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Objective: To quantify the prevalence of known health‐related risk factors for severe COVID‐19 illness among Aboriginal and Torres Strait Islander adults, and their relationship with social determinants. Methods: Weighted cross‐sectional analysis of the 2018‐19 National Aboriginal and Torres Strait Islander Health Survey; Odds Ratios for cumulative risk count category (0, 1, or ≥2 health‐related risk factors) by social factors calculated using ordered logistic regression. Results: Of the adult population, 42.9%(95%CI:40.6,45.2) had none of the examined health‐related risk factors; 38.9%(36.6,41.1) had 1, and 18.2%(16.7,19.7) had ≥2. Adults experiencing relative advantage across social indicators had significantly lower cumulative risk counts, with 30‐70% lower odds of being in a higher risk category. Conclusions: Aboriginal and Torres Strait Islander peoples must continue to be recognised as a priority population in all stages of pandemic preparedness and response as they have disproportionate exposure to social factors associated with risk of severe COVID‐19 illness. Indigeneity itself is not a ‘risk’ factor and must be viewed in the wider context of inequities that impact health Implications for public health: Multi‐sectoral responses are required to improve health during and after the COVID‐19 pandemic that: enable self‐determination; improve incomes, safety, food security and culturally‐safe healthcare; and address discrimination and trauma.

Background The Interpersonal-Psychological Theory of Suicide (IPTS) aims to elucidate the key antecedents of suicide deaths. Limited research has tested the IPTS in a community setting, and very little longitudinal research has been conducted. The current study longitudinally tested the predictions of the IPTS for suicidal ideation in a large population-based sample. Methods The PATH through Life study assesses three age cohorts (20's, 40's, 60's) every four years. Two interpersonal factors were estimated at the third wave of assessment: thwarted belongingness (TB) and perceived burdensomeness (PB). The roles of these factors in suicide ideation (active and passive) four years later were estimated using logistic regression models (n = 4545). Results A one SD increase in TB was associated with increased odds of 37% for passive ideation and 24% for active ideation. For PB, odds were increased 2.5-fold for passive ideation and 2.4-fold for active ideation. A significant negative PB × TB interaction was found for passive but not active ideation. Effects were not consistent by age group or gender. Limitations Proxy measures were used to assess the constructs. The extended timeframe and low prevalence of suicidal ideation limited power to find effects within subgroups. Conclusions Although TB and PB were individually associated with suicidal thoughts, little evidence was found for the key predictions of the IPTS longitudinally. Further investigation of the dynamic interplay between interpersonal factors over time is needed.

Background Depression and anxiety interfere with an individual's quality of life and result in substantial economic costs to the workplace through lost productivity. The internet offers an unparalleled opportunity for the large scale, cost-effective delivery of mental health awareness and destigmatisation programs in the workplace. However, to date high quality assessments of the effectiveness of such workplace programs have been confined to health professional settings. The current study reports the effectiveness of Mental Health Guru (MH-Guru), a two-module online mental health workplace induction program. Methods A total of 507 employees from a large multi-departmental government workplace were randomised to a 2-week online depression and anxiety educational program (Mental Health Guru; MH-Guru), or a Wait List Control condition. Participants completed online surveys at baseline, 1 week post-intervention and at 6-month follow-up. Primary outcome measures included depression and anxiety literacy, personal stigma about depression and anxiety, and help seeking intentions for anxiety and depression at post-test. Secondary measures included help-seeking attitudes and self-reported help seeking behaviour. Satisfaction measures were also collected. Results Dropout at post intervention was 26.7% and 21.0% for the MH-Guru and Control conditions respectively. Relative to Control, MH-Guru participants showed significantly greater improvements in depression and anxiety literacy at post intervention. Between group standardized effect sizes at post-test and 6-months were 0.78 and 0.81 for depression literacy and 0.80 and 0.79 for anxiety literacy. Compared to the Control participants, the MH-Guru group also showed significantly greater reductions in depression and anxiety personal stigma. Between group effect sizes in stigma for depression were − 0.56 and − 0.47 at post-test and 6-months respectively and − 0.42 at both time points for anxiety. The MH-Guru intervention was not associated with a differentially greater increase in anxiety or depression help-seeking intentions or improvement in help seeking attitudes compared to the Control group. However, self-reported help-seeking behaviour was significantly greater in the MH-Guru group at post-test. In addition, the MH-Guru group showed greater intentions to seek help for depression from the Internet at 6-month follow-up. Satisfaction items suggested that the program was acceptable to employees. Conclusions Brief online programs such as MH-Guru have the potential to play an important role in increasing mental health awareness and decreasing stigmatizing attitudes in the workplace, and by extension the general community., Highlights • First RCT in the workplace to demonstrate the effectiveness of an online intervention for anxiety and depression in staff without health credentials. • The intervention (MH-Guru) was associated with reductions in stigma and improvements in literacy for depression and anxiety, sustained over 6 months. • Intentions to seek help from the Internet were greater at 6 months among those receiving the workplace intervention.

Summary Reflection has long been used as a developmental tool within nursing education, however the benefits of structured reflection for qualified nurses does not receive the same emphasis within clinical practice despite its well documented benefit in terms of professional development. The aim of this paper is to examine a specific clinical experience through the process of structured reflection to demonstrate that nurses can learn through the process of reflection and re-evaluate their perception of expert care. It was found that many nurses do not consider themselves to be expert in the areas in which they work; however, the use of structured reflection can assist nurses to identify areas of practice in which they operate in an expert manner and therefore enable themselves and others to value their work as expert professionals.