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Issue Addressed: Lifelong eating behaviours are established in childhood. Improving parents' food literacy skills is essential, as parents play a fundamental role in establishing their children's healthy eating behaviours and preferences for nutritious food. This paper describes the development and evaluation of an innovative program that combines food literacy with positive parent feeding practices, targeting parents in disadvantaged areas of Western Australia. Methods: The Food Sensations® for Parents five‐week program was delivered to participants from community‐based parenting organisations during 2020 and 2021. Formative research and a pre‐post evaluation design were adopted. Results: Pre‐ and post‐evaluation data were collected from 224 participants (96% female). There was a statistically significant improvement in the mean score for 13 food literacy behaviours, 10 positive parenting feeding practices and a mean increase in parents' daily vegetable intake of 1/3 serve. Participants reported significantly greater net improvements in food literacy behaviours than feeding practices, the largest being the Use a nutrition information panel to make food choices (33.1%). Multivariate logistic regression analyses found English as a first language, being older than 35, and from a higher Socio‐Economic Index for Areas resulted in a higher likelihood of positive changes in behaviours and practices. Conclusions: The findings indicate that the program is effective in improving the frequency of use of food literacy behaviours, positive parenting feeding practices and increasing vegetable consumption. So What?: Analysing improvements in food literacy behaviours and feeding practices provides clarity on what change can be expected with a five‐week parent program. [ABSTRACT FROM AUTHOR]

Issues Addressed: Discussion of family violence is important but many men and boys struggle to engage with the topic. Primary prevention approaches focus on communicating with and educating the population, including men and boys, in the areas of healthy relationships, gender and violence. There can be both barriers to and also gains from these interventions. This paper describes a project implemented in Geraldton, Western Australia, and discusses what has been effective and ineffective during the project.Methods: The 'Men Against Violence' project targeted men and boys through local sporting clubs in the City of Greater Geraldton, in the Midwest region of Western Australia, through the use of face to face education, community radio and television interviews and other appropriate engagement strategies. 'Men Against Violence' events were held to connect with local male community members and address the role men can have in family violence prevention.Results: We describe the three key engagement activities, working with the local Australian Rules football league, state-league basketball team and a local high school Aboriginal football academy. These strategies provided avenues for contact with and the education of men and boys aged 12 years and older.Conclusion: Through successful partnerships with a number of local organisations, the 'Men Against Violence' project saw a high level of engagement with local men. The project also gained strong community support, with pockets of resistance encountered and managed.So What: The 'Men Against Violence' project experienced highlights and barriers throughout the pilot project that can guide and inform future family violence prevention programs. [ABSTRACT FROM AUTHOR]

Issues Addressed: To explore adolescents' experiences of access to and continued use of mental health services, and identify factors influencing their perceived satisfaction with their care. This paper focusses on the role of organisational and policy-level factors in the mental health system.Method: Qualitative semi-structured face-to-face interviews with 22 adolescents aged 14-18 years living in Perth, Western Australia.Results: Adolescents identified key policy, systemic and service-based factors which influenced their access to and continued use of mental health services. These were strongly related to the processes of service intake, level of orientation towards person-centred care and adequacy of service resourcing and funding. Areas of concern for adolescents included, complex service intake procedures, suboptimal mental health service environments, lack of client-centred care and the quality of mental health support provided in school settings.Conclusions: Our research has identified a wide spectrum of factors influencing mental health service access and use amongst adolescents. The findings further support the growing national consensus for major reform to address the mental health needs of this age group. The current strengths within mental health services and the system identified by adolescents need to be supported and extended. SO WHAT?: Although there have been numerous recommendations on ways to improve mental health service access and ongoing engagement for Australian adolescents, a number of the major challenges faced by this high-risk population have shown little improvement. The findings of this research indicate the importance of now moving towards implementing meaningful plans for action. [ABSTRACT FROM AUTHOR]

Issue Addressed: The aim of this study was to use a novel approach to geographically model the relationship between socio-economic disadvantage and prevalence of profound and severe disability.Method: This study used national census data and the survey of disability, ageing and carers data to geographically model the relationship between socio-economic disadvantage and prevalence of profound and severe disability.Result: The results in this study show that there were more people living in the least disadvantaged areas (wealthiest) when compared to the most disadvantaged (poorest) areas. Whereas for people with a disability as the relative socio-economic disadvantage of the area increased, the number of people reporting any disability also increased, with the highest number coming from the most disadvantaged areas. The maps show a significant distribution with fewer cases of disability in metropolitan areas and relatively higher number in the rural area along with the higher proportion of people with disability living in the relatively more disadvantaged areas.Conclusion: Socio-economic profile is one of the key factors influencing the various aspects of health and hence should hold an important place during policy making. Policy should be formulated and implemented to help reduce the inequality by either directly aiming at the most disadvantaged group or by trying to bridge the gap between them. SO WHAT?: This paper provides a geographic visualisation of the distribution of people with profound and severe disability to help identify priority areas with high prevalence of disability. [ABSTRACT FROM AUTHOR]

Background: Leavers Festivals have become an institution for Australian youth to celebrate the completion of secondary school. Reported hazardous consumption of alcohol by leavers has focused concern on risk-taking behaviour. In response to this, campaigns such as "Don't Drink and Drown" have targeted youth to reduce alcohol consumption during aquatic activities. This research investigated intended and actual alcohol consumption, particularly during aquatic activities at a Leavers Festival located in the coastal town of Dunsborough, southern Western Australia.Method: In November 2016, 549 leavers aged 17 or 18 years completed a paper-based survey over a four-day period during the Festival.Results: Overall, 90% of leavers reported intending to drink during the Festival, with expected average daily consumption being seven to nine standard drinks; reported daily consumption was five to six standard drinks (P < 0.001). Of the 29% of leavers who consumed alcohol around water during Leavers, 47% had done so while swimming. About 91% were aware of the campaign "Don't Drink and Drown."Conclusion: Awareness of the "Don't Drink and Drown" campaign and knowledge of risks associated with alcohol consumption and swimming were relatively high. Intention and actual consumption of alcohol did not correlate, with daily consumption less than anticipated.So What: Leavers appear to have a reasonable level of awareness and knowledge of the risks associated with alcohol consumption and aquatic activities, which may reflect the impact of education campaigns. However, this knowledge is not always translated into nonrisky aquatic behaviour. [ABSTRACT FROM AUTHOR]

Issue addressed: Food literacy programs aim to build individuals' knowledge, skills and self‐efficacy to adopt healthy food choices conducive to reducing the risk of chronic diseases, such as obesity. Foodbank WA's (FBWA) Healthy Food for All® nutrition programs have supported the improvement of food literacy knowledge and skills among vulnerable people living in the Pilbara. Methods: A Sustainability Framework containing ten sustainability factors was overlaid with social ecological model (SEM) levels of influence to form a matrix. The use of this matrix facilitated sustainability strategy appraisal within three food literacy programs delivered in remote WA. Results: Programs included multiple sustainability strategies across levels of influence; all programs addressed all ten sustainability factors at community and organisational SEM levels of influence. Few sustainability strategies were employed at the public policy level of influence. No program employed formal governance structures to guide program direction, such as steering groups; however, school and parent program staff developed Memoranda of Understanding to ensure the continuation of program delivery between the FBWA teams' regional visits. Conclusions: This study has showcased the comprehensive assessment of food literacy program sustainability across levels of influence and identified gaps for improvement by FBWA teams. So What?: The sustainability of food literacy programs aiming to increase knowledge and skills could be enhanced by conducting a similar analysis, during program planning or at program review. Using the matrix provides the opportunity to focus resources to address sustainability; supporting health promotion practitioners to transform the impacts of short‐term food literacy interventions into long‐term sustained outcomes. [ABSTRACT FROM AUTHOR]

Issue addressed: In Australia, food sovereignty of traditional landowners has been marginalised by the globalisation of food systems and resulted in limited opportunities for children to experience familiar bush tucker foods as healthy choices, particularly in a school environment. Superhero Foods® themed teaching resources focus on the development of nutrition education materials that included traditional Aboriginal foods together with contemporary foods readily available in regional/remote communities. Methods: Consultation with an Aboriginal expert and Aboriginal artist; local, regional/remote teachers and stakeholders informed the development of tailored resources including food cartoon characters, school lesson plans and a storybook. The latter was guided by a resource development model. Users of the resources were surveyed to ascertain the useability, alignment with the Australian Dietary Guidelines, cross‐curricular learnings and cultural relevance. Results: Respondents across regional/remote and urban locations completed a lesson plan and food character (clipart) survey (N = 51) and storybook survey (N = 14). Respondents advised the resources were relevant, enjoyable, engaging and culturally appropriate for all students regardless of Aboriginality. The resources provided learning opportunities for all children to enhance knowledge about Aboriginal culture and bush foods. Independent evaluation has further indicated the translation of messaging into student's knowledge and learning. Conclusions: Key enablers to the success of the resource included; free online access, the highly engaging nature of the resources and adaptability to be implemented across a number of Aboriginal language groups in WA. Ensuring visual representation of healthy choices was fundamental to reinforcing nutrition messaging. Superhero Foods resources are a positive and important inclusion in the health promotion toolbox for Aboriginal children. So what?: Superhero Foods are novel nutrition education resources depicting Aboriginal foods and Aboriginal children. These food literacy resources will engage children's understanding of Aboriginal culture, improve food literacy and strengthen equitable access for regional and remote communities. [ABSTRACT FROM AUTHOR]

Objective: The South West Food Community (SWFC) project (2018) was implemented to identify initiatives working to enhance healthy food availability, access and use in the South West region of Western Australia (SWWA); and enhance how they functioned as a system. The SWFC project participants included government and community members. This study aimed to understand how a tailored food security website could be developed as a support mechanism to increase understanding of food security, connect participants and enhance the effectiveness of SWFC initiatives. Methods: Initiative leaders from the SWFC project (n = 46) were invited to participate in semi‐structured telephone interviews which sought to understand needs for a food security website. Fifteen stakeholders completed the interviews (32% response rate). Data relating to desirable and undesirable website components were analysed thematically using QSR NVivo 12. Results: Participants requested the website to include concise content, food security resources, inviting/useful images and information about initiatives. Undesirable features included academic literature, difficult‐to‐use functions, discussion boards and hard‐to‐view images. Conclusion: A tailored, co‐designed website that is monitored, user‐friendly and functional were key stakeholder requirements. Implications for Public Health: A tailored, co‐designed food security website that promotes partnership development, builds networks, increases understanding and communication about food security and implementation strategies is needed. [ABSTRACT FROM AUTHOR]

Issue addressed: Since 1986, injury prevention and control has been classified as a National Health Priority. However, no reviews into the injury prevention workforce have been conducted in Australia since 2011 and to date; none has focused specifically on the injury prevention and safety promotion sector in Western Australia (WA). This research sought to review the scope of the injury prevention and safety promotion workforce in WA to gain a greater understanding of sector characteristics, work and needs. Methods: An online, cross‐sectional survey was conducted between mid‐January and mid‐March 2018. Participants were required to be: (a) based in WA or have a program running within WA; and (b) working in injury prevention and safety promotion relating to programs, policy or legislation development, implementation and/or evaluation within intentional (eg interpersonal violence, suicide and self‐harm) or unintentional injuries (eg transport, poisoning, falls, drowning, burns) or farm, child and community, occupational health and safety, sport and recreation and trauma. Results: The research found that participants were predominantly female (82%), aged 40 years or older (66.1%) and were employed full time (55.6%). The majority of participants worked in falls prevention (38.5%), alcohol and other drugs (38.0%), injury in general (31.8%) and community safety (30.7%). Conclusions: Findings demonstrate significant heterogeneity with a core workforce supported by a range of non‐core and indirect actors. Identifying characteristics and needs of the workforce supports coordinated capacity building to implement effective injury prevention and safety promotion initiatives. With this being the first review of the workforce in WA, this article highlights the need to more regularly audit the sector to determine its breadth and composition. So what?: In the light of the recent announcement by the Commonwealth for a new national Injury Prevention Strategy, this study provides timely insights into the injury prevention and safety promotion sector in WA. [ABSTRACT FROM AUTHOR]

Issue Addressed: Evaluation of the behavioural impact of Western Australia's LiveLighter healthy weight and lifestyle campaign focussed on decreasing consumption of sugar-sweetened beverages (SSBs) using graphic imagery, as well as monitoring unintended consequences.Methods: A cohort design with pre-campaign telephone survey of Western Australian adults aged 25-49 (Time 1 May/Jun 2013: N = 1504) undertaken and repeated following the campaign (Time 2 Aug/Sep 2013: N = 822).Results: Post-campaign awareness was 67% with respondents in low socio-economic areas most likely to report viewing the campaign frequently. There was evidence of reduced SSB intake from baseline to follow-up among frequent (4+/week) SSB consumers (22% cf. 16%; P = 0.003) and some evidence among overweight (BMI 25+) weekly SSB consumers (56% cf. 48%; P = 0.013). There was also some evidence consumption of sweet food decreased (3+/week: 53% cf. 48%; P = 0.035) while fruit, vegetable and fast food consumption remained stable. Knowledge of potential health consequences of SSBs increased (70% cf. 82%; P < 0.001) with no change in knowledge of potential health consequences of overweight generally (86% cf. 89%). Importantly, there was no increase in endorsement of overweight stereotypes.Conclusions: The LiveLighter "Sugary Drinks" campaign positively impacted adults' knowledge and behaviour with regard to SSB consumption in a pattern specific to the campaign messaging and without adverse impact on weight-related stereotypes. SO WHAT?: Findings support the use of mass media for healthy lifestyle change. They suggest the public are receptive to undertaking the campaign's simple concrete lifestyle recommendation and provide an indication of the campaign dose required to achieve positive behaviour change. [ABSTRACT FROM AUTHOR]

Issue Addressed: Building health promotion workforce capacity and infrastructure is critical to ensure a strong evidence base for effective interventions, sustainability and ultimately positive health outcomes for the community. Accordingly, there is a need to build workforce capacity by providing pathways into the health promotion sector with opportunities for core health promotion competency development. Currently, there is a lack of transition programs and graduate-specific positions in health promotion.Methods: This study presents a descriptive case study of a 20-year health promotion scholarships program administered by the Australian Health Promotion Association (WA Branch) and Healthway for health promotion graduates and Aboriginal health workers. Scholarship recipients and supervisors reported on demographics, projects and perspectives on the value of participating in the program.Results: More than 2 million dollars has been invested to provide health promotion career pathways in WA via 100 scholarships. Key themes relating to program value included as follows: practical application of theoretical concepts; reciprocity; and building skills and capacity in both recipients and supervisors.Conclusions: The scholarships program results in a number of benefits to the recipient, host organisation and the overall health promotion sector and is an example of long-term investment to build health promotion capacity with potential for replication. SO WHAT?: Investment in competency-driven health promotion scholarships to create dedicated health promotion career pathways for new practitioners contributes to the capacity of an effective health promotion workforce. [ABSTRACT FROM AUTHOR]

Issue Addressed: Excessive alcohol consumption places adolescents at increased risk of preventable, acute alcohol-related injury. Parental attitudes and behaviours influence adolescents' alcohol use. This study examined alignment in parent and child reports of alcohol-related parenting and whether misalignment related to the child ever having drunk alcohol.Methods: A cross-sectional online survey was conducted in five secondary schools in [information removed for blinding in Perth, Western Australia] in 2015. All students in Years 7, 10 and 12 and their parents were eligible, and data were matched for 124 child-parent dyads. Alignment of parent-child reports was assessed using kappa statistics. In dyads where the parent reported protective attitudes and behaviours, the association between misalignment and alcohol use was tested in logistic regressions.Results: Overall, child-parent reports were aligned on parents' expectations, knowledge and actions (65% and higher agreed). While alignment on parental expectations seemed to decrease with age, alignment on parental communication and rule-setting increased. Misalignment on reports of parents' expectations was associated with increased odds of the child reporting having ever had alcohol (OR = 5.5; 95% CI = 2.7-47.7), as was parental supply (OR = 20.2; 95% CI = 3.3-121.5), but misalignment on parental communication, rule-setting and knowledge were not.Conclusions: Parent nonsupply of alcohol and disapproval of use were most important in terms of associations with ever drinking. SO WHAT?: These findings call for interventions that support parents to expect no alcohol use and enable parents to communicate their expectation in a manner that resonates with their child. Effective parenting will contribute to reducing alcohol-related harm in adolescents. [ABSTRACT FROM AUTHOR]

Issue addressed The study aim was to investigate the relationships between social capital measures and playgroup participation in a local residential area for parents with children of playgroup age (1-4 years) compared with non-participation and participation in a playgroup outside the local residential area. Research indicates playgroup participation has benefits for families, however, less is known about the potential local community social capital for parents who participate in playgroups. Methods Data were collected through a cross-sectional survey from March 2013 to January 2014 in Perth, Western Australia. The data from a group of parents (n=405) who had at least one child aged between 1 and 4 years were analysed using multivariable regression. Reported playgroup participation (local, outside the area or non-participation) in the previous 12 months was investigated for associations with three measures (Neighbourhood Cohesion Index, Social Capital and Citizenship Survey and local reciprocity) that capture attributes of social capital. Results Participation in playgroup locally was generally associated with higher levels of social capital than both participation in playgroup outside the local area and non-participation. Mothers with two or more children fared better for social capital measures than mothers with one child. Conclusions Participation in a locally placed playgroup may provide an important opportunity for families with children of playgroup age (1-4 years) to build social capital in their local community. So what? Playgroups in a family's local area have the potential to foster locally placed social capital through community interaction, social networks and cohesion, which are important for mental health promotion in communities. [ABSTRACT FROM AUTHOR]

Issue addressed Despite being viewed as a core competency for public health professionals, public health advocacy lacks a prominent place in the public health literature and receives minimal coverage in university curricula. The Public Health Advocacy Institute of Western Australia (PHAIWA) sought to fill this gap by establishing an online e-mentoring program for public health professionals to gain knowledge through skill-based activities and engaging in a mentoring relationship with an experienced public health advocate. This study is a qualitative evaluation of the online e-mentoring program. Methods Semi-structured interviews were conducted with program participants at the conclusion of the 12-month program to examine program benefits and determine the perceived contribution of individual program components to overall advocacy outcomes. Results Increased mentee knowledge, skills, level of confidence and experience, and expanded public health networks were reported. Outcomes were dependent on participants' level of commitment, time and location barriers, mentoring relationship quality, adaptability to the online format and the relevance of activities for application to participants' workplace context. Program facilitators had an important role through the provision of timely feedback and maintaining contact with participants. Conclusion An online program that combines public health advocacy content via skill-based activities with mentoring from an experienced public health advocate is a potential strategy to build advocacy capacity in the public health workforce. So what? Integrating advocacy as a core component of professional development programs will help counteract current issues surrounding hesitancy by public health professionals to proactively engage in advocacy, and ensure that high quality, innovative and effective advocacy leadership continues in the Australian public health workforce. [ABSTRACT FROM AUTHOR]

Issue addressed Evidence-informed practice underpinned by ethics is fundamental to developing the science of health promotion. Knowledge and application of ethical principles are competencies required for health promotion practice. However, these competencies are often inconsistently understood and applied. This research explored attitudes, practices, enablers and barriers related to ethics in practice in Western Australian health organisations. Methods Semistructured, in-depth interviews were conducted with 10 health promotion practitioners, purposefully selected to provide a cross-section of government and non-government organisations. Interviews were recorded, transcribed and then themed. Results The majority of participants reported consideration of ethics in their practice; however, only half reported seeking Human Research Ethics Committee (HREC) approval for projects in the past 12 months. Enablers identified as supporting ethics in practice and disseminating findings included: support preparing ethics applications; resources and training about ethical practice; ability to access HRECs for ethics approval; and a supportive organisational culture. Barriers included: limited time; insufficient resourcing and capacity; ethics approval not seen as part of core business; and concerns about academic writing. Conclusion The majority of participants were aware of the importance of ethics in practice and the dissemination of findings. However, participants reported barriers to engaging in formal ethics processes and to publishing findings. So what? Alignment of evidence-informed and ethics-based practice is critical. Resources and information about ethics may be required to support practice and encourage dissemination of findings, including in the peer-reviewed literature. Investigating the role of community-based ethics boards may be valuable to bridging the ethics-evidence gap. [ABSTRACT FROM AUTHOR]

Issue addressed Indigenous Australians are 14 times more likely than non-Indigenous Australians to develop diabetic retinopathy (DR). Blindness can be prevented in 98% of cases if DR is identified and treated early. While the National Health and Medical Research Council recommend annual screening for Indigenous Australians, screening attendance rates remain low. The objective of this study was to evaluate whether a targeted health promotion intervention improved patient compliance and screening rates. Methods Bad Sugars, Bad Eyes - a culturally appropriate video targeting DR awareness and the importance of screening among Indigenous Australians - was developed at the Lions Eye Institute, Western Australia. The study used a patient questionnaire pre and post viewing of the video, as well as semi-structured interviews with Aboriginal Health Workers, to explore the influence the resource had on patient knowledge and attitudes. Eighty-four participants, currently involved in DR screening programs, were recruited from Aboriginal Medical Services (AMS) and Aboriginal Community Controlled Health Services (ACCHS). Results The video was found to increase patient knowledge about key DR issues as well as alter patient attitudes identified as potential barriers to screening. The areas most affected by the video resource were knowledge of recommended screening intervals, the severity of potential visual complications if DR is left undiagnosed and untreated and that screening is needed even when asymptomatic. Aboriginal Health Workers positively evaluated the video, all rating it as 'very' culturally appropriate, understandable and relatable. Conclusion The findings of this study suggest that Indigenous DR screening attendance rates could be increased through the expanded use of this video. So what? Indigenous DR screening attendance rates remain low, despite annual recommendations by the National Health and Medical Research Council. This gap needs to be addressed. [ABSTRACT FROM AUTHOR]