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In regional Australia "communities of place," defined as bounded geographic locations with a local society, undertake community-wide primary prevention programs. In helping to prevent chronic illness, communities provide valuable resources to the health system. To understand the role of community-health sector partnerships for primary prevention and the community contextual factors that affect them, we studied eight partnerships. We used an embedded multiple case study design and collected data through interviews, nonparticipant observation, and document analysis. These data were analyzed using a typology of community-health sector partnerships and community interaction theory to frame the key community contextual factors that affected partnerships. The dominant factor affecting all partnerships was the presence of a collective commitment that communities brought to making the community a better place through developing health. We call this a communitarian approach. Additional research to investigate factors influencing a communitarian approach and the role it plays in partnerships is required.

Community-based organizations hold an increasingly central role in the representation and advocacy of marginalized groups and individuals. In these capacities, such organizations make significant contributions to the areas of health and health services. In particular, they are considered well-positioned to operationalize 'bottom-up' approaches to health promotion. In this article we use a case study to illuminate unforeseen consequences of government funding of community-based organizations involved in health promotion and health service work. Previous research has found that many health promotion practitioners are engaged in a shift towards 'bottom-up' approaches to health promotion (1). In contrast, our findings suggest that due to government funding, those best positioned to promote community participation and empowerment may be experiencing a converse shift away from 'bottom-up' approaches.

The concepts of community participation, empowerment and capacity building are central tenets of contemporary health promotion theory. They reflect the view that health and well-being are shaped by a wide range of social, economic, political and organisational forces that are outside the control of individuals.Despite its theoretical appeal, the practice of Community Empowerment is ethically contentious and can produce ethical dilemmas for health promotion practitioners. In this paper we relate these dilemmas to theoretical considerations, and argue that the empowerment of communities should be understood as a means rather than an end . This leads us to argue for the adoption of what we call a Reflective Equilibrium Community Empowerment approach, which draws on both "top-down" and "bottom-up" methods to help resolve the ethical tensions in health promotion programmes.

Introduction: Internationally, cultural factors are associated with vaccine uptake and completion in ethnic minority communities. Whilst Australia has achieved high human papillomavirus (HPV) vaccination, little is known about how culture or ethnicity influences HPV vaccination engagement. To address these gaps, we partnered with our Local Health District to explore how one culturally and linguistically diverse (CALD) community engages with school and HPV vaccination. Methods: We adapted a participatory research method (the World Café) to engage one local CALD community—the Macedonian community (Our bi‐cultural researcher and participants preferred the term 'Macedonia' rather than The Republic of North Macedonia as outlined in the 2018 Prespa agreement) in New South Wales (Australia)—to discuss HPV and school vaccination. Our qualitative analysis combined deductive codes taken from the Tailoring Immunization Programme framework, inductive codes guided by narrative inquiry (temporality, sociality and place) and previously known vaccination 'trust' frameworks. Results: In late 2019, 31 local Macedonian community members were purposely recruited for two World Cafés (n = 15 mothers/grandmothers and n = 16 young adults). Our themes reveal a community narrative grounded in historical vaccine experiences, family views on vaccination and a general trust in schools. Participants collectively discussed how 'increasing knowledge' and 'tailoring health communications' could strengthen community vaccine decision‐making. Conclusion: This study demonstrates how research partnerships and participatory methods can be applied in CALD community settings to research engagement with school and HPV vaccination. Our World Café dialogues highlight a positive narrative about vaccines, where community vaccination behaviours were built on multilayer trust relationships despite low vaccine knowledge. Our findings further knowledge around 'public trust' in school vaccination, highlighting the importance of existing (or missing) trust relationships when tailoring vaccine communication to local CALD communities. Patient or Public Contribution: Participants who took part in the World Cafes were all local Macedonian community parents or young adults who have been or will be exposed to the health services offered by school‐based HPV vaccination. Thus, all the data collected came from their personal experiences with the school vaccination programme, or how they expect to participate in the programme. To ensure our study design was culturally appropriate and tailored to the Macedonian community, we engaged with the relevant local health stakeholders (the bi‐cultural Multicultural Health Officer and Multicultural Health Service Manager Programme Director) to adapt and refine the World Café method for this context and setting. Our local health stakeholders also reviewed our preliminary findings, assisted with data interpretation and participated in manuscript editing. [ABSTRACT FROM AUTHOR]

Issue Addressed: Sugar-sweetened beverages (SSB) are the leading source of free sugars in Australian children's and adults' diets. This study explores drivers of consumption among parents and young adults to inform interventions.Methods: Eight focus groups (n = 59) stratified by gender, age/life stage and SES were analysed thematically.Results: Daily SSB consumption was normalised. Participants drank SSBs to avoid perceived energy/sugar deficits, to treat themselves and as a function of familial influence. Frequent consumption was considered acceptable if "in moderation" and/or "balanced" with exercise/diet; however, there was a large disconnect between this language of moderation and actual consumption practices. Participants acknowledged that social norms had changed over time. There was little evidence of accurate knowledge of sugar content for any beverage type. Participants relied heavily on packaging and labelling, much of which conveyed a health halo effect. While participants could list health effects of excess consumption, they were considered long-term or of low personal relevance. Awareness of health recommendations was low.Conclusions: Consumers' adoption and use of concepts such as "treat," "moderation" and "balance" reflect both food and beverage industry marketing and public health messaging. However, the disconnect between this language and knowledge and consumption practices is problematic. SO WHAT?: SSB consumption is very high with serious implications for health. Curbing consumption among young adults and parents has potential to change the health trajectories for current and future generations. There is a clear need to increase health literacy around SSB consumption. Simple consumption guidelines, clearer sugar content labelling and health warnings offer potential. [ABSTRACT FROM AUTHOR]

Reducing population consumption of sugar-containing beverages has become a public health priority in many countries due to causal evidence between high consumption, weight gain and non-communicable diseases. This study aims to explore how sugar-containing beverages are associated with health and wellness in television advertisements. Our sample consisted of all televised advertisements from sugar-containing beverage manufacturers aired on free-to-air television from one Australian network (four channels) in 2016 (n  = 30 unique advertisements). We transcribed advertisements for audio and visual information. We analysed data inductively using methods from thematic, discourse and multi-modal analysis. Advertisements for sugar-containing beverages reflected both traditional (physical health and reduced risk of disease) and broader (wellbeing) conceptualizations of health. Beverages were positioned in advertisements as contributing a functional role to promote and enhance health and wellbeing within the physical, mental and social domains. Beverages were advertised as correcting suboptimal states of being to achieve desirable outcomes, including relaxation, increased resistance to disease, enhanced performance, better cognitive functioning and improved social connections. Positioning beverages within a wider conceptualization of health and wellbeing aligns with how health and nutrition are increasingly being understood and sought out by consumers, creating increased opportunities for the marketing of sugar-containing beverages as 'healthy'. [ABSTRACT FROM AUTHOR]

Understanding the processes and the factors influencing intersectoral collaboration is vital for the ongoing success of programmes that rely on effective partnerships between sectors, such as the school-based immunization programme, the school dental health programme and health promotion interventions delivered in school settings. We studied school-based health programmes delivered by partnerships between health, education and the local government sectors. We used purposive sampling to identify 19 people working in school-based health programmes and interviewed them about the barriers and enablers of successful collaboration. Data were analysed thematically. We found that collaboration between complex systems was a skilled endeavour which relied on a strong foundation of communication and interpersonal professional relationships. Understanding the core business, operational context and intersectoral point-of-view of collaborative partners was important both for establishing good intersectoral programmes and sustaining them as contexts and personnel changed. Aligning divergent sectoral agendas early in the collaborative processwas essential for ensuring that all partners could meet their core business needs while also delivering the programme outcomes. [ABSTRACT FROM AUTHOR]

The Australian health system requires novel strategies to implement widespread primary prevention to reduce the burden of chronic illness. One approach is for health sectors to draw on resources available in communities of place and to form partnerships which maximize the relevance and uptake of initiatives designed to promote healthy lifestyles. This article presents a typology of conceptual approaches to community and health sector partnerships, developed through an extensive literature search and empirically tested using in-depth case studies across regional Australia. The article finds that the health sector’s orientation to primary prevention is generally instrumental involving highly targeted outcomes and pre-defined programmes. Communities of place have multifaceted priorities that include building the social and economic sustainability of their community. While these approaches might appear incompatible, careful ‘manipulation’ and ‘massaging’ of instrumental objectives to adjust to community agendas and the presence of ‘boundary crossers’ can lead to successful primary prevention outcomes. [ABSTRACT FROM AUTHOR]