Health Promotion Journal of Australia最新文献

Issue addressed: Communication tools have long been used to address complex social policy problems, known as wicked problems, in communities around the world. However, the challenge has remained, how do we measure the impact of social change with communication for development (C4D)? Evaluators recommend utilising evaluation tools that take a wider systems-based approach to assist in the evaluation of C4D projects. Health Communication Resources (HCR) Inc., a health promotion charity that supports C4D projects around the world, aimed to trial a tool to assist evaluation of a project addressing gender inequality, an underlying driver of family violence in the community.

Methods: WickedLab's tool for systemic change was utilised to assist the evaluation of the complex adaptive system. The research team mapped the system that existed in Geraldton working towards addressing the wicked problem of gender inequality.

Results: Mapping the system highlighted how integral C4D actions were in maintaining and strengthening the system as it works together towards gender equality in the community.

Conclusion: A systems-based approach can strengthen evaluation and demonstrates the role C4D projects play in addressing wicked problems in a defined location. SO WHAT?: WickedLab's tool for systemic change provides significant potential for the evaluation of other health promotion and communication for development projects.

Issue addressed: This article explores how belonging can enhance well-being for takatāpui (a traditional Māori term that embraces all Māori with diverse genders, sexualities and sex characteristics) who are trans and non-binary across a range of contexts.

Methods: We drew data from the 2018 Counting Ourselves, a nationwide community-based survey of trans and non-binary people in Aotearoa (New Zealand) (N = 1178); of which 161 (13.7%) identified as Māori, the Indigenous people of Aotearoa.

Results: Based on generalised regression models, feelings of belonging with friends, takatāpui communities, Māori communities, and work communities were correlated to higher feelings of life satisfaction, life worthwhileness, and identity pride for takatāpui who are trans and non-binary. In Te Ao Maōri (the Māori worldview), such concepts of belonging and relationships are collectively known as whanaungatanga.

Conclusions: Our findings affirm whanaungatanga as foundational to well-being among trans Māori people, enabling them to locate themselves within nurturing and supportive networks. SO WHAT?: Whanaungatanga is a key policy agenda, alongside other system-level change, that is needed to buffer takatāpui who are trans and non-binary from poverty, stigma, and racism they face. This will require changes to the current policy and practice context. We argue that whanaungatanga, while an important strategy of well-being for trans and non-binary people, must also occur alongside wider system transformations to address transphobia, racism, and cisheteronormativity.

While comprehensive mental health promotion inherently involves individuals, there is an ongoing need to address large-scale determinants of people's mental health and wellbeing-particularly policies and environments. To have the best possible chance of creating positive change, mental health promotion must also work throughout key mediating structures such as places of education and work. This includes universities. Yet, in their efforts to address student and staff mental health and wellbeing, Australian universities have demonstrated limited uptake of comprehensive mental health promotion approaches. In this commentary, I discuss a recent review of Australia's higher education system-the Australian Universities Accord-as a catalyst for strengthening institutional action and change through a comprehensive mental health promotion lens. I discuss key findings-and silences-made clear throughout the review process. I then advocate several urgent priorities for university-level change-across institutional assessment, institutional accountability and performance, and institutional leadership and power-if Australia's universities are genuinely committed to improving mental health and wellbeing among students and staff.

Background: This cross-sectional study aimed to understand the need and desire for a diabetes prevention program within the Y (formerly YMCA: Young Men's Christian Association) of the Greater Brisbane region, Queensland, Australia.

Methods: An anonymous online survey was distributed (March-April 2023) by The Y Queensland targeting adults within the Greater Brisbane Y community. Data were collected on Y membership and branch attended, postcode, diabetes risk in the next 5 years (low, medium, or high), and interest in participation in a diabetes prevention program. Data were analysed via descriptives and cross tabulation with statistical significance considered at p < .05.

Results: Respondents (n = 575) were primarily female (65%), attending a Y branch located in the outer city (51%), and aged under 55 years (68%). Twenty Y sites were represented, with a mix of inner-city, outer-city, and regional areas. Overall, 46% (n = 241/530) of respondents were at high diabetes risk, with those living in relatively socio-economically disadvantaged areas more likely (p < .001) to be at high-risk (57%) than intermediate (26%) or low-risk (18%). Most (68%) respondents were interested/potentially interested in program participation; those at high risk of developing diabetes in the next 5 years were most interested (55%).

Conclusions: The Y in Greater Brisbane may provide a suitable setting to host a community-based diabetes prevention program. Locations outside the inner city should be prioritised to target those who are relatively socio-economically disadvantaged to align with higher need and demand. SO WHAT?: Findings inform the implementation and prioritisation of a community-delivered diabetes prevention program.

Issue addressed: The Healthy Me, Healthy Planet program was an evidence-informed pilot program conducted by a local libraries to promote the health co-benefits of action on climate change.

Background: An impact evaluation of the Healthy Me, Healthy Planet program was conducted using a mixed methods research design including pre-, during, and post-program surveys and online focus groups.

Methods: The evaluation included 136 participants aged 18+ years who were able to understand and communicate in English or simplified Chinese language. Descriptive analyses of the survey data were integrated with thematic analyses of focus group (N = 2) data to generate key themes.

Results: Key impacts included individual and organisational capacity building, personal and social well-being, and pro-environmental knowledge, attitudes, and behaviour. Impacts on program participants included increased confidence, motivation, positive feelings, and personal well-being after taking part in the Healthy Me, Healthy Planet program. Participants reported enhanced social connections, mental well-being, and environmental benefits such as engaging within the community on environmental issues and feeling inspired to make sustainable lifestyle changes.

Conclusion: Libraries play a key role in promoting the health of people and planet in the community because they are a trusted, safe, and supportive community setting, a curator of credible and reliable evidence-based information on health and planetary topics and a local and free provider for skills and literacy development.

So what: The evaluation of the pilot suggests that participants improved their capacity to practice sustainable living and it is recommended that this program be expanded to other library settings to enhance community connection and support local planetary health initiatives.

Issue addressed: Children and adolescents are particularly receptive to cues from food and drink advertising. Several policies recommend restricting unhealthy or discretionary ('junk') food advertising on government infrastructure such as public transport. Prior research in New South Wales (NSW) and Western Australia (WA) reveals a high proportion of discretionary food advertising outdoors and on public transport. The aim of this study was to identify the landscape of food and drink advertising on public transport assets around Adelaide schools.

Methods: An environmental scan of food and drink advertising on public transport assets within 500 m of 65 Adelaide schools was conducted. The Council of Australian Governments Health Council's interim guide was used to categorise advertisements as 'suitable' or 'unsuitable' for promotion.

Results: Almost four in every five food and drink advertisements on public-transport assets observed around Adelaide schools included discretionary food or drink, and therefore were categorised as unsuitable for promotion. Advertisements on bus exteriors were more likely to promote discretionary foods, compared with bus shelters.

Conclusions: This proportion of 'unhealthy' food advertising was comparable to previous research conducted in WA and NSW. SO WHAT?: In light of historic state/territory actions such as the ACT preventing discretionary food advertising on public transport, these findings should prompt a review and discussion of the suitability of food and drink promotion on government-owned South Australian transport and their associated assets.

Issue: Universal school lunches hold the potential to improve student nutritional intake and access to food, but to do so menus must be nutritionally adequate. There is growing interest in school lunch programs (SLPs) in Australia, and one is currently being trialled in Tasmania. No nutrition guidelines currently exist for menu development in Australian schools.

Methods: A desktop review of international SLPs was completed, and findings analysed in the context of Australian Nutrient Reference Values and Australian Dietary Guidelines to inform the development of Tasmanian SLP guidelines.

Discussion: Globally, SLPs are guided by portion sizes and/or nutrient criteria. SLPs (many of which address food insecurity) must provide children the opportunity to meet energy and nutrient needs, while minimising food waste. We propose energy-based nutrient criteria and qualitative recommendations for menu development. SO WHAT?: We have developed guidelines to inform the development of Tasmanian SLP menus. These guidelines may be applicable to other states and territories piloting similar programs.

Issue addressed: Increasing and maintaining vaccination uptake is crucial for preventing and managing infectious diseases. In the context of the post-coronavirus disease 2019 (COVID-19) pandemic landscape, this paper examines the perceptions of immunisation implementers and policymakers to uncover the challenges and evidence gaps in routine immunisation efforts.

Methods: We conducted an online two-round modified Delphi survey with immunisation experts, senior public servants, policymakers, policy advisory groups, and representatives from peak bodies from across Australia. We asked respondents to outline what they see as the greatest challenges to increasing and maintaining uptake of recommended vaccines in Australia; the most difficult aspects of their work in vaccination; the largest evidence gaps in vaccine uptake; and the kinds of social and behavioural research they would like to see prioritised.

Results: The two most important challenges for increasing and maintaining vaccine uptake were effectively communicating the benefits of vaccines to parents and the public and ensuring accessible and affordable vaccination services. Participants strongly agreed that 'communication about the importance of vaccination' was the most difficult aspect of their work. Consistently important was the need to better engage specific population groups, such as culturally and linguistically diverse people, pregnant people, at risk cohorts, and health care providers. Social and behavioural research about 'how to effectively address hesitancy' was ranked highly among participants.

Conclusions: Findings from this project help provide an understanding of the behavioural, social, ethical, and policy knowledge needs for immunisation policy and implementation in Australia. To respond to vaccine challenges, increase coverage and build public trust in vaccination, policymakers and governments should incorporate social research into vaccination programmes. SO WHAT?: Australia is preparing to launch a Centre for Disease Control. This study demonstrates the importance of integrating social, behavioural, ethical, and policy research into the fabric of this new enterprise. It underlines the need to capacity-build a workforce able to deliver high-quality research in these areas, address the needs of immunisation implementers and policymakers, and achieve good outcomes for Australians.

Issue addressed: The Australian government's 'Closing the Gap' (CTG) strategy has been implemented via multiple strategies. We examined CTG policy in early childhood within Southern Adelaide during the first decade of implementation (2008-2018) and critiqued the complexity and challenges of policy that is designed to promote health and well-being of Aboriginal and Torres Strait Islander children but lacked Aboriginal control.

Methods: A qualitative case study was conducted in Southern Adelaide, and we interviewed 16 policy actors from health and early childhood education sectors. Thematic analysis revealed key themes to show how policy had been implemented through mainstream structures.

Results: The rapid roll out of the CTG strategy, the limitations of short-term funding, cuts to Aboriginal health services, tokenistic consultation, and the mainstreaming of service provision were key features of policy implementation. The influence of Aboriginal leaders varied across implementation contexts. Participants advocated for services in health and education that are culturally safe to improve health of children, families, and communities.

Conclusions: The implementation of the CTG strategy in Southern Adelaide was rushed, complex, and lacking Aboriginal control. This contributed to the marginalisation of Aboriginal leaders, and disengagement of families and communities. A more collaborative and Aboriginal led process for policy implementation is essential to reform policy implementation and address health inequity. SO WHAT?: Findings from this study suggest that policy has continued to be implemented I ways that reflect colonial power imbalances. Alternative processes that promote the recognition of Indigenous rights must be considered if we are to achieve the targets set within the CTG strategy.