in the register.

Breastfeeding is a critical component of infant nutrition, and breastfed infants are less likely to become stunted or obese reducing the risk of non-communicable diseases in adult life. Optimal breastfeeding practices remain a challenge worldwide; as adolescents are the mothers and fathers of tomorrow, integrating DOHaD-informed knowledge into school curricula is called for. However, research indicates adolescents have low awareness of the importance of the first 1000 days of life, only see specific elements as relevant to them, and gender-related differences exist in their comprehension. This study evaluated the impact on adolescents of an in-class presentation on parenting and the benefits of breastfeeding in high schools in 5 African countries. Pre- and post-intervention questionnaires were completed by 345 pupils (182 girls, 163 boys, mean age 17.9 years). Analysis indicated the education session impacted pupils’ perceptions of parenting and changed which aspects of breastfeeding they viewed as most and least interesting. A statistically significant difference was evident between genders on the importance of cost-benefits; more boys saw relevance for fathers that no cost is incurred for formula. Boys also ranked the potential to reduce diabetes healthcare costs in adult life higher than girls. Girls preferentially ranked breastfed babies crying less, being easier to feed at night, and diaper changing being less gross as benefits for fathers. School-based education can engage adolescents and impact knowledge and attitudes about breastfeeding. Awareness of differences in girls’ and boys’ perceptions of relevance will enable educational content to be targeted to attract and inform both genders.

This paper focuses on recognizing the contribution made to development by grassroots women working on a voluntary basis in long term development projects. Using the example of healthcare, the paper problematizes the widespread move towards an increased reliance on voluntary and third sector provision. Drawing on literature around women’s community activism, the research considers the extent to which women carrying out health promotion work in Peru have taken on this role as more than “just voluntary work,” highlighting their long term commitment during more than a decade of health promotion activities. The paper develops debates around the professionalization of voluntary work, particularly considering the issue of economic remuneration for health promoters, and emphasizing the gendered nature of their voluntarism; concluding by questioning the sustainability of poor women’s long term, and largely unpaid, involvement as the linchpins of community development projects.

Over 15 million children in the United States have been infected with COVID-19; nearly 2,000 have died. Approval of COVID-19 vaccines for children enabled reductions in disease severity and mortality. Disparities in vaccine adoption exist along racial, ethnic, and rural–urban lines, with lower uptake among medically underserved populations (e.g. Black, non-Hispanic White rural populations) compared to urban White populations. This study examined efforts to recruit and engage a diverse cohort as part of a vaccine communication randomized trial conducted across 15 states and compared demographic characteristics of the enrolled cohort to the broader US population. To enhance recruitment of diverse populations, eligible clinics had to serve a significant proportion of medically underserved individuals based on race, ethnicity, or geographic location. Coordinators used both traditional (in-person daily clinic schedule review) and retrospective (EHR and billing data review) recruitment methods adapted to enrich engagement with focus populations. Demographic characteristics were compared to national statistics obtained from the CDC’s Household Pulse Survey. In total, 2999 parents/caregivers were screened; 725 were randomized (24.1%). Comparing enrolled subjects to the demographics of participating states, 17.3% vs 9.8% self-identified as Hispanic, 39.6% vs 13.0% as Black. Additionally, 34.3% self-described as living in a rural area. Of the 725 randomized, 512 (70.6%) completed the baseline survey. Of these 512, 422 (82.4%) also completed the final survey of the 24-week study. This analysis demonstrates the Institutional Development Award States Pediatric Clinical Trials Network can successfully recruit and engage populations from diverse and underrepresented populations in research.

Nourishing kai supports behaviour and concentration, tamariki learn well when food secure and eat regularly(1). Early food experiences influence our relationship with food as adults(2) and that tamariki health and wellbeing are shaped by education environments(3). WAVE (Well-being and Vitality in Education) has enduring partnerships with all preschools, kindergartens, playcentres, primary and secondary schools in our South Canterbury rohe(3), supporting healthy education environments with the goal of reducing inequities in health and education outcomes. Despite concerns about food security and processed foods, health promotion advisors note kaiako reluctance to promote nutrition using a whole-setting approach. The whole school approach(4) includes policies and procedures for kai (food) and wai (water), nutrition education within teaching and learning and nutrition messages promoted to whānau through enrolment information, learning stories/newsletters and displays, and in conversations with whānau. We describe an increase in kaiako acceptability occurring with the move from discussing nutrition as ‘healthy eating’ to using language of ‘supporting positive kai environments’. We include examples of mahi that the education settings put in place in this process. Between October 2023 and June 2024, WAVE provided internal professional development for health promotion kaimahi, focusing on supporting positive kai environments. Resources were redeveloped to align with messages about fostering positive relationships with kai and encouraging tamariki to be food explorers(5). The updated approach was widely communicated through newsletters and meetings with kaiako, alongside sharing relevant webinar and article resources from the Education Hub and Heart Foundation to support kaiako professional development. Health promotion advisors working with early childhood education and primary schools discussed nutrition within the broader context of positive kai and wai environments, aiming to develop positive relationships with food. These discussions took place through a combination of one-on-one meetings with lead kaiako each term and staff team meetings. Interview questions were sent to priority education (n=10) settings in September 2024 to gather feedback on barriers to promoting nutrition, how the change to ‘positive kai and supporting kai explorers’ has made a difference, and to hear the settings’ plans for current and future action in their setting. Responses from 8 ECE indicated that WAVE PD workshops using Heart Foundation resources were the resources they found most useful in enabling them to support tamariki as kai explorers. The shift to ‘positive kai environments’ has given kaiako consistent positive language around food, created space for tamariki to be self-directing with food, and has been mana-enhancing for tamariki and whānau. Kaiako stated that this evidence-based approach has taken the pressure off food, and kaiako are more responsive to tamariki needs. Kaiako are more willing to approach nutrition messages in a holistic manner to support tamariki.

An independent evaluation of The Resilience Project’s School Partnership Program in Australian secondary schools found that longer participation (6+ years) in this whole-school programme was associated with improved student outcomes, including reduced symptoms of depression and anxiety. This commentary aims to: (a) describe whole-school approaches to improving health and well-being, with reference to their historical context and some selected key studies; (b) highlight the lack of data on the effectiveness of whole-school approaches for reducing depression and anxiety; (c) signal the potential benefits of whole-school approaches when sustainably implemented; and (d) reinforce the need for research that examines links between implementation factors and outcomes. Overall, this commentary underscores the value of viewing schools as complex social systems where multiple components can align to enhance mental health and well-being outcomes for students.

Older adults have largely been excluded from health research despite bearing a disproportionate disease burden. The Community Engagement Studio (CES) model, initially developed at Vanderbilt University in 2009, allows potential research participants to help shape research to promote greater inclusion. The University of Pittsburgh adapted the CES model for older adults (OA-CES). Tailored specifically to older adults, OA-CES addresses underrepresentation in research by gathering valuable feedback that allows investigators to make research more accessible and relevant to older people. An OA-CES toolkit will help in adapting the model in other research areas to close the gap in research inclusion.