Health promotion is a core component of the Pacific region's response to noncommunicable diseases (NCDs) prevention and control. However, while health promotion should build on and be informed by contextually specific norms and social discourse, there remains a paucity in research that seeks to understand how people in the Pacific region comprehend chronic conditions and their determinants. Based in peri-urban Vanuatu, this codesigned study utilized an open-ended survey to investigate community perceptions of factors contributing to the development of type 2 diabetes. Results demonstrate a complex picture of diabetes-specific health literacy, with 22 distinct causes identified by 308 respondents. Dietary factors were commonly acknowledged; however, dietary complexity was not well understood. Limited recognition of the role of tobacco and alcohol consumption in disease development was also noted. Overall, findings demonstrate mixed successes in NCD-related health promotion. Moving away from more universalized approaches commonly advocated by donors, this research identifies the need for locally designed and driven health promotion that focuses on more nuanced, culturally sensitive, and contextually grounded messaging.
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