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Issue Addressed Methods Results Conclusions So What? Food environments in early childhood, such as early childhood education and care services, influence the development of dietary patterns and behaviours that traverse into adulthood, where they affect health and longevity. Nutrition policies are mandatory in early childhood education and care services in Australia and can positively or negatively shape the food environment. However, the quality of such nutrition policies is unknown. This study aimed to evaluate the comprehensiveness and strength of nutrition policies of early childhood education and care services among services participating in a university‐community alliance in South East Queensland.Early childhood education and care services (n = 12) in Nerang, Queensland, Australia, participated in a cross‐sectional study evaluating the comprehensiveness and strength of nutrition policies across four domains (Nutrition Education, Nutrition Standards, Promoting Healthy Eating and Communication and Evaluation) of the Wellness in Child Care Assessment Tool.Nutrition policies evaluated in this study had median total comprehensiveness scores of 55 (out of 100) and median total strength scores of 19 (out of 100). ‘Nutrition Education’ had the highest median scores for comprehensiveness (67 out of 100) and strength (33 out of 100), while ‘Nutrition Standards’ had the lowest comprehensiveness score (41 out of 100), and ‘Communication and Evaluation’ had the lowest strength score (0 out of 100).All services have a nutrition policy, but there are opportunities to enhance both the content and linguistic strength of statements within policies related to nutrition domains.There is a clear need to improve the comprehensiveness and strength of written statements in nutrition policies across all four domains, particularly ‘Nutrition Standards’ and ‘Communication and Evaluation’. [ABSTRACT FROM AUTHOR]

Issue Addressed Methods Results Conclusions So What? Community‐based healthy eating and exercise programs are effective interventions to support some people with chronic conditions. This research aimed to explore the experiences and perceptions of participants regarding the integration of nutrition education into a successful group based exercise program for people with chronic medical conditions.Semi‐structured interviews were conducted with past participants of a community based group exercise program (Health Moves) with embedded nutrition advice based in a regional area of New South Wales. A total of 60 individuals who had participated in the Health Moves program between 2017 and 2019 were invited to participate and 19 (32%) randomly selected participants consented to be interviewed. Interviews explored participants' experiences, program impacts, and barriers to sustaining changes post program. Similar concepts and patterns were grouped into themes.Four themes were identified that described the experiences with a community‐based group exercise intervention with a nutrition component. The major themes evident were that Health Moves facilitated motivation (via access to health professionals, peer support, accountability, affordability); and there were challenges identified to sustaining change (including cost, comorbidities, end of program support, environmental factors); Nutrition advice was valuable for some but not for all (difficulty recalling nutrition components, superficial coverage) Practical and interactive nutrition advice is desired.Participants expressed a high degree of satisfaction with the program but require ongoing support to sustain changes post program. The position and integration of nutrition education within this exercise program was perceived by participants to be suboptimal. Increased access to practical, interactive nutrition education components may improve participant satisfaction and engagement.Key findings from this research include a desire for removal of didactic nutrition education sessions and request for increased peer support. Modifications to the program include the integration of interactive self‐paced nutrition modules. Peer support partnerships are now encouraged by trainers to support ongoing motivation of participants to keep training together outside the structured exercise program and transition to managing their own exercise routine. Discussions between organisations involved about ongoing pathway/program support or reduced cost ‘off peak’ gym membership is underway to help with costs incurred by participants. [ABSTRACT FROM AUTHOR]

Issue Addressed: As the population ages the prevalence of dementia increases and children are increasingly experiencing family members and older friends living with dementia. Unfortunately, stigma about living with dementia is common. Increasing understanding about dementia among children has the potential to reduce this stigma. This paper reports on the qualitative findings of Project DARE (dementia knowledge, art, research and education), a school‐based, multi‐modal, arts program designed to increase understanding about dementia among children aged 8–10 years. Methods: A constructivist grounded theory approach was used to understand students' experience of the intervention. Thematic analysis was used to identify key themes emerging from interviews with randomly selected students (n = 40) who had taken part in the program. Results: The data analysis generated three themes related to students' awareness of dementia and experiences of the program: (1) nurturing empathy, (2) memory loss is complex, (3) learning about dementia through the arts to promote resilience. These themes show that the intervention increased students' awareness of dementia, and empathy towards people who are both directly and indirectly affected by dementia. Conclusions: Although dementia education can be viewed as too sensitive for primary aged students, the current study demonstrates that such initiatives are feasible and can be effectively implemented with this age group. So What?: Changing student's beliefs about dementia can positively impact their relationships with people living with dementia. [ABSTRACT FROM AUTHOR]

Issue Addressed: Early childhood education and care (ECEC) settings are ideal environments to optimise nutrition and positively influence children's food behaviours. However, recent research has identified the need to improve nutrition policies, food provision, and mealtime environments in Australian ECEC settings. This study explored the perceptions of ECEC directors regarding barriers and enablers to a health‐promoting food environment within ECEC services. Methods: Eleven directors from ECEC services in Nerang, Queensland, and surrounding areas, participated in qualitative interviews between March and May 2021. Transcripts were analysed using qualitative content analysis that followed a deductive‐inductive approach employing nutrition‐related domains from the Wellness Child Care Assessment Tool, these being: (i) nutrition policy; (ii) nutrition education; (iii) food provision; and (iv) mealtimes. Transcripts were coded independently by two researchers in NVivo and consensus for barriers and enablers was achieved through discussion. Results: Barriers and enablers were reported across four domains (nutrition policy, nutrition education, food provision, and mealtimes). Comprehensive nutrition‐related policies were an enabler to a healthy nutrition environment but were sometimes described as lacking detail or customisation to the service. Nutrition education for children was described as competing with other activities for time and resources in an already‐crowded curriculum. Financial and time pressures faced by families were a barrier to healthy food provision in services where families provided food for children. The ability of staff to sit with children and engage in conversation during mealtimes was an enabler; however, competing demands on time and the unavailability of food for staff were cited as barriers to health‐promoting mealtimes. Conclusions: Directors in ECEC services report both barriers and enablers to a healthy food environment. Nutrition policies were an enabler when comprehensive and relevant but a barrier when vague and not tailored to the service environment. ECEC services should be supported to develop and implement service‐specific nutrition policies and practices by engaging with parents and staff. So What?: The barriers and enablers reported in this study should be considered when designing and implementing future evidence‐based interventions to improve the nutrition environment in ECEC services. [ABSTRACT FROM AUTHOR]

Issue addressed: Evaluated the impact of the Understanding Multiple Sclerosis (MS) massive open online course, which was intended to increase understanding and awareness about MS, on self‐reported health behaviour change 6 months after course completion. Methods: Observational cohort study evaluating precourse(baseline) and postcourse (immediately postcourse and six‐month follow‐up) survey data. The main study outcomes were self‐reported health behaviour change; change type; and measurable improvement. We also collected participant characteristic data (eg, age, physical activity). We compared participants who reported health behaviour change at follow‐up to those who did not and compared those who improved to those who did not using χ2 and t tests. Participant characteristics, change types and change improvement were described descriptively. Consistency between changes reported immediately postcourse and at the 6‐month follow‐up was assessed using χ2 tests and textual analysis. Results: N = 303 course completers were included in this study. The study cohort included MS community members (eg, people with MS, healthcare providers) and nonmembers. N = 127 (41.9%) reported behaviour change in ≥1 area at follow‐up. Of these, 90 (70.9%) reported a measured change, and of these, 57 (63.3%) showed improvement. The most reported change types were knowledge, exercise/physical activity and diet. N = 81 (63.8% of those reporting a change) reported a change in both immediately and 6 months after course completion, with 72.0% of those that described both changes giving similar responses each time. Conclusion: Understanding MS encourages health behaviour change among course completers up to 6 months after course completion. So what?: An online education intervention can effectively encourage health behaviour change over a 6‐month follow‐up period, suggesting a transition from acute change to maintenance. The primary mechanisms underpinning this effect are information provision, including both scientific evidence and lived experience, and goal‐setting activities and discussions. [ABSTRACT FROM AUTHOR]

Issue Addressed: A lack of programs to develop clinician knowledge and confidence to address weight gain within pregnancy is a barrier to the provision of evidence‐based care. Aim: To examine the reach and effectiveness of the Healthy Pregnancy Healthy Baby online health professional training program. Methods: A prospective observational evaluation applied the reach and effectiveness elements of the RE‐AIM framework. Health professionals from a range of disciplines and locations were invited to complete questionnaires before and after program completion assessing objective knowledge and perceived confidence around aspects of supporting healthy pregnancy weight gain, and process measures. Results: There were 7577 views across all pages over a year period, accessed by participants across 22 Queensland locations. Pre‐ and post‐ training questionnaires were completed 217 and 135 times, respectively. The proportion of participants with scores over 85% and of 100% for objective knowledge was higher post training (P ≤.001). Perceived confidence improved across all areas for 88%–96% of those who completed the post‐ training questionnaire. All respondents would recommend the training to others. Conclusions: Clinicians from a range of disciplines, experience and locations accessed and valued the training, and knowledge of, and confidence in delivering care to support healthy pregnancy weight gain improved after completion. So What?: This effective program to build the capacity of clinicians to support healthy pregnancy weight gain offers a model for online, flexible training highly valued by clinicians. Its adoption and promotion could standardise the support provided to women to encourage healthy weight gain during pregnancy. [ABSTRACT FROM AUTHOR]

Australian national, state and territory school‐based drug education policies advise that volatile substance use (VSU) should be excluded from general drug education curriculum for fear of alerting young people to the intoxicating properties of substances such as petrol, sprays and glues. We review evidence from the United States and United Kingdom on the effects of including volatile substances in school‐based drug education, to argue that these policies are due for reconsideration. Nitrous oxide and nitrites are classified as volatile substances along with solvents such as those listed above, although their patterns of use, effects and harms are different. In an era of widespread social media access, more young people than in the past are likely to have heard about VSU. But because VSU is often short‐term, parents and teachers may be unaware when young people in their care consume volatile substances. The general silence about VSU in schools, difficulty in detecting use and the varying sets of risks associated with inhaling different substances mean that young people may be unaware of toxicity or harm reduction strategies when they consume volatiles as drugs. We consider some implementation challenges to be negotiated if VSU education were introduced in Australian schools. [ABSTRACT FROM AUTHOR]

Issue Addressed Methods Results Conclusions So What? Aboriginal and Torres Strait Islander women experience considerable disparities in gynaecological cancer outcomes. Accessible and culturally appropriate health promotion resources about gynaecological cancers may support health literacy in this area. This study aimed to determine the understandability, actionability, readability, and cultural relevance of gynaecological cancer health literacy resources for Aboriginal and Torres Strait Islander consumers, families, and caregivers.We conducted a general Google search and targeted searches of Australian gynaecological cancer organisation websites in January and February 2022. Resources were assessed for understandability, actionability and cultural relevance to Aboriginal and Torres Strait Islander audiences.We found 16 resources. The resources were generally understandable, actionable, readable, and culturally relevant, however, most resources were focused on cervical cancer prevention through vaccination and screening. Few resources focused other gynaecological cancer types or aspects of the cancer care continuum. While many resources contained elements that made them culturally relevant, areas for improvement were identified. These included: greater transparency relating to the Aboriginal and Torres Strait Islander leadership, governance, and involvement in the development of the resources as well as availability of different resource formats with an emphasis on visual aids.This study highlighted a need for the development of resources relating to a wider range of gynaecological cancer types and different stages of the cancer care continuum for Aboriginal and Torres Strait Islander women.The development of a broader range of culturally appropriate gynaecological cancer health literacy resources, ideally developed through co‐design with Aboriginal and Torres Strait Islander peoples, may contribute to addressing the disparities in gynaecological cancer outcomes for Aboriginal and Torres Strait Islander women. [ABSTRACT FROM AUTHOR]

Issued addressed: To assess the impact of a multi‐lingual education video on the healthy eating knowledge of individuals in refugee and newly arrived migrant community groups. Methods: A mixed methods, pre‐ and post‐test study design was used. Participants completed a verbal questionnaire with pictorial answer sheets prior to and immediately after viewing one chapter of a healthy eating video. Qualitative data was obtained through semi‐structured, focus group discussions following the video viewing. Eighty‐six participants were recruited via convenience sampling through refugee community organisations in the Illawarra Shoalhaven, South Western Sydney and Northern Sydney Local Health Districts. Study participants self‐selected to attend Arabic (n = 17), Dari (n = 12), Karen (n = 32) or Tibetan (n = 25) sessions. Results: In 85 participants with pre‐post results, there was a significant improvement in healthy eating knowledge after viewing the video (mean score 61% [SD 23.2] vs 75% [SD 24.2]; [P <.05]). Increased mean scores were observed in all language groups except the Karen‐speaking group. Focus group responses indicated the video improved food literacy, particularly in the areas of food safety, fruit and vegetable consumption, label reading, writing a shopping list and decreasing intake of sugary drinks. Conclusion: The video improved healthy eating knowledge of individuals in refugee and newly‐arrived migrant community groups. So what?: There is potential for these nutrition education resources to inform and educate newly arrived refugees and migrants to Australia about healthy eating practices, however, future research is required to determine their effect on actual behaviour change. [ABSTRACT FROM AUTHOR]

Issue addressed: It is well‐established that health education and promotion programs work best when they have been tailored to meet local contextual needs. In this brief report we describe a health education program and how it identified and incorporated local priorities into its delivery in two remote Aboriginal communities in the "Top End" of the Northern Territory. Methods: During the first visit to each community team members met with local stakeholders and ran an inaugural HealthLAB session. Fieldnotes were taken during or directly after each interaction. At the end of each day team members debriefed regarding their fieldnotes. After both trips had been completed, priority areas were extracted from fieldnotes and synthesised. Results: Although some health priorities were congruent across all groups, Community Members and Childcare staff tended to identify practical solutions while School and Clinic staff were focused on the clinical outcome. Community Members were particularly focused on the wider social and systemic factors impacting health. Conclusion: In response to the need for practical support, HealthLAB modified their health education packages to upskill mothers and sports coaches to provide brief health education sessions to local children and young people. So what?: It is recognised that many health promotion programs focus on individual behaviours without creating supportive environments. While it was out of scope for HealthLAB to address physical environmental factors, by building local capacity and knowledge to deliver health education, the program can contribute to a healthier and supportive social environment. [ABSTRACT FROM AUTHOR]

Issue addressed: The preconception period provides opportunities for health behaviour optimisation for improved maternal and child well‐being. However, preconception information sources women engage with are not well‐known. Methods: To address this gap, the current cross‐sectional study retrospectively explored (1) preconception information or advice accessed on recommended preconception health topics and (2) preferred sources of preconception information amongst pregnant women receiving care through Australian public and private maternity settings. Results: Overall, 78% of women reported accessing any preconception health information, predominantly concerning achieving/maintaining a healthy weight, diet, folic acid and multivitamin supplementation. Preferred information sources included health professionals, e.g. general practitioners (74%) and the internet (66%), although source engagement varied. Conclusions: Whilst women predominantly prefer seeking preconception health information from health professionals and the internet, multi‐modal resources are needed to reach women and enhance engagement with evidence‐based information and healthcare in preparation for pregnancy. So what?: Evaluation of preconception health resources for women and health professionals is warranted, appraising their adequacy in supporting engagement with key preconception health messages. In particular, assessment of the quality, readability and evidence‐base of online resources is needed. Our findings highlight the need for public health experts to take action to raise awareness amongst women of the importance of preconception health, encourage health professional engagement for preconception care and direct women to more appropriate evidence‐based online resources. [ABSTRACT FROM AUTHOR]

Issue addressed: It is well‐established that health education and promotion programs work best when they have been tailored to meet local contextual needs. In this brief report we describe a health education program and how it identified and incorporated local priorities into its delivery in two remote Aboriginal communities in the "Top End" of the Northern Territory. Methods: During the first visit to each community team members met with local stakeholders and ran an inaugural HealthLAB session. Fieldnotes were taken during or directly after each interaction. At the end of each day team members debriefed regarding their fieldnotes. After both trips had been completed, priority areas were extracted from fieldnotes and synthesised. Results: Although some health priorities were congruent across all groups, Community Members and Childcare staff tended to identify practical solutions while School and Clinic staff were focused on the clinical outcome. Community Members were particularly focused on the wider social and systemic factors impacting health. Conclusion: In response to the need for practical support, HealthLAB modified their health education packages to upskill mothers and sports coaches to provide brief health education sessions to local children and young people. So what?: It is recognised that many health promotion programs focus on individual behaviours without creating supportive environments. While it was out of scope for HealthLAB to address physical environmental factors, by building local capacity and knowledge to deliver health education, the program can contribute to a healthier and supportive social environment. [ABSTRACT FROM AUTHOR]

Issue addressed: The preconception period provides opportunities for health behaviour optimisation for improved maternal and child well‐being. However, preconception information sources women engage with are not well‐known. Methods: To address this gap, the current cross‐sectional study retrospectively explored (1) preconception information or advice accessed on recommended preconception health topics and (2) preferred sources of preconception information amongst pregnant women receiving care through Australian public and private maternity settings. Results: Overall, 78% of women reported accessing any preconception health information, predominantly concerning achieving/maintaining a healthy weight, diet, folic acid and multivitamin supplementation. Preferred information sources included health professionals, e.g. general practitioners (74%) and the internet (66%), although source engagement varied. Conclusions: Whilst women predominantly prefer seeking preconception health information from health professionals and the internet, multi‐modal resources are needed to reach women and enhance engagement with evidence‐based information and healthcare in preparation for pregnancy. So what?: Evaluation of preconception health resources for women and health professionals is warranted, appraising their adequacy in supporting engagement with key preconception health messages. In particular, assessment of the quality, readability and evidence‐base of online resources is needed. Our findings highlight the need for public health experts to take action to raise awareness amongst women of the importance of preconception health, encourage health professional engagement for preconception care and direct women to more appropriate evidence‐based online resources. [ABSTRACT FROM AUTHOR]

Issue Addressed: International competencies for health promotion education require ethical practice that is supported by reflexive health promotion practitioners, yet professional bodies do not codify how health promotion curriculum should support students' skill development in reflexive practice. Methods: Reflexivity in teaching and learning was scaffolded through short, progressive reflective blogs assessments, supportive feedback/feedforward mechanisms, and nested assessment design. Results: Student feedback is offered to demonstrate the impact of reflexive pedagogy in health promotion education. Conclusion: Reflexivity in teaching and learning supports students in learning the role of health promotion in planetary health and developing skills in planetary health advocacy. So What: Explicitly teaching the practice and process of critical reflexivity can help students develop personal insight, support professional practice, and promote positive change in the health of people and our planet. [ABSTRACT FROM AUTHOR]

Issue Addressed: The experiential teaching method draws on research-based principles of adult education. The integration of academic learning and practice provides students opportunities to increase their knowledge while developing capabilities to meet the International Union for Health Promotion and Education (IUHPE) Core Competencies and Professional Standards.Methods: Community Health Promotion is a second-year subject offered in the Bachelor of Health Sciences at La Trobe University. The project-based curriculum, delivered over 12 weeks, consists of theoretical material which students apply through hands-on project planning, implementation and evaluation; projects are carried out on campus. To bridge academic content and project practicalities the Victorian government's Integrated Health Promotion Resource Kit is used as a foundational teaching resource. Students are supported by teaching staff and a project sponsor throughout the project cycle. Assessment tasks comprised of problem definition and priority setting, project planning and critical reflection on project implementation.Discussion: The experiential learning approach enables students, in a self-directed yet collaborative manner, to develop skills aligned with health promotion competencies. Students were able to safely "experiment" and apply health promotion theory while actively developing project management and partnerships skills, reflecting on their practice and communicating project findings. Students consistently provide feedback articulating the value they place on the purposeful and scaffolded transition of classroom learning to real-life environments which they recognised as building their competencies and enhancing their employability skills.Conclusion: Experiential learning through small-group projects prepares students for the health promotion workforce in a low-risk, high-impact educational setting while contributing to promoting the ethos of a health-promoting university. SO WHAT?: The authentic assessments provide students with the opportunity to develop competency within several domains of the IUHPE Core Competencies and Professional Standards. [ABSTRACT FROM AUTHOR]

Issue addressed: Insufficient sleep and unhealthy sleep practices in adolescents are associated with significant health risks. Sleep education programs in schools aim to improve sleep behaviour. A new eLearning sleep education program, Healthy Sleep for Healthy Schools (HS4HS), was developed focused on these goals and is distinguishable from other sleep education programs because it is delivered by teachers, making it more sustainable and adaptable for schools. We aimed to evaluate if HS4HS would improve student sleep knowledge, healthy sleep practices, sleep duration and reduce sleepiness. We also aimed to understand if this intervention could be successfully implemented by trained teachers. Methods: Teachers trained in sleep delivered HS4HS to 64 South Australian students in year 9 (aged 13‐14 years) over 6 weeks during regular school curriculum. A sleep education survey assessing sleep patterns (such as healthy sleep practices, time in bed and sleepiness), and a sleep knowledge questionnaire was completed pre‐ and post‐HS4HS delivery. Evaluations were also completed by teachers. Results: Sleep knowledge and healthy sleep practices significantly improved post intervention. Time in bed on both school days and weekends increased slightly and sleepiness decreased slightly, but these changes were not statistically significant. Teachers found the program useful, comprehensive and easy to incorporate into their curricula. Conclusions: After short training, teachers can deliver sleep education during class and improve sleep practices in their students. This suggests that this program may offer potential as an effective and useful resource for teachers wanting to include sleep health in their curriculum. So what?: Sleep is the foundation of good health and teachers can promote and integrate sleep education into their curricula for the first time with this online teacher focussed program, which has the potential to be a sustainable sleep health promotion resource. [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]

Issue addressed: Although government promoted public health, social media and media campaigns have communicated nutrition information, the Australian population remains chronic under‐consumers of fruit and vegetables and overconsumers of ultra‐processed foods. This scoping review aimed to determine how social media influencers (SMI) communicate nutrition information and the factors that influence the popularity of messages. Identified factors could inform how governments may utilise social media to impact positively on food choices. Methods: Nine databases were searched in the past 5 years (2016‐2021). After relevant sources were identified, entire texts of the grey literature and the "Results" sections of the academic literature were coded. Using Microsoft Word, each key feature of the relevant text was highlighted, and the relevant code was recorded. Inductive coding was utilised where codes were created based on the text itself. These codes were then sorted iteratively into relevant themes and subthemes. Results: Eleven studies were included. From these sources, five themes were identified. These were, (i) promoting dietary change, (ii) certain modes/styles of content delivery, (iii) an attractive individual, (iv) language features and (v) appearing connected to the audience. Conclusion: SMI are selective in their content and communication techniques to ensure their nutrition messages are popular with social media users. These methods exhibited by SMI could inform strategies to build trust in government messages about food and nutrition. [ABSTRACT FROM AUTHOR]

Issue addressed: Evaluated the impact of Understanding Multiple Sclerosis (MS) massive open online course, which was intended to increase understanding and awareness about MS, on self‐reported health behaviour change. Methods: Observational cohort study evaluating pre‐ (baseline) and post‐course (8‐10‐week follow‐up) survey data. The main study outcomes were self‐reported health behaviour change, change type and measurable improvement. We also collected participant characteristic data (eg, age, physical activity). We compared participants who reported health behaviour change at follow‐up to those who did not and compared those who improved with those who did not using chi square and t tests. Participant characteristics, change types and change improvement were described descriptively. Results: A total of N = 560 course completers were included in this study. The study cohort included MS community members (eg, people with MS, health care providers) and nonmembers. Two hundred and forty‐seven (44.1%) reported behaviour change in ≥1 area at follow‐up, 160 (64.8%) reported a measurable change and, of these, 109 (68.1%) showed improvement. Participants who reported a change and those who improved had significantly lower precourse health behaviours and characteristics (eg, quality of life, diet quality). The most reported change types were knowledge, exercise/physical activity, diet and care practice. Conclusion: Understanding MS encourages health behaviour change among course completers, primarily through the provision of information and goal‐setting activities and discussions. So what?: An online education intervention can effectively encourage health behaviour change over an 8‐10‐week follow‐up period. Information provision, including both scientific evidence and lived experience, and goal‐setting activities and discussions are the primary mechanisms underpinning that change. [ABSTRACT FROM AUTHOR]

Issue addressed: Australia's ageing population has growing health care needs, challenging timely health service provision. In rural and regional areas, older Australians have poorer health care outcomes and higher rates of potentially preventable hospital (PPH) admissions. The objective of this study was to identify Australian Governmental initiatives designed to reduce PPH of older adults (65 years and over) in rural and regional areas. Methods: An internet search, underpinned by an environmental scan methodology, was utilised to systematically search the websites of Australian government health departments for relevant initiatives. Stakeholder interviews were then conducted to enrich the findings of the environmental scan. Thematic analysis was utilised to analyse all data. Results: We identified 13 initiatives currently in existence in Australia that fulfilled the search criteria. Stakeholder interviews revealed a range of other local interventions in rural communities across the country, driven largely by community need and a lack of health service accessibility. Conclusions: The identified small number of Governmental health initiatives designed to reduce the PPH of older people living in rural and regional Australia may indicate gaps in the provision of services designed to enable older adults to remain at home and avoid subsequent hospital admissions. So what?: A coordinated, systemic approach to health promotion targeting older people in rural and regional areas should be explored, with a focus on collaboration between sectors (including primary care, allied health and prehospital services). [ABSTRACT FROM AUTHOR]

Issue addressed: Skin self‐examination (SSE) empowers individuals to be aware of their skin and to identify and present to a doctor with any suspicious lesions; however evidence‐based, clear guidance for SSE is lacking. Methods: A new acronym entitled SCAN (Sore, Changing, Abnormal, New) was compiled to help laypeople recognise early signs of skin cancer. This study undertook a qualitative investigation on how well laypeople understand SCAN and other commonly used educational tools (ABCDE, AC, and "ugly duckling"), whether they have a preferred SSE tool, and whether pictorial presentations enhance their understanding. Results: Seven focus groups were conducted with 28 participants (age range 19‐78 years), including 6 participants with a previous melanoma diagnosis. Among all the educational tools presented, SCAN was commonly described as the favoured to guide SSE. SCAN was perceived as patient‐oriented due to its simplicity and use of easily understood words, while other tools, although perceived as positive in some aspects, were often identified as complex, difficult to understand and aimed towards clinician use. Pictorial presentations were desired as part of an educational tool; however, many also raised their potential disadvantages. Conclusion: This was the first study to determine the patient perspective of SCAN and established a diverse range of potential quality indicators for SSE educational tools. So what?: The findings of this study suggest that current widely used SSE tools may not be the most effective to promote SSE. SCAN may be preferred, as it simplifies SSE by using lay language and is applicable to all skin cancers. [ABSTRACT FROM AUTHOR]

Issue addressed: To describe the need for high school sleep education from the perspective of undergraduate university students. Methods: Undergraduate students who completed an online course on sleep and circadian health were surveyed 6 months after course completion. Students were asked whether a similar course would have benefited them as high school students, and about the need for sleep education in high schools. Thematic analysis of this qualitative data was carried out. Results: Eighty‐nine students who had attended 71 unique high schools provided responses. Eight‐one per cent thought they would have benefitted from a similar course during high school and identified domains of sleep knowledge particularly relevant to high school students. They cited environmental barriers to healthy sleep present during high school and believed that sleep education could improve students' lifestyle, sleep and performance. Nineteen per cent of students said they would not have benefited, because they perceived sleeping patterns during high school to be nonmodifiable or believed that previous sleep education was sufficient. Of the respondents who did not think students would benefit, 53% would still tell their high school principal that there was a need for sleep education. Conclusions: The findings support the need for engaging sleep education for high school students. Future studies should examine the perspectives of students in high school directly, rather than undergraduate students who have already shown an interest in sleep health. So what?: Sleep health is missing from the Australian school curriculum. Online courses may be an engaging method of promoting sleep and circadian health to high school students. [ABSTRACT FROM AUTHOR]

Issue addressed: Alcohol‐influenced drowning among young Australians (aged 18‐24 years) is a prominent health concern. However, effectiveness of targeted prevention campaigns for this age group is unknown, as this information is not typically published in peer‐reviewed or easily accessed grey literature. Accordingly, future campaigns cannot build on prior efforts to address this health problem. Methods: Semi‐structured interviews ascertained young Australian adults' perspectives on preventing alcohol consumption in aquatic settings, and their awareness of appropriate safety strategies and Australian national and state drowning prevention campaigns. Discussions were transcribed verbatim and thematically analysed using an interpretative phenomenological approach. Results: Twenty‐three individuals (mean age 20.65 years) participated in an interview. Participants had poor understanding of alcohol‐focused drowning prevention campaigns and used logos and names to decipher key campaign messages. Education was recommended as the preferred method for prevention, and participants suggested preferences for delivery (eg social media, in schools, humour and shock tactics). The safety strategies discussed appeared to be transferred from strategies used in other contexts, rather than related to the specific risks of aquatic scenarios. Conclusions: Drowning prevention practitioners should ensure transparency and clarity of their campaign names and logos to enhance understanding of the messages. Practitioners should also consider using audience analysis during campaign design, delivery and evaluation, alongside best practice recommendations from literature, to enhance campaign suitability and effectiveness. So what?: Water safety practitioners and policy makers should acknowledge these findings when developing campaigns which address young adults' lack of awareness of safe aquatic behaviours to encourage a sustained behaviour change. [ABSTRACT FROM AUTHOR]

Issue addressed: To develop, implement and evaluate the impact of a short education intervention on the understanding of dementia through visual art by primary school‐aged children. Methods: A series of three lessons were developed in consultation with a local schoolteacher and community artists and taught in a local primary school. Stage 2 students (8‐10 years old) created an artwork about memory, learned about dementia and adapted their artworks to represent their developing understanding of dementia. Empirical data were collected through pre and postinterventions surveys and content analysis of the artworks. Results: Matched pre and postintervention survey data were obtained for 74 students and showed a significant improvement in seven domains. This indicated that the students had an increased understanding of dementia and its impact on the individual following the intervention. Matched artwork was analysed from lessons 1 and 3 for 109 students using a coding schema developed specifically for this project. The students developed their artwork to show memories fading or being lost altogether. They also used abstract shapes to create a sense of disorder and chaos. Conclusion: Participation in the intervention was shown to increase students' understanding and knowledge of dementia using both qualitative and quantitative measures. So what?: It is likely that by educating children about dementia, we have the potential to reduce the stigma faced by people living with dementia and their carers. This is important, as the ageing population means that more people within the community, including children, will know someone living with dementia. Further, this represents the cornerstone in creating dementia‐friendly communities. [ABSTRACT FROM AUTHOR]

Issue addressed: Reducing drug and alcohol harm is a public health priority and the Australian government has adopted a harm minimisation approach to policy. Understanding the needs of local youth is necessary for the design of relevant prevention and harm reduction services. Methods: Using 5 unstructured focus groups and 10 interviews involving 30 participants recruited from different settings, this study explored youth perspectives around alcohol and other drugs and the psychosocial factors that influence their substance use. Results: Three main themes were identified. First, young people perceived that drugs fell into a hierarchy related to the harm they cause and the stigma associated with use. Second, the importance of validating a young person's experience with using drugs (regardless of where they were placed on their substance‐use trajectory) as a measure to increase the credibility of drug education programs. Third, the significant influence of peers on young people's drug attitudes and behaviours. Conclusions: Drug and alcohol education strategies must be more explicit regarding harm across all drug types, regardless of legal status or perceived social acceptability. Prevention services would benefit from including lived realities from young people's varied and changing experiences with using substances. Peer involvement in the design of preventive strategies (and involvement in participatory research to identify felt needs) is paramount to ensure teachings are grounded in a young person's social context and lived realities. So what?: This study provides information to guide the development of appropriate and authentic drug and alcohol prevention and harm reduction services for young people. [ABSTRACT FROM AUTHOR]

Issues addressed: The new National Cervical Screening Program (NCSP) has recently been implemented. Little research is available on women's attitudes towards the program. This study aims to quantitatively assess Australian women's understanding and attitudes towards the new guidelines and their barriers to screening. Method: Authors designed a cross‐sectional survey which was piloted and distributed as a waiting room survey to eligible women who attended a private general practice in North Queensland. Results: Of the respondents, 53.8% had accurate knowledge of the new NCSP. Most participants (75.8%) believed they were not provided sufficient information about the NCSP and 60.2% wished to receive this information from their general practitioner. The screening test itself remains an issue, with embarrassment and discomfort listed as the most common barriers to screening. Conclusion: Many women do not have accurate knowledge of the new NCSP. Further health promotion in this area is warranted, where the general practitioner may play a key role. So what?: While the new NCSP will lead to further reduction in cervical cancer mortality, it appears from the data that women did not fully understand cervical cancer and its screening. This suggests the need for further health education to women about updated screening guidelines. [ABSTRACT FROM AUTHOR]

Issue addressed: This brief report documents teaching practice that has facilitated deeper connections between Bachelor of Oral Health (BOH) students at The University of Adelaide and community support agencies to promote increased health literacy and confidence to seek care amongst marginalised populations. The aim was to increase the capacity of marginalised groups "to access, understand, appraise and apply information to make effective decisions about health and health care" (Australian Commission on Safety and Quality in Health Care. Hlth Lit; 2014. Available from: https://www.safetyandquality.gov.au/standards/nsqhs‐standards/partnering‐consumers‐standard/health‐literacy. Accessed January 21, 2020). Methods: The health promotion curriculum in the BOH course at The University of Adelaide encourages students to focus on health literacy, equity and partnerships in the development of several small targeted health promotion programs. Students co‐create, implement and evaluate these programs, engaging community groups, supportive partners and industry stakeholders in a range of unique ways. Results: Sustainable relationships have been established and are growing with partner organisations. As these relationships strengthen, so too does the trust, creative licence, innovation and promotion of the students' involvement directly or indirectly with community. That leads to more frequent touch points with community and greater community buy‐in. As familiarity increases, so too does community health literacy and confidence to enter oral health care pathways. Conclusion: Strategically planned activity outside of dental setting has the potential to draw community members and dental service providers together, with the enhancement of health literacy and access amongst at‐risk populations, an important by‐product. So what?: There seems great potential for further benefits to be realised by oral health students and members of the public when there is multi‐stakeholder involvement in co‐created health promotion initiatives, that see students further engage with community outside clinical environments. [ABSTRACT FROM AUTHOR]

Issue addressed: Access to meaningful health information is limited in remote regions of Australia where Indigenous languages and culture are strong but the prevalence of chronic conditions is extremely high. This qualitative study aimed to support and understand the evolution of an educational approach to improve communication about chronic conditions for Yolŋu (Aboriginal people of Northeast Arnhem Land). Methods: Within a culturally responsive research design, data were gathered through participant observation and semi‐structured interviews with educators and community members. An iterative and continuous process of data collection and inductive analysis, exploring key elements of the process as it evolved, supported the Project Team to modify and refine their approach as the project progressed. Results: A high level of community participation and control was a critical element of the project. Collaboration between Yolŋu educators and community experts, with culturally competent support from others, enabled Yolŋu to share health information in ways that could not be achieved by outsiders. Yolŋu and biomedical knowledges were integrated to build and share meaningful, in‐depth (not simplified or directive) oral explanations in local languages using culturally responsive communication processes. The urgent need for ongoing, sufficient and meaningful health education was a consistent and recurring theme in this context where chronic conditions are having a devastating impact. Conclusion: Sustained and equitable access to meaningful information, using a culturally responsive approach led by community educators, is crucial to improve health literacy and to enable genuinely informed decisions in prevention and management of chronic conditions. Long‐term funding is needed to support ongoing programs. These findings may have relevance for others who do not share the culture and language of the majority population. So what?: Equity of access to meaningful health information through sustained support for community‐led education processes is essential to improve First Nations health outcomes. [ABSTRACT FROM AUTHOR]

Issue addressed: Healthy behaviours prior to conception can improve pregnancy outcomes and intergenerational health. Adolescence is an important period to promote preconception health, but education resources need to be age and culturally appropriate. Few studies have addressed preconception awareness and knowledge among Aboriginal and Torres Strait Islander youth, and few culturally appropriate resources exist. Methods: A mixed methods, co‐design process engaging Aboriginal and Torres Strait Islander youth and an Indigenous Reference Group (IRG). Additionally, a survey was carried out to identify preconception health awareness and interest among a broader youth audience. Results: Several main themes emerged from consultation meetings with youth reflecting an awareness of preconception health, but limited understanding. Youth revealed an interest in fertility, and a need for more information on lifestyle factors associated with infertility. Preconception information related to the opposite sex was seen as important as well as information incorporating current local knowledge and world views. Among the survey respondents, 46% (11/24) had a pre‐existing understanding of preconception health. Optimising lifestyle behaviours prior to pregnancy was perceived as important for women (21/24; 88%), but less so for men (16/24; 67%), highlighting a gap in knowledge regarding the importance of preconception health for men. Conclusion: The co‐designed resource "Getting healthy before pregnancy" is available in print and electronically, with illustrations and synchronised audio overlay in Aboriginal English or East‐side Kriol. The resource includes information on preconception health and behavioural risk factors. So what: We present a co‐designed preconception health resource for evaluation with Aboriginal and Torres Strait Islander youth. [ABSTRACT FROM AUTHOR]

Issue addressed: Given the increasing prevalence of cancer, there is a growing need for health interventions educating individuals about the disease and its impacts, risk‐reduction strategies and how to support others who are affected. School‐based programs are a promising medium addressing these issues in adolescents, yet no comprehensive cancer education program exists in Australia. This paper reports on the piloting of a cancer awareness program for Australian students. Methods: When Cancer Comes Along is a 90‐minute interactive presentation covering cancer's impacts, risk‐reduction strategies and how to support those affected. The program was piloted in four Australian secondary schools, with students (N = 113, 13‐16 years) and teachers (N = 2) providing feedback via postprogram survey. Results: Participants reported high satisfaction overall (92%‐97%) and with each program component (71%‐95%), and agreed that the program achieved learning outcomes (72%‐95%). Conclusions: Results indicate that When Cancer Comes Along is relevant, engaging and age‐appropriate. Participants reported improved understanding of cancer, its impacts, risk‐reduction strategies and how to support those affected. A larger‐scale evaluation is underway to more comprehensively evaluate program outcomes. So what?: The program has potential in educating students about various aspects of the cancer experience. It further demonstrates the feasibility and value of addressing psychosocial impacts and support strategies as well as information about cancer risks, elements which have not previously been combined in educational interventions. Equipping adolescents with the knowledge and skills to reduce their cancer risk and support others who are affected has significant health promotion implications for cancer prevention and support provision. Summary: This paper describes the piloting of a cancer awareness program for high school students that addresses what cancer is, its impacts, risk‐reduction strategies and how to support someone affected by cancer. Participating students and teachers indicated high satisfaction, suggesting the program is relevant, age‐appropriate and effective in educating adolescents about cancer. [ABSTRACT FROM AUTHOR]

Issue Addressed: Australia's national cervical screening program has reduced rates of cervical cancer morbidity and mortality. However, these benefits have not been experienced by all women. A Cervical Cancer Screening Project was implemented with lay health educators to address inequitable screening access by women experiencing socio-economic disadvantage.Methods: Resources and a training program were developed and piloted with the specialist homelessness services workforce in Sydney, NSW. Data was collected to inform their development and evaluation through interviews, focus groups, self-administered surveys and analysis of NSW Pap Test Register data.Results: Women reported low familiarity with the term 'cervical screening'. They identified a good patient-doctor relationship, and seeing a female practitioner, as screening enablers. While the majority reported having cervical screening before, NSW Pap Test Register data showed only 74% had screened previously and of those, 69% were overdue. Homelessness service workers expressed interest in talking with clients about cervical screening, and reported increased knowledge and confidence following training.Conclusion: The homelessness sector is an appropriate venue to access women who are disadvantaged and under-screened. However, increasing workforce capacity to discuss screening does not lead to increased screening for women accessing these services. Further efforts are required. SO WHAT?: Access to cervical screening by women experiencing disadvantage remains a challenge. Sustained multi-faceted health promotion efforts are required to increase access. These should be informed by additional research exploring barriers and enablers for this group of women. [ABSTRACT FROM AUTHOR]

Issue Addressed: Overexposure to ultraviolet radiation during childhood is a significant determinant of lifetime skin cancer risk, but can be mitigated through primary schools' adoption of appropriate sun protection policies and practices. The present study aimed to evaluate the changes in these policies and practices in Australia, and to assess the impact of the National SunSmart Schools Program.Methods: A random sample of primary schools were selected in 2011 and 2016 (N = 1577, 1533), and asked to complete a survey describing their current sun protection policies and practices. Significant changes across the study period, and relative to previously reported data from 2005, were identified.Results: Sun protection policies and practices remained relatively stable over the period, although there was a notable decrease in incorporating sun protection material into the curriculum. SunSmart membership was associated with a significantly greater likelihood of several policies and practices being employed. The launch of the SunSmart program in New South Wales was linked with significant improvements to sun protection practices, relative to other states and territories.Conclusion: The National SunSmart Schools program continues to have a substantial impact in supporting the adoption of appropriate sun protection policies and their practical implementation. SO WHAT?: Even small changes to sun protection practices in Australian primary schools can have a major positive impact on long-term health outcomes. SunSmart membership can be leveraged to broaden existing policies and practices, targeting priority areas such as shade provision and the incorporation of sun protection into school curriculum. [ABSTRACT FROM AUTHOR]

Issues Addressed: To establish the views of clinicians on the feasibility and effectiveness of using a novel lifestyle prescription form (LRx) which requires co-signing by clinician and patient and is uniquely based on the design of the standard drug prescription form, in the primary and secondary health care settings.Methods: Thirty-six participants were issued with a "prescription" pad, of 20 LRx scripts, for 1 month and requested to issue an LRx prescription to patients they deemed suitable during their consultation, recording their reason for use of the LRx. Each clinician was then asked to complete a comprehensive feedback questionnaire.Results: Feedback of the LRx was overwhelmingly positive. The script was viewed as a more effective way to convey and support cardiovascular lifestyle advice, than usual care. Forty per cent (196 of 480) of the LRx scripts that were provided to primary and secondary care clinicians during the study period were issued. In most consultations, the LRx script was issued to reaffirm dietary advice. Nurses and health care assistants were more likely than doctors to use the LRx in response to a request for lifestyle advice from a patient.Conclusions: The LRx may be a useful addition to the clinician's communication toolkit to stimulate lifestyle behaviour changes in their patients. The main barrier to use in the study was lack of consultation time. SO WHAT?: Issuing the LRx is a method of solidifying lifestyle advice that clinicians could utilise, providing them with another tool in their behaviour change arsenal, particularly with familiarity with the tool. [ABSTRACT FROM AUTHOR]

Issue Addressed: Early primary school children with diabetes require adult support for insulin therapy and primary school teachers often fulfil this health promotion role. Availability of support is inconsistent across Australia and insulin administration at school is avoided for some children. The aims of the study were to explore the experiences of Australian early primary school teachers who were supporting a student using intensive insulin therapy and to identify facilitators and implications of this support.Method: A qualitative research design using narrative inquiry was utilised. Early primary school teachers (n = 11) from six Australian states/territories and across Government, Catholic and independent schools participated in semi-structured telephone interviews between August 2015 and May 2016. Narrative analysis was used to interpret the interview data.Results: Six narrative threads told a collective story of early primary school teachers' experience of supporting a student using intensive insulin therapy. The factors that facilitated support were: suitable class allocation, a transition process, and diabetes education and diabetes models of care. The implications of providing intensive insulin therapy support were legal considerations and burden of responsibility. The outcome was that all teachers supported intensive insulin therapy.Conclusion: School teachers in this study had a pivotal role in promoting the health of students with type 1 diabetes. This role was often associated with anxiety and the burden of responsibility. Support strategies for teachers include formal diabetes skills training, ongoing assistance from both teacher's aides and Diabetes Educators, and greater understanding of the legal aspects of intensive insulin therapy support. The development of consistent health promotion policy for students with type 1 diabetes across all Australian schools is required. SO WHAT?: Adopting the supportive strategies for teachers identified in this study will further promote the health of early primary school children with type 1 diabetes. [ABSTRACT FROM AUTHOR]

Objective: This qualitative study aimed to explore sun protection barriers and enablers in secondary schools in Victoria.Methods: Five focus groups were conducted with nominated Health or Physical Education (PE) Coordinators (or other staff representatives) from schools in metropolitan and regional Victoria. Discussions were audio-recorded, transcribed and coded thematically.Results: Participants identified the need for regulatory influences that included minimum standards for sun protection policy, training and shade in the built environment. Participants perceived that sun protection is not always acknowledged to be a duty of care in secondary schools. A crowded health and well-being curriculum, a focus on fostering independence, and challenges overcoming peer norms were perceived to be important contextual influences. At an organisational level, strong leadership and a united approach among staff were identified as critical ingredients for successful policy implementation and organisational change. Several potentially effective strategies were proposed, including increased shade, leveraging from student leaders, normalising sun protection practices and prioritising staff role modelling.Conclusions: A cultural shift is required for many schools to accept and act on sun protection as a duty of care. A comprehensive approach that includes regulatory action, healthy school policies and leading by example may help protect students and staff from harmful UV exposure during school hours. SO WHAT?: Without regulatory support, strong leadership is required to implement and enforce sun protection practices within schools. Health promotion programs could assist schools to trial and evaluate the sun protection strategies that involve student-led solutions, role modelling and increasing shade. [ABSTRACT FROM AUTHOR]

Issue Addressed: Evidence suggests that participation in a Chronic Disease Self-Management (CDSM) program improves the health of clients. Many factors are known to influence participation in these programs for the broader Australian population. However, less is known about why Aboriginal and Torres Strait Islanders choose to participate. This study identifies key factors that support or enable Aboriginal and Torres Strait Islanders to participate in a CDSM program in an urban setting.Methods: Twelve focus groups were undertaken with a total of 102 participants who were diagnosed with or at risk of chronic disease. These participants were recruited from the Work It Out program, a CDSM program comprising exercise and health education. The Work It Out program is specifically designed for Aboriginal and Torres Strait Islanders and delivered by an Aboriginal led and community-controlled organisation in South-East and Central Queensland. The study received ethical clearance through the Behavioural and Social Sciences Ethical Review Committee at The University of Queensland (Approval Number 2011001283).Results: Findings indicate that key features of program design based on a culturally responsive approach influences participation. The main features are as follows: providing easy access to the program; permitting flexibility in attendance; a group environment; the approach of program staff that prioritises relationship building; personalised and integrated care; communicating result regularly; and ensuring community ownership of the program.Conclusion: These findings are useful to consider when designing a health program for Aboriginal and Torres Strait Islanders. Programs which are culturally responsive and include the design features identified in this study are more likely to increase participation amongst Aboriginal and Torres Strait Islanders. SO WHAT?: Increasing participation of Aboriginal and Torres Strait Islanders in CDSM programs using the design features identified in the paper may contribute significantly in closing the health disparity gap. [ABSTRACT FROM AUTHOR]

Issue Addressed: Tobacco is a major risk factor contributing to Indigenous health disparities. Art may be a powerful and transformative tool to enable health providers to develop targeted messages for tobacco control.Methods: Indigenous and non-Indigenous staff, working in Indigenous tobacco control, attended a 2-hour workshop, and were led through a process to create individual artworks. Participants completed surveys before and after the workshop. Scales compared understandings of how art can be used in tobacco control, and the likelihood of utilising arts in future programs. Three pairs of Indigenous and non-Indigenous researchers analysed the artworks, using the Four Frames (New South Wales Board of Studies), explored themes, and developed a model.Results: Nineteen participants completed both surveys; 17 artworks were analysed. Pre- to post-workshop increases in "understanding" about the use of arts (P < 0.00001) for tobacco control, and "likelihood" of use of arts in the next 6 months (P < 0.006) were significant. Participants expressed personal and professional benefits from the workshop. Artworks demonstrated themes of optimism, the strength of family and culture, smoking as a barrier, resilience, recovery and urgency.Conclusions: The workshop increased the understanding and likelihood of using the arts for tobacco control. Artworks revealed contemporary challenges impacting on equity; health staff expressed optimism for being engaged in their work. SO WHAT?: The Framework Convention for Tobacco Control supports novel techniques to increase the reach and relevance of health messages for diverse populations. This study successfully demonstrated how a novel, positively framed art-based technique proved to be advantageous for health professionals, working in an area of Indigenous tobacco control, where behavioural change can be complex. [ABSTRACT FROM AUTHOR]

Issue Addressed: The recommended first aid for burns, consisting of 20 minutes of cool running water (CRW) delivered within three hours of the injury, offers a simple yet effective means of improving health outcomes. The aim of this study was to determine patient and injury characteristics associated with inadequate CRW therapy among children with thermal burns, with the goal of identifying populations at greatest risk of undertreatment.Methods: A cross-sectional study was performed on children treated at a large tertiary paediatric burns centre. First aid was evaluated as either "adequate" or "inadequate", and then descriptive analyses were conducted to examine differences between the groups in age, ethnicity, location and socioeconomic status, among others.Results: From 2013 to 2016, the families of 2522 patients were interviewed. Overall, 31.3% of children received adequate CRW at the scene of the injury. Provision of adequate CRW did not significantly differ with sex, ethnicity or nationality. Factors that were associated with inadequate first aid included very young age and early adolescence (P < 0.001), rural or remote location (P = 0.045), low socioeconomic status (P = 0.030), radiant heat and flame burns (P < 0.001), as well as burns occurring at recreational sites, on farm/trade/industrial properties and in the street (P = 0.001).Conclusions: Although most burns occurred in close proximity to sources of CRW, first aid was poor across all demographics. The highest levels of undertreatment were found in children aged 0-2, adolescents aged 15-16, those living rurally or remotely, and the socioeconomically disadvantaged. SO WHAT?: The study highlights the need for improved public education of first aid for burn injuries. [ABSTRACT FROM AUTHOR]

Issue Addressed: Fall injuries among people aged 65 years and over (older people) cause substantial health decline and cost to the health system. In 2009 in New South Wales, 25.6% of older people fell in the previous year, and 10.7% (32 000) were hospitalised. Pharmacists are trusted professionals, who interact extensively with older people and have potential to augment fall prevention in pharmacies. This brief report describes how professional development improved pharmacist's knowledge and confidence in fall prevention, encouraged implementation of fall prevention plans and facilitated the provision of brief fall prevention interventions for older clients, after identification of fall risk.Methods: In 2014, pharmacists from all Central Coast pharmacies (n = 76) were invited to free, continuing professional development (CPD) in fall prevention. It provided education and resources to identify clients' fall risk, conduct brief fall prevention interventions and implement fall prevention health promotion plans (FPHPP). Pharmacists completed written: Baseline and postworkshop questionnaires to assess changes in pharmacist's knowledge and confidence, and existing fall prevention in pharmacies. Logs of client fall risk and brief fall prevention interventions offered to clients. Four-month follow-up questionnaires to assess implementation of FPHPPs and pharmacy practice changes.Results: Pharmacists representing 36% of pharmacies participated. At four-month follow-up, 67% had implemented FPHPPs, and 62% delivered brief interventions determined by client fall risk.Conclusion: Fall prevention in pharmacies can be augmented through locally provided CPD tailored for pharmacists. SO WHAT?: This model could increase fall prevention reach. It is transferable to settings where health professionals provide services to older adults and require reregistration through professional development. [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: Smartphone apps have emerged as a mode for provision of information to women during pregnancy. More apps are available for pregnancy than for any other medical topic. This review aimed to assess the quality of Android pregnancy apps, including pregnancy‐specific nutrition information. Methods: A keyword search was conducted in the Google Play Store followed by the screening of app title, app store description and the downloaded app. To be included, apps needed to be free, in English, aimed at pregnant women and contain nutrition information. App quality was assessed using the Mobile Application Rating Scale (MARS) and the presence of nutrition topics was reported. Results: A total of 76 apps were included in the analysis. Mean overall MARS quality score was 3.52 (max 5; SD: 0.58) ("1" = inadequate and "5" = excellent). The functionality subscale scored the highest (mean 4.06) and information scored the lowest (mean 3.23). The median number of pregnancy‐specific nutrition topics per app was four (range: 0‐6), with the most common related to caffeine consumption (n = 55, 72% of apps) and fish intake (n = 53, 69%), although the quality and quantity of nutrition information varied greatly between apps. Conclusions: Although there are a large number of pregnancy apps available, few are of high quality and most contain only a small number of pregnancy‐focused nutrition topics. It is important to be aware of the limitations of current apps in providing dietary advice during this key life stage. So what?: The current review does not support the use of freely available android apps currently on the market as an appropriate nutrition resource for pregnant women. [ABSTRACT FROM AUTHOR]

Issue Addressed: Building the health promotion evaluation capacity of a workforce requires more than a focus on individual skills and confidence. We must also consider the organisational systems and supports that enable staff to embed learnings into practice. This paper describes the processes used to build health promotion evaluation capacity of staff in an Aboriginal Community Controlled Health Service (ACCHS).Methods: To build health promotion evaluation capacity three approaches were used: (i) workshops and mentoring; (ii) strengthening systems to support program reporting; and (iii) recruitment of staff with skills and experience. Pre- and post-questionnaires determined levels of individual skills and confidence, updated systems were assessed for adequacy to support new health promotion practices and surveys captured the usefulness of workshops and mentoring.Results: There was increased participant skills and confidence. Participants completed program impact evaluation reports and results were successfully presented at national conferences. The health promotion team was then able to update in-house systems to support new health promotion practices. Ongoing collaboration with experienced in-house researchers provided basic research training and professional mentoring.Conclusions: Building health promotion evaluation capacity of staff in an ACCHS can be achieved by providing individual skill development, strengthening organisational systems and utilising professional support. SO WHAT?: Health promotion practitioners have an ongoing professional obligation to improve the quality of routine practice and embrace new initiatives. This report outlines a process of building evaluation capacity that promotes quality reporting of program impacts and outcomes, reflects on ways to enhance program strengths, and communicates these findings internally and to outside professional bodies. This is particularly significant for ACCHSs responsible for addressing the high burden of preventable disease in Aboriginal and Torres Strait Islander populations. [ABSTRACT FROM AUTHOR]

Issue Addressed: Health information can be easily and cheaply provided through the Internet. However, we do not know whether older adults, those people most likely to be living with a chronic disease, are online or whether they use the Internet to find health information.Methods: In order to establish the proportion of older Australians online, the impact of their current health status and chronic disease diagnosis on Internet usage and whether they use the Internet to search for health information, a paper-based survey was developed and mailed to 9000 older adults, resident in New South Wales, Australia (response rate = 46.8% ).Results: Results showed that many older Australians are online (52.3%) and that the majority who are use the Internet to find health information (68.5%). Respondents were more likely to use the Internet if they reported good health. The presence of most chronic diseases reduced use of the Internet; however, this was not the case for those reporting asthma, anxiety or sleep apnoea. Internet use decreased as the number of reported co-morbidities increased. However, once online, self-perceived overall health and number of chronic diseases did not affect use of the Internet to find health information.Conclusions: This study is important as there is currently little information available about Internet use for health information by older Australians. Findings show that the provision of health information online has the potential to reinforce existing barriers created by the social determinants of health. SO WHAT?: There is a role for the Internet in providing preventative, health promotion information, to older adults, who are already online and younger, computer literate audiences. However, practitioners need to consider the fact that this mode of delivery reinforces existing social divides; requires people to have Internet access and be both literate and e-literate. [ABSTRACT FROM AUTHOR]

Issue Addressed: Research suggests that young Indigenous people want carers to take a more active role in discussions about sexual health. The aim of this study was to ascertain carers' perspectives of: the importance of providing young people with information about sex and sexual health; what they want young people to know about sex and sexual health; and facilitators and barriers to discussing sex and sexual health with youth.Methods: Thirteen focus groups and three interviews were conducted with 81 carers in four rural and urban regions of Western Australia. Data were coded using a thematic approach, analysed using inductive Framework Analysis, and interpreted using the Aboriginal Family Wellbeing Model of Empowerment.Results: Many participants recognised the need for talking with young people about sex, and said they drew upon resources such as books, pamphlets and television and used humour to impart lessons. However, a large proportion of participants reported difficulties in educating youth about sex. Participants noted that colonisation had disrupted traditional structures for educating young people, and that sex was a challenging topic. The forced removal of children had interfered with Indigenous family structures and deprived some participants of the opportunity to acquire knowledge and skills from their own parents.Conclusions: Our findings emphasise the potential role of culture and empowerment in further improving outcomes related to relationships and sexual health. There is a need for more research into models of culturally-empowering, family-centred strategies for improving the sexual literacy of Indigenous youth. [ABSTRACT FROM AUTHOR]

Issue Addressed: Foetal Alcohol Spectrum Disorder (FASD) includes a range of life-long impairments caused by alcohol exposure in utero. Health professionals are vital to preventing FASD but many are hesitant to discuss FASD with clients due to their need for additional resources to aid the conversation. This scan sought to identify the scope and gaps in publicly available FASD prevention and health promotion resources, and assess their cultural appropriateness for use among five key groups of Indigenous Australian people including: (i) pregnant women, (ii) women of childbearing age, (iii) grandmothers and aunties, (iv) men, and (v) health professionals.Methods: Relevant resources published 1995-2017 were identified through the Australian Indigenous HealthInfoNet, FASD organisation websites, grey literature, Google searches, and field experts. Results were screened by inclusion and cultural appropriateness criteria developed and piloted by the research team, and further screened by health professionals attending FASD training workshops.Results: 115 of the 2146 identified resources were eligible. Relevant resources were found for all five key groups; however, no resources were specifically designed for men, grandmothers or aunties.Conclusions: A range of high-quality, culturally appropriate resources were identified, however, health professionals attending the training workshops were not aware of their availability. Further resource development is suggested for men, grandmothers and aunties. SO WHAT?: Prioritisation of active dissemination and implementation strategies is suggested to increase awareness and use of future resource developments. The inclusion of a resource trial among health professionals is a recommended strategy to increase awareness and use of newly developed resources. [ABSTRACT FROM AUTHOR]

Issue Addressed: Social marketing (SM) campaigns can be a powerful disease prevention and health promotion strategy but health-related campaigns may simply focus on the "promotions" communication activities and exclude other key characteristics of the SM approach. This paper describes the application of a checklist for identifying which lifestyle-related chronic disease prevention campaigns reported as SM actually represent key SM principles and practice.Methods: A checklist of SM criteria was developed, reviewed and refined by SM and mass media campaign experts. Papers identified in searches for "social marketing" and "mass media" for obesity, diet and physical activity campaigns in the health literature were classified using the checklist.Results: Using the checklist, 66.6% of papers identified in the "SM" search and 39% of papers identified from the "mass media" search were classified as SM campaigns. Inter-rater agreement for classification using the abstract only was 92.1%.Conclusions: Health-related campaigns that self-identify as "social marketing" or "mass media" may not include the key characteristics of a SM approach. Published literature can provide useful guidance for developing and evaluating health-related SM campaigns, but health promotion professionals need to be able to identify what actually comprises SM in practice. SO WHAT?: SM could be a valuable strategy in comprehensive health promotion interventions, but it is often difficult for non-experts to identify published campaigns that represent a true SM approach. This paper describes the application of a checklist to assist policy makers and practitioners in appraising evidence from campaigns reflecting actual SM in practice. The checklist could also guide reporting on SM campaigns. [ABSTRACT FROM AUTHOR]

Issue Addressed: Individuals who are knowledgeable about nutrition are more likely to eat healthily. Yet, few studies have investigated levels of nutrition knowledge using a validated tool. The present study measured nutrition knowledge using the Re-examined General Nutrition Knowledge Questionnaire (R-GNKQ) to confirm influencing demographic characteristics.Methods: Adults aged 18-60 years were recruited. Nutrition knowledge was assessed using the R-GNKQ, examining four domains (dietary guidelines, sources of nutrients, choosing everyday foods, and diet-disease relationships) with 96 questions.Results: Of 606 respondents (mean age 38.8 ± 11.8 years), 506 completed all questions. R-GNKQ score was positively associated with education (p<0.001) and age (p<0.001). Those with the highest education levels scored higher across 89% of the R-GNKQ and the oldest (≥50 years) respondents scored higher than younger respondents. Other characteristics that were associated with higher levels of knowledge were being female, and having a healthy BMI. Lowest knowledge pertained to questions about diet-disease relationships and fatty acids in foods.Conclusions: The majority of individuals had a good understanding about the Australian Dietary Guidelines, however the health benefits of adhering to the dietary guidelines was less well understood. Gaps in knowledge pertained to the specific details of how to adhere to the guidelines, particularly knowledge about the types of beneficial fats and their everyday food sources. SO WHAT?: Those with lower educational attainment, younger, males and those with higher BMI's would benefit from nutrition communications that identify foods with beneficial fatty acids to assist with adherence to the Australian Dietary Guidelines. [ABSTRACT FROM AUTHOR]

Issue Addressed: Young people have a high burden of sexual and reproductive health (SRH) problems, and it is important to reach this group through health promotion initiatives. We conducted a systematic review of reviews to identify successful elements of health promotion programs for improving SRH of young people.Methods: We identified and collated systematic reviews published in 2005-2015 which focused on young people (10-24 years), reported on SRH outcomes (pregnancy, sexually transmissible infections, condoms/contraceptive use, risky sexual behaviour, sexual healthcare access or intimate partner violence), and included primary studies predominantly conducted in high-income countries. This report focuses on features of successful SRH programs identified in the interpretation and discussion of included systematic reviews.Results: We identified 66 systematic reviews, of which 37 reported on program features which were anecdotally or statistically associated with improved program effectiveness and success. Common features of effective interventions were: longer term or repeated implementation; multi-setting and multi-component; parental involvement; culturally/gender/age appropriate; and inclusion of skills-building. SO WHAT?: There is marked consistency of features improving SRH program effectiveness for young people despite the wide variation in interventions reviewed. There is a need to better implement this knowledge in future programs, and our findings provide useful guidance for optimising the design of SRH interventions for young people. [ABSTRACT FROM AUTHOR]

Issue addressed Identification of the factors that facilitate nurses to provide smoking cessation advice to hospitalised patients. Method Six semistructured focus groups with 26 nurses were conducted in June 2015. Participants completed a structured survey to collect patient demographic data and assess attitudes towards their role in addressing smoking cessation among inpatients. Results Important themes that emerged from the qualitative data were: nurses' negative perceptions of smokers, nurses' confidence in their knowledge of smoking cessation care and nurses' uncertainty around whose role it is to provide smoking cessation care. Conclusion Nurses require training in order to confidently and competently address smoking among inpatients as part of routine care. Formal ways to document the smoking status of inpatients and the offer of smoking cessation support from a nurse to an inpatient would enhance the communication between nurses around which inpatients had been asked about their smoking status and which had not. For patients who are resistant to conventional cessation strategies, innovative ways are needed to reduce the harm caused to them by tobacco use. So what? Nurses need to be provided with education and training around smoking cessation to increase their confidence and skills to provide smoking cessation care to inpatients. [ABSTRACT FROM AUTHOR]

Issue addressed Workplaces are promising settings for health promotion, yet employee participation in workplace health promotion (WHP) activities is often low or variable. This study explored facilitating factors and barriers associated with participation in WHP activities that formed part of a comprehensive WHP initiative run within the Tasmanian State Service (TSS) between 2009 and 2013. Methods TSS employee (n=3228) completed surveys in 2013. Data included sociodemographic characteristics, employee-perceived availability of WHP activities, employee-reported participation in WHP activities, and facilitators and barriers to participation. Ordinal log-link regression was used in cross-sectional analyses. Results Significant associations were found for all facilitating factors and participation. Respondents who felt their organisation placed a high priority on WHP, who believed that management supported participation or that the activities could improve their health were more likely to participate. Time- and health-related barriers were associated with participation in fewer activities. All associations were independent of age, sex, work schedule and employee-perceived availability of programs. Part-time and shift-work patterns, and location of activities were additionally identified barriers. Conclusion Facilitating factors relating to implementation, peer and environmental support, were associated with participation in more types of activities, time- and health-related barriers were associated with less participation. So what? Large and diverse organisations should ensure WHP efforts have manager support and adopt flexible approaches to maximise employee engagement. [ABSTRACT FROM AUTHOR]