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This commentary reports on the development and implementation of the competency-based IUHPE Health Promotion Accreditation System in the context of workforce capacity as a key activity of the International Union for Health Promotion and Education (IUHPE). The process of developing the System is described, including how it built on, and added to, international research and experience in competency-based approaches to health promotion. An overview of how the System works, its current status and future plans, is presented. Evidence of the positive impact of the System to date, in particular in the context of health promotion education, is considered.

Introduction Little is known about workplace health promotion for bus drivers. Bus drivers are at-risk of chronic disease because they are exposed to the risk factor combination of poor nutrition, low levels of physical activity, high levels of sedentary time and are often overweight or obese. The purpose of this paper is to situate the quantitative baseline data collected from bus drivers within qualitative findings about the socio-cultural context of the workplace. Materials and methods Baseline data about physical activity, dietary intake and sedentary hours was collected from 58 drivers employed by a large bus company in southeast Queensland. Ten drivers and seven key workplace informants participated in interviews and discussion groups about driver health behaviours, workplace structure, culture, and resources. Results The quantitative results of our study reveal bus drivers have a cluster of poor health behaviours—limited physical activity, lower than recommended consumption of fruit and vegetables and high levels of sitting time during working-hours—which contribute to a high prevalence of overweight and obesity and a heightened risk of chronic disease. The qualitative findings suggest there are individual and structural barriers to improving drivers’ modifiable health behaviours. Individual barriers include ingrained poor habits and more pressing life concerns, while structural barriers in the context of the workplace include time constraints, shift work, long days, a lack of work amenities and a general disconnect of drivers with their workplace. Conclusion In this workplace, health promotion strategies for bus drivers should be prioritised as a means of improving drivers’ health. To maximise uptake and effectiveness, these strategies should make use of existing workplace resources and consider the context of workplace health behaviour change. Further research is warranted in a broader sample of Australian bus companies to explore the context of workplac

A large university in Queensland, Australia with a diverse staff and student community introduced a campus wide smoke-free policy in 2016. The purpose of this enquiry was to understand attitudes about a new smoke-free policy, its potential impact and the shift in social norms and organizational culture to inform the next phase of implementation. An electronic survey was distributed to all staff and students approximately 12 weeks after the smoke-free policy was implemented. The survey consisted of multiple-choice questions about demographics, smoking behaviour, attitudes towards smoking and tobacco control, awareness of the smoke-free policy, and attitudes towards the effect of a completely smoke-free campus on quality of life, learning and enrolment. The survey was completed by 641 university staff and students. Respondents reported seeking out (80.4%) and socialising in smoke-free environments (86.6%) and supported smoke-free buildings (96.1%), indoor areas (91.6%), and outdoor areas (79%). The results revealed overwhelming support for a completely smoke-free campus (83%) and minority support for designated smoking areas (31%). Overall, respondents reflected positively towards a campus wide smoke-free policy. These findings suggest Queensland’s early adoption of tobacco control laws influenced the social environment, de-normalised smoking, changed behaviour, preference for smoke-free environments and shifted social norms. These findings provide convincing evidence for organisational change and suggest health promotion policy makers should progress the implementation of smoke-free policies nationally across the higher education sector.

Schools are critical spaces for young men from refugee backgrounds. They play an integral role in literacy development, educational attainment, and providing a sense of belonging. Inclusive education practices for this group are largely absent in Australian schools. Research shows focusing on these young men from a non-deficit position assists with inclusivity. There is a lack of research exploring the agentic practices of young men from refugee backgrounds within schools. This paper explores the symbolic value of swagger for a group of young men from refugee backgrounds at a high school in Australia. A Bourdieusian theoretical framework guided critical awareness of power in schools. This research shows how a group of young men found a meaningful way to acquire social and cultural capital. Despite the school’s constraints, this group developed a group identity reflected in their clothing and embodied dispositions referred to here as swagger. Our findings demonstrate the complex power relations at work, including the opportunity for the young men to resist and be included. In the spirit of Bourdieu’s concern for reflexivity our findings point to the need for schools, teachers, and education policy makers to consider the workings of power in schools in more considered ways.

Introduction: Previous studies have shown teaching public health in medical courses improves students’ analytical, problem-solving and communication skills. However, little research to date has shown if public health teaching is helpful to paramedic students. The aim of this study was to examine if having paramedic tutors teach public health had a positive effect on students’ learning and interest in public health. Methods: 184 second-year paramedic students at an Australian university completed a printed survey and provided feedback about their learning experience. Students answered multiple choice and open-ended questions about whether their understanding of a public health subject was improved by having a paramedic tutor, and if having different tutors each week affected students’ learning. Results: Most students reported their understanding of public health improved when the subject was taught by a paramedic tutor and when paramedic scenario examples were included in teaching. Nearly half felt having different tutors each week made learning difficult. The following themes emerged from student narratives: the relevance of public health to their career; an improved understanding of public health; a realisation about the importance of public health; difficulties presented by an inconsistent teaching style; and poor follow-up and conflicting advice. Conclusion: Teaching public health from a paramedic perspective enabled students to understand the relevance of paramedic practice and the role paramedics play in the public health system. Having the same paramedic tutor teaching each week helped students understand the relationship between public health and paramedic practice.

The year 2020 highlighted significant health disparities in global population outcomes and forces a critical evaluation of learning and teaching in health promotion. More so than ever, health promotion demands graduates underpin their practice with a critical realist perspective and are ever-vigilant advocates in tackling constructs of power and privilege. These new-world order graduates have the foresight and fortitude to call out injustice, to truly promote equity, and ensure all populations have the same start to healthy and productive lives. Essentially, health promotion graduates are practice savvy, socially conscious, politically astute, and creatively entrepreneurial to respond in unprecedented circumstances. To this end, health promotion educators are mandated to be ahead of the game and design courses to graduate global citizens cognizant of local practice environments in a global context. This editorial emboldens dialogue about the challenges of graduating health promotion practitioners who can acclimatize to multifaceted and swiftly moving contemporary milieu infused with evolving social consciousness and implied social decrees on a stage of neoliberalist ideologies, bureaucratic inaction, and political rhetoric.

BACKGROUND: There is little published research about managers’ views about implementing and embedding workplace health promotion interventions. OBJECTIVE: To shed light on research-to-practice challenges in implementing workplace health promotion interventions in the Australian road transport industry. METHODS: In this Participatory Action Research project, managers from small-to-midsized companies in the Australian road transport industry were asked their views about enablers and barriers to implementing nutrition and physical activity interventions in their workplace. RESULTS: Managers identified practical assistance with resources, ideas, and staffing as being key enablers to implementation. Barriers included time restraints, worker age and lack of interest, and workplace issues relating to costs and resources. CONCLUSION: Manager perspectives add new insights about successful implementation of workplace health promotion. A Participatory Action Research approach allows managers to develop their own ideas for adapting interventions to suit their workplace. These findings add to a small body of knowledge about managers’ views regarding implementing workplace health promotion in small-to-midsized road transport companies – a relatively unexplored group. Managers highlight the importance of time constraints and worker availability when designing interventions for the road transport industry. Managers require a good understanding of the workplaces’ socio-cultural context for successful health promotion and health behaviour change.

Background: Nurses are key decision makers in residential aged care facilities and play a significant role in the transfer of residents from residential aged care facilities to emergency departments. There is scant literature about the role of nurses in the transfer decision-making process. Aim: To describe the experiences of residential aged care facility nurses who engage in decision-making to transfer residents to emergency department. Methods: This research has adopted interpretive qualitative approach of phenomenography. In-depth interviews were undertaken with 20 residential aged care facility nurses across two sites. Uniquely,drawing was used as one way to collect rich, textured data in these in-depth interviews. Findings: Six categories emerged to represent residential aged care facility nurses’ conceptions of decision-making about transferring a resident to the emergency department: “Being a marionette”; “Too dumb to have an opinion”; “Making the family happy”; “Not about the resident”; “Having experience”; and “Being on your own”. Discussion: Residential aged care facility nurses experienced decision-making as not being able to do what is right for the resident most of the time due to a myriad of factors, with heavy influence of other key stakeholders. Conclusion: Decision-making is described as a professional responsibility wherein residential aged care facility nurses face dilemmas related to the transfer of a resident to the emergency department and perceived as a constraint.

Issue addressed: Obesity and non-communicable diseases (NCDs) are largely preventable by understanding the connection between socio-cultural knowledge, yet intervention effectiveness may be hindered changes in lifestyles and behaviours in Indigenous health. This study performed to understand the social and cultural components, which contribute to obesity in rural areas of the Indigenous Fijian. Methods: This study is a Community Based Participatory Research (CBPR) project, which engaged community members from a rural iTaukei village in the Fiji Islands. Data collection was carried out through community consultation, and semi-structured interviews. The data was analysed using descriptive thematic analysis. Results: Food intake was associated with socio-cultural, economic, political and physical environmental factors. Participants reveal previous health promotion programs did not incorporate the cultural values, cultural competence beliefs and traditional ways of rural Indigenous Fijian community. Conclusion: The healthcare providers and policymakers need to be involved in recognising iTaukei community culture and appreciate traditional methods to promote equitable community participation in decision-making for health promotion. So what? Community-wide lifestyle interventions, conceptual approaches based on communal perceptions of the problem at hand can also be the basis for future research on identifying socio-cultural factors, for example, the community and family support that can help shape behaviours.

COVID-19 has disrupted the global higher education sector more profoundly than any event since World War 2. Due to the role of public health in responding to the pandemic, the field has been particularly affected, with a number of decision-points emerging over the coming months. This editorial highlights two imperatives for the global public health education sector. Public health educators must iteratively improve the educational adaptations used to continue teaching during the pandemic. After the pandemic, society and higher education will not simply return their previous states, and public health educators must optimise education to shape and adapt to this new environment.

Perceptions acquired during tertiary health promotion education can influence students’ interactions with their future service-users. Reflective practice can highlight these perceptions. Here we describe the findings of a reflective exercise conducted with postgraduate health promotion students as part of a learning activity. Students (n = 44) reflected on their understandings of at-risk populations in three priority areas—tobacco, obesity and alcohol. The activity aimed to deconstruct students’ understandings of these populations and identify understandings juxtaposed to the philosophical underpinnings of health promotion, for addressing through teaching and learning. Thematic analysis revealed students’ understanding of all three at-risk populations fit within five themes: apathy/lack of altruism, complexity/choice, pressure/control, escaping/excuses, and environmental contexts. Students also have varying levels of tolerance to at-risk populations, expressing greatest tolerance towards those whose addiction undermines choice and self-control, and least towards those who are overweight/obese or whose behaviour causes risk to others. Our findings show reflective practice is a valuable tool to help educators understand students’ attitudes and values and implement changes to support their future role in the community.

BACKGROUND: Despite many Australian universities introducing smoke-free policies on campus, there is little information about staff and students understanding of smoking on campus in the context of the implementation of a smoke-free policy. OBJECTIVE: This research explores the qualitative views of university staff and students about smoking on campus during the implementation of a smoke-free policy. METHODS: In 2016, an electronic survey was distributed to all current staff and students of a large university in Queensland, Australia during the implementation of a smoke-free policy. The survey consisted of multiple-choice questions about demographics, tobacco use, attitudes towards smoking, awareness of and attitudes towards the policy, and intentions to quit smoking. The final question asked for a short, open-ended response: "Would you like to comment on the issue of smoking on QUT* campuses?" This question was extracted from the survey and analysed using inductive thematic analysis. This paper reports the findings from this question. *Queensland University of Technology. RESULTS: The survey was completed by 641 staff and students. There were 351 responses to the final question. Five inductive themes emerged about smoking on campus during the implementation of a smoke-free policy: 1) the watering down of the policy, if it is not enforced, 2) the creation of hot spots on campus boundaries affecting those who pass by, 3) concern, especially by those who don't smoke, about the impact on smokers emotional health and welfare, 4) disagreement about the value of designated smoking areas and 5) suggestions about how to better implement the policy. CONCLUSION: Overall, participants views about smoking on campus during the implementation of a smoke free policy suggest broad agreement but reflect concerns about enforcement, boundaries, non-smokers and designated areas. Consistent and systematic processes for implementation, maintenance and enforcement of policy goals, and