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This review was commissioned by the Department of Health WA as part of the development process for the fourth WA Aboriginal sexual health and blood-borne virus (SHBBV) strategy (2019–2023). This strategy aims to prevent and reduce rates of infection in Australian communities.This review has followed the structure of the third strategy, analysing the data through each domain: prevention and education; testing and diagnosis; disease management and clinical care; workforce development; enabling environments, and; research, evaluation, and surveillance. The review aims to provide a broad overview of evidence on the way SHBBV health promotion, care, and research are negotiated with Aboriginal populations across three countries: Aotearoa/ New Zealand, Australia, and Canada. The data were collected through a scoping review of academic and grey literature (2005-2018), and further developed with the guidance of an advisory group. Culturally appropriate reviews can provide inroads to more constructive policy-making and research practices in health [45, 46]. Reviews can help to address the gaps in inclusive practice guidelines that are evident in current Australian Aboriginal health strategies, in part due to significant knowledge gaps [47]. In particular, reviews which utilise ‘decolonising methodologies’ (such as stakeholder consultation and the expansion of what can be considered ‘valid’ knowledge) can include research that is informed by the needs of communities, as well as the data collected through standard literature searches [48]. Decolonisation, the positioning of Aboriginal-led frameworks at the fore of service delivery, is a crucial aspect of positive and constructive health care, promotion, and research for Aboriginal people [49-51]. It involves directly engaging affected communities, keeping Aboriginal voices amplified and considered throughout institutional processes, practicing reflexivity and immersion, and ensuring that any research or health care/promotion ou

This supporting document consists of a series of checklists and summaries on the six domains and the priority populations identified in the WA Aboriginal sexual health and blood-borne virus strategy 2019–2023. This document is a supplement to the full evidence review, An evidence review from Australia, Aotearoa/New Zealand and Canada for the WA Aboriginal Sexual Health and Blood-borne Viruses Strategy.

Introduction: There is recognition of the importance of comprehensive relationships and sexuality education (RSE) throughout the school years worldwide. Interventions have found some positive outcomes; however, the need for a greater focus on positive sexuality and relevant contemporary issues has been identified by teachers and students. The Curtin RSE Project provides training for teachers and preservice teachers and supports schools through training and advice to implement comprehensive school health promotion (CSHP) focusing on RSE allowing schools to develop programmes relevant to their school community. To examine contemporary phenomenon within a real word context, a case study design will be used to measure implementation. This paper will describe the protocol for a multiple, embedded case study to measure the implementation of CSHP focusing on RSE in a purposive sample of Western Australian schools. Methods and analysis: This mixed methods study will include a multiple, embedded case study. Schools (n=3-4) will be purposively selected from within Western Australia based on their capacity to commit to implementing RSE as a case study school. Data will be collected from students (Grade 6 for primary school; Grades 7-12 for secondary school); teachers and other key staff and parents. Methods include school climate and school curriculum audits, documentation (collected with key staff at baseline and annually), interviews (parents and teachers at Year 2), focus groups (students at Year 2) and an online student survey (collected with students baseline and annually). Ethics and dissemination: School principals will provide consent for school participation and staff and parents will provide individual consent. Student assent and parental consent will be obtained for student participants. Results will be disseminated through open-access reports, peer-reviewed journals and conference presentations.

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. People born in sub-Saharan Africa and Southeast Asia are overrepresented in HIV notifications in Australia. Just under half of all notifications among people from sub-Saharan Africa and Southeast Asia are diagnosed late. Increased HIV testing among these communities is necessary to ensure early diagnosis, better care and reduce likelihood of HIV onward transmission. Recently, Australia has made new HIV testing methods available: rapid HIV testing and self-testing kits. We conducted 11 focus groups with 77 participants with people from sub-Saharan Africa, Southeast Asia and Northeast Asia in four jurisdictions in Australia. Focus groups discussed barriers to HIV testing and the acceptability of new testing methods. Barriers to HIV testing included: cost and eligibility of health services, low visibility of HIV in Australia, HIV-related stigma, and missed opportunities by general practitioners (GPs) for early diagnosis of HIV and linkage into care. Participants had low levels of knowledge on where to test for HIV and the different methods available. Diverse opportunities for testing were considered important. Interventions to increase HIV testing rates among sub-Saharan African, Southeast Asia and Northeast Asian migrants in Australia need to be multi-strategic and aimed at individual, community and policy levels. New methods of HIV testing, including rapid HIV testing and self-testing, present an opportunity to engage with migrants outside of traditional health care settings.

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Migration is a significant risk factor for the acquisition of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and other sexually transmitted infections (STIs). An increasing proportion of these infections in high-income countries, such as Australia, are among migrants moving from low and middle-income countries with a high prevalence of HIV, HBV and other STIs. This systematic review explored the prevention and control of HIV, HBV and other STIs in migrants (>18 years) from Southeast Asia, Northeast Asia and sub-Saharan Africa living in high-income countries with universal health care. This systematic review followed PRISMA guidelines and was registered with PROSPERO. Six academic databases were searched for articles published between 2002 and 2018. Sixteen peer-reviewed articles met the inclusion criteria, consisting of fourteen quantitative and two qualitative studies conducted in Australia, the Netherlands, Canada, Spain, Italy, and Germany. Three levels of interventions were identified: individual, community and structural interventions. Most studies addressed factors at an individual level; interventions were most commonly outreach testing for HIV, HBV and other STIs. Few studies addressed structural factors or demonstrated comprehensive evaluation of interventions. Limited population-specific findings could be determined. To prevent further transmission of HIV, HBV and other STIs, comprehensive public health approaches must consider the complex interactions between migration, health care system determinants, and broader socioeconomic and sociocultural factors.

Early diagnosis is a critical component of the global response to the human immunodeficiency virus (HIV). In Australia, more than two-thirds of women from Southeast Asia are diagnosed late with HIV. There is limited evidence regarding the barriers to HIV testing and which interventions work to increase an uptake among migrants living in high-income countries. This participatory action research (PAR) project will work with women from Indonesia to co-design an intervention to increase HIV testing uptake in Western Australia. The project will involve trained community researchers, representatives from relevant organizations, and community women born in Indonesia. We will conduct three PAR cycles. Phase one will use focus groups to understand enablers for HIV testing among community members. In phase two, data will be presented back to members of the participating communities who will be invited to co-design an intervention to increase HIV testing. The final cycle will focus on implementing and evaluating the resulting intervention. This project will add to the small body of literature on pathways and enablers to HIV testing, and to new insights regarding interventions that work for women from migrant communities and why.

© James Cook University. Rural clinicians in small communities face the pressure of always being 'on duty', and the ethical challenges of overlapping relationships with members of the community and duality of roles. The lead author of this commentary has experience as an insider researcher living within a small rural community, and has navigated the ethical challenges and community pressures of conducting qualitative research within an interconnected network. With appropriate measures and planning, insider research can be conducted rigorously, while maintaining ongoing relationships, confidentiality and anonymity.

OBJECTIVES: This study aimed to develop and validate an online instrument to: (1) identify common alcohol-related social influences, norms and beliefs among adolescents; (2) clarify the process and pathways through which proalcohol norms are transmitted to adolescents; (3) describe the characteristics of social connections that contribute to the transmission of alcohol norms; and (4) identify the influence of alcohol marketing on adolescent norm development. SETTING: The online Youth Alcohol Norms Survey (YANS) was administered in secondary schools in Western Australia PARTICIPANTS: Using a 2-week test-retest format, the YANS was administered to secondary school students (n=481, age=13-17 years, female 309, 64.2%). PRIMARY AND SECONDARY OUTCOME MEASURES: The development of the YANS was guided by social cognitive theory and comprised a systematic multistage process including evaluation of content and face validity. A 2-week test-retest format was employed. Exploratory factor analysis was conducted to determine the underlying factor structure of the instrument. Test-retest reliability was examined using intraclass correlation coefficient (ICC) and Cohen's kappa. RESULTS: A five-factor structure with meaningful components and robust factorial loads was identified, and the five factors were labelled as 'individual attitudes and beliefs', 'peer and community identity', 'sibling influences', 'school and community connectedness' and 'injunctive norms', respectively. The instrument demonstrated stability across the test-retest procedure (ICC=0.68-0.88, Cohen's kappa coefficient=0.69) for most variables. CONCLUSIONS: The results support the reliability and factorial validity of this instrument. The YANS presents a promising tool, which enables comprehensive assessment of reciprocal individual, behavioural and environmental factors that influence alcohol-related norms among adolescents.

Issue addressed: Rates of sexually transmissible infections among young people are high, and there is a need for innovative, youth-focused sexual health promotion programs. This study evaluated the effectiveness of the Sharing Stories youth theatre program, which uses interactive theatre and drama-based strategies to engage and educate multicultural youth on sexual health issues. The effectiveness of using drama-based evaluation methods is also discussed. Methods: The youth theatre program participants were 18 multicultural youth from South East Asian, African and Middle Eastern backgrounds aged between 14 and 21 years. Four sexual health drama scenarios and a sexual health questionnaire were used to measure changes in knowledge and attitudes. Results: Participants reported being confident talking to and supporting their friends with regards to safe sex messages, improved their sexual health knowledge and demonstrated a positive shift in their attitudes towards sexual health. Drama-based evaluation methods were effective in engaging multicultural youth and worked well across the cultures and age groups. Conclusions: Theatre and drama-based sexual health promotion strategies are an effective method for up-skilling young people from multicultural backgrounds to be peer educators and good communicators of sexual health information. Drama-based evaluation methods are engaging for young people and an effective way of collecting data from culturally diverse youth. So what?: This study recommends incorporating interactive and arts-based strategies into sexual health promotion programs for multicultural youth. It also provides guidance for health promotion practitioners evaluating an arts-based health promotion program using arts-based data collection methods.

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

Investment, bipartisan support and involvement from affected communities have characterised Australia's HIV response, and helped maintain a low prevalence epidemic. Patterns of HIV acquisition are changing, with an increasing number of infections acquired overseas by migrant and mobile populations. A coordinated national response is required to address HIV acquisition in the context of population mobility.

of a paper presented at 22nd Congress of The World Association For Sexual Health, Singapore, July 25-28, 2015

Introduction and Objective: An audit of Western Australian universities found pre-service teachers have limited opportunity to study health-related courses (termed units in Australia), and when they are offered there is often little focus on sexuality and relationships education (SRE). Curtin University has recently established an undergraduate course for Bachelor of Education students, which focuses solely on the delivery of evidence-based SRE. Methods: Formative mixed methods research was conducted to inform the course development. It was piloted during 2014 with 20 undergraduate students and involved 36 hours of face-to-face contact during one semester. Students participated in a range of qualitative and quantitative pre- and post-evaluations to examine content, delivery, process and impact. Results: Course content was viewed positively by all students. Selfassessment of teaching competency and inclusive attitudes towards sexuality concepts increased for each student at the end of the semester. Assessment tasks were viewed positively and, in particular, a teaching resource file was viewed as a useful tool that could be utilised and added to throughout one’s teaching career. Post-course reflection papers provided rich qualitative data regarding learning experience. Students reported becoming empowered as SRE educators and intended to implement learning immediately. Conclusions: An undergraduate course dedicated specifically on school-based SRE has been successfully incorporated for pre-service teachers within the School of Education at Curtin University, Australia. Regardless of their teaching speciality (special needs, early childhood, primary and secondary), all students reported the unit content applicable to their future work as educators. This has implications for universities and/or teaching colleges that address SRE in an ad hoc manner or provide it only in specific degrees like B.Ed. (Secondary) or B.Ed. (Health and Physical Education).

BackgroundThe vital role of evaluation as integral to program planning and program development is well supported in the literature, yet we find little evidence of this in health promotion practice. Evaluation is often a requirement for organisations supported by public funds, and is duly undertaken, however the quality, comprehensiveness and use of evaluation findings are lacking. Practitioner peer-reviewed publications presenting evaluation work are also limited. There are few published examples where evaluation is conducted as part of a comprehensive program planning process or where evaluation findings are used for program development in order to improve health promotion practice. DiscussionFor even the smallest of programs, there is a diverse array of evaluation that is possible before, during and after program implementation. Some types of evaluation are less prevalent than others. Data that are easy to collect or that are required for compliance purposes are common. Data related to how and why programs work which could be used to refine and improve programs are less commonly collected. This finding is evident despite numerous resources and frameworks for practitioners on how to conduct effective evaluation and increasing pressure from funders to provide evidence of program effectiveness. We identify several organisational, evaluation capacity and knowledge translation factors which contribute to the limited collection of some types of data. In addition, we offer strategies for improving health promotion program evaluation and we identify collaboration of a range of stakeholders as a critical enabler for improved program evaluation. SummaryEvaluation of health promotion programs does occur and resources for how to conduct evaluation are readily available to practitioners. For the purposes of program development, multi-level strategies involving multiple stakeholders are required to address the organisational, capacity and translational factors that affect pract