Health Promotion Journal of Australia最新文献

Issue addressed: This study examines Australia's Hepatitis B public health policies with a focus on the Pacific Australia Labour Mobility scheme seasonal workers as a priority population. The aim is to evaluate if Australia's Hepatitis B public health policies adequately address health disparities and equitable access to health care for seasonal workers as a priority population. We draw comparisons with the public health policies of New Zealand and Canada, to understand how these nations approach similar health concerns among their temporary seasonal workers.

Methods: A health policy analysis was conducted on the public health Hepatitis B policies in Australia and then compared with those in Canada and New Zealand. Due to the nature of the study question, the review had a major focus on grey literature. The search was undertaken in two stages, including (1) Google search engine and (2) targeted websites. Basic document data was produced in descriptive summaries. Any data either explicitly or inexplicitly relating to the elimination of hepatitis B or equity towards the inclusion of seasonal workers was produced as analytical summaries through multiple revisions.

Results: Nineteen documents were identified, predominantly from Australia. Although Hepatitis B public health policies emphasised testing and awareness in priority populations, specifically mentioning seasonal workers as a priority population was absent in all three countries.

Conclusions: The study underscores the exclusion of temporary seasonal workers in public health policies and strategies as a human rights issue, conflicting with principles of equity and equitable access to health care. Despite acknowledging challenges for temporary visa holders, policies lack specific provisions for seasonal workers. Addressing this gap is crucial for health equity and inclusive health systems. SO WHAT?: Our findings highlight the need to prioritise equity for temporary seasonal workers to achieve hepatitis B elimination goals by 2030. Exclusion from public health policies is a human rights concern, impacting access to quality health care. This study advocates for inclusive policies explicitly recognising temporary seasonal workers as a priority population, aligning with international human rights commitments to health care for all.

Issue addressed: Nutrition-related obesity is rising among adolescents in New Zealand with an estimated one in eight children being obese. The school environment is an ideal community setting for encouraging a healthy lifestyle as schools contain a diverse population and involve students and parents. However, the healthiness of food available to intermediate and secondary school students (Years 7-13) is unknown. This study assessed how food and drink menus from schools align with policy guidelines for healthy school food environments.

Methods: A convenience sample of NZ schools' (years 7-13; ages 10-19) menus was collected in 2020. Menus were classified using traffic light criteria. A toolkit was developed by three nutritionists and one dietitian (with trained staff support) to aid with menu classification. Menu quality was evaluated against school characteristics and policy use.

Results: Of the school menus assessed (n = 60), 3.3% met the recommendation for the provision of 75% 'green' items. 'Red' items were the main contributors (mean = 53.6%). Schools with high socio-economic status (deciles 8-10; 14.3%; p < 0.05) and small school size (<749 students; 14.1%; p < 0.025) were associated with a higher proportion of 'green' items. Community (19.3%) and in-house (25.9%) food providers provided a lower percentage of 'amber' items than school providers (39.3%; p < 0.001). In-house providers (64.6%) had a greater percentage of 'red' items than school providers (48.2%; p = 0.017).

Conclusion: Food available in schools (Years 7-13) tends to be unhealthy. A national nutrition policy could improve the school food environment, especially in schools with large populations and low socio-economic status. SO WHAT?: School demographics have been associated with menu quality but further research within these schools is needed to identify the gaps to improve equitable outcomes within school food environments.

Issue addressed: Food environments surrounding schools have a strong influence on the adolescent's food choices. Moreover, the prevalence of diet-related chronic diseases is higher in regional than metropolitan areas in Australia. Understanding school food environments in these different settings is crucial for informing future strategies to improve adolescent health.

Methods: Google Street View was used to identify food outlets within 1.6 km around all secondary schools in Wagga Wagga and Blacktown in New South Wales which were selected as regional and metropolitan case study areas. Based on food outlet type, healthfulness categories were assigned, and Chi-squared tests were performed. The Health Advisory Panel for Youth at the University of Sydney (HAPYUS) were engaged to obtain their perspectives on findings.

Results: Unhealthful food outlets were consistently most prevalent around schools in Wagga Wagga and Blacktown over 17 years. In 2023, these were predominantly restaurants (19.4% vs. 21.1%), cafés (16.8% vs. 11.1%), fast-food franchise outlets (15.1% vs. 17.4%) and independent takeaway stores (14.1% vs. 9.6%). No significant difference in healthfulness between regional and metropolitan areas was found. Youth advisors recognised price and social reasons as major contributors to food choices.

Conclusions: Google Street View was used as a novel resource to examine school food environments in regional and metropolitan areas which have remained consistently unhealthful for nearly two decades. SO WHAT?: Unhealthful school food environments may encourage poor diets and exacerbate rates of adolescent overweight and obesity. Critical government action is needed to improve school food environments.

Issue addressed: Few population-wide efforts have targeted physical activity in Australia. Mass media campaigns are used to promote physical activity and walking, and World Health Organisation recommends their linkage to broader cross-government initiatives. This project evaluates a South Australian (SA) walking mass media campaign linked to the overall SA Walking Strategy.

Methods: Between January and June 2022, Wellbeing SA (a SA government agency) conducted two waves of a mass media campaign, 'A walk can work wonders', to promote walking. The campaign was part of the SA Walking Strategy, targeting the goal to change the 'community culture towards recognising walking' as convenient, affordable and health-promoting. Evaluation was formative (pre-campaign), process (campaign implementation and delivery) and impact. Formative evaluation comprised concept and tagline testing with adult SAs to develop the campaign messages and theme. Process evaluation was comprised of media monitoring of social media, mainstream media and other media monitoring metrics. The process evaluation was dominated by social media marketing in Wave 1, with substantially more paid TV media and radio in Wave 2. The impact evaluation comprised two independent sample surveys of adult SAs (n = 800 each) following each wave of the campaign. Measures included generic and prompted campaign recall and attitudes to physical activity. An independent South Australian Population Health Survey (SAPHS) tracked walking and physical activity behaviours from 2021 to the end of 2022.

Results: Process evaluation showed intensive social media usage in Wave 1, and through increased paid television and radio in Wave 2. Generic recall of any walking message (23.9%) and prompted recall of the specific campaign message (27.8%) reached most socio-demographic groups, especially those with chronic health problems. Increases in intention to increase activity and increased self-reported activity were seen between the campaign Wave 1 and Wave 2 notable as the Wave 2 increase followed substantial television advertising. The SAPHS data showed increased population walking following the campaign waves, compared to the same period in 2021.

Conclusions: Detailed and structured evaluation of a comprehensive mass media campaign showed good reach, and population changes in intentions and walking behaviour amongst SAs. SO WHAT?: It is likely that comprehensive approaches are needed to support mass media campaigns and amplify their effects. Serial, sustained campaigns are needed to monitor ongoing effects.

Issue addressed: Little is currently known about the relationships between body composition and the social determinants of health among Aboriginal and Torres Strait Islander youth in Australia, which could help inform policy responses to address health inequities.

Methods: This study aimed to explore the relationship between various social factors and healthy body mass index (BMI) and waist/height ratio (WHtR) among Aboriginal and Torres Strait Islander youth aged 16-24 years. Baseline survey data from 531 participants of the 'Next Generation: Youth Well-being study' were used. Robust Poisson regression quantified associations between healthy body composition and self-reported individual social factors (education, employment and income, government income support, food insecurity, home environment, relationship status, racism), family factors (caregiver education and employment) and area-level factors (remoteness, socioeconomic status).

Results: Healthy body composition was less common among those living in a crowded home (healthy WHtR aPR 0.67 [0.47-0.96]) and those receiving government income support (healthy BMI aPR 0.74 [0.57-0.95]). It was more common among those with tertiary educated caregivers (healthy BMI aPR 1.84 [1.30-2.61]; healthy WHtR aPR 1.41 [1.05-1.91]) and those in a serious relationship (healthy BMI aPR 1.33 [1.02-1.75]).

Conclusions: Social factors at the individual and family level are associated with healthy body composition among Aboriginal and Torres Strait Islander youth. SO WHAT?: The findings of this study highlight the potential for health benefits for youth from policies and programs that address social inequities experienced by Aboriginal and Torres Strait Islander people in Australia.

Issue addressed: An important part of preventing and managing Aedes-borne mosquito disease outbreak risk is engaging the community. Research shows that high-income countries tend to use top-down measures for Aedes mosquito management, favouring educational approaches to engage the community over participatory approaches that actively involve and empower the community in addressing disease risk. Little is known about the reasons behind the use of these approaches and how they could be strengthened. This research explores the community engagement approaches used in Aedes mosquito management in Cairns, Queensland, Australia and the factors influencing the choice of these approaches.

Methods: A case study design was used, drawing on two qualitative methods-key informant, semi-structured interviews (n = 25), and a document review (n = 20). Thematic analysis was used to identify, analyse and attribute meaning from the data.

Results: Various approaches were used to engage the community, including direct interaction through door-to-door inspections, broad outreach via mass media campaigns, and community participation in a novel mosquito replacement strategy. Factors influencing the choice of these approaches included government legislative responsibilities, research-related ethical obligations, work norms within local government and public health units, the perceived importance of gaining community trust, constraints on workforce capacity, time and funding.

Conclusions: There were multiple factors influencing the community engagement approaches used in this study. Resource constraints, institutional norms and prevailing attitudes and beliefs were identified as hindering the use of more empowering approaches to engaging the community. These barriers should be considered and addressed in the planning of Aedes mosquito management to better support community engagement in this setting. SO WHAT?: Community engagement is an important aspect of managing the Aedes mosquito disease threat. With the global increase in Aedes mosquito-borne disease risk, these findings can help other at-risk settings understand potential organisational impediments to engaging the community. This is particularly important when advocating for the inclusion of bottom-up approaches in policy, and to ensure sufficient resources are allocated to strengthen community engagement in Aedes mosquito management.

Issue addressed: International students are at a heightened risk of experiencing negative health and wellbeing outcomes, which was further exacerbated during the COVID-19 lockdowns. This research sought to explore the impact of the COVID-19 pandemic on the health and wellbeing of international students in Australia.

Methods: Thirty-one international students participated in qualitative in-depth interviews between March and April 2022 to explore their experiences of health and wellbeing during 2020-2021 while they lived and studied in Australia. Interviews were coded and analysed thematically using NVivo software.

Results: Findings highlight the impact of the pandemic on international students' mental, social and financial wellbeing, including worry about loved ones, social isolation, financial and employment insecurity and challenges related to online learning. The pandemic exacerbated and brought more attention to existing issues and placed students in unequal positions in relation to domestic students and each other.

Conclusions: The COVID-19 pandemic has increased students' vulnerability to poor mental health and to a range of social and financial issues. SO WHAT?: The findings of this study highlight the need for support strategies to improve international students' mental health and social wellbeing outcomes in Australia.

Issue addressed: Out of School Hours Care (OSHC) is an important setting to promote healthy eating and physical activity. Between 2017 and 2018, The Eat Smart Play Smart (ESPS) resources were disseminated to OSHC services across New South Wales (NSW), Australia. The aim of this study was to evaluate the awareness and usability of ESPS to support OSHC healthy eating and physical activity practices.

Methods: All NSW OSHC services (approximately 1700) were invited to complete an online survey to assess awareness and use of the ESPS resources (manual and online modules). Data were analysed using SPSS (Version 29).

Results: A total of 393 OSHC staff responded to the survey. Most (75%) had used the ESPS resources. Of the 25% who had not used the resources, 63% indicated it was because they did not receive the manual and 52% were not aware of the resources. Of the OSHC services that knew about the resources, 69% indicated that ESPS contributed to their service's ability to meet the Australian National Quality Standards. Respondents identified additional support was required regarding physical activity educational materials and professional learning. Suggestions for improvements included offering content in different formats (e.g., digital).

Conclusion: This evaluation identified factors influencing the uptake of the ESPS resources and will inform future interventions for OSHC staff to improve knowledge and practices in healthy eating and physical activity promotion. SO WHAT?: Our findings will support the optimisation of ESPS resources and inform future development of future healthy eating and physical activity interventions in the OSHC setting.