Background: Food insecurity in Australia has worsened in recent years, disproportionately impacting vulnerable populations, and contributing to poorer health outcomes. To address this, action must go beyond immediate food relief and focus on shaping healthier, sustainable, and equitable food environments. The ACCC recently called for stronger planning and policies to improve food environment sustainability. Policy reform at the local government (LG) level is therefore critical to improving food security.

Aim: To identify policies or mechanisms LGs can use to improve access to healthier food options and reduce unhealthy food outlet saturation.

Method: A scoping review of English-language studies from January 2010 to March 2025 was conducted. Eligible studies were (1) full-text original articles or reviews, and (2) from high-income Western countries. Reports from food insecure LGAs in north-eastern Melbourne were also reviewed.

Results: 18 studies were included; two on urban planning, five on zoning, five on LG planning documents, and six on community behaviour models. Four key insights emerged: (1) While LG plans often acknowledged food security and healthy eating, practical strategies targeting food environments were largely absent. (2) Compared to the UK and US where multipronged zoning policies have shown potential to reduce unhealthy food density, Australian LG policies are lacking. (3) The absence of public health objectives in urban planning limits efforts to improve food access in new development areas. (4) Modelling tools like agent-based and individually calibrated models can simulate food access dynamics and inform more tailored, equitable interventions.

Conclusion: This study contributes to understanding how LGs might influence structural food environments and underscores the value of international approaches in informing future policy development. Given food environment diversity, no single intervention will be universally effective. Therefore, tailored strategies are crucial, and further research into broader environmental factors is essential to develop well-rounded interventions for healthier food environments.

Objective: To examine the association between maternal diabetes and developmental vulnerability at school entry among children in New South Wales (NSW), Australia.
Methods: This study included all children born in NSW between 2003 and 2005 who were assessed with the Australian Early Development Census (AEDC) in 2009. Developmental vulnerability was measured using the AEDC and defined as scoring below the 10th percentile in one or more domains (DV1), two or more domains (DV2), or within each individual domain. Maternal exposure to gestational diabetes mellitus (GDM) and pre-existing diabetes was identified from the NSW Admitted Patient Data Collection using ICD-10-AM codes. Binary logistic regression models were used to estimate unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs).
Results: Among 67,633 children included in the study, 4.7% were exposed to GDM and 0.3% to pre-existing diabetes. Overall, 25% of children were identified as developmentally vulnerable in at least one domain (DV1), and 23% in two or more domains (DV2). After adjusting for relevant confounders, exposure to GDM was significantly associated with DV1 (OR = 1.18; 95% CI: 1.08–1.29), as well as with increased odds of vulnerability in the domains of physical health and well-being (OR = 1.15; 95% CI: 1.01–1.30), language and cognitive skills (OR = 1.26; 95% CI: 1.09–1.46), and communication skills and general knowledge (OR = 1.25; 95% CI: 1.11–1.40). No significant associations were observed for DV2 (OR = 1.06; 95% CI: 0.94–1.20), or for the domains of emotional maturity (OR = 0.97; 95% CI: 0.84–1.12) and social competence (OR = 1.08; 95% CI: 0.95–1.22). Pre-existing diabetes was not associated with DV1, DV2, or any individual domain.
Conclusion: Exposure to gestational diabetes, but not pre-existing diabetes, was linked to increased developmental vulnerability at school entry, particularly in the physical health, language, and communication domains. These findings highlight the importance of early developmental screening and interventions for children prenatally exposed to GDM.

Despite the extensive physical, mental, and social health advantages of physical activity, children’s physical activity levels remain disturbingly low globally, including within Australia. Low levels of physical activity are especially apparent in children from diverse cultural and linguistic populations and for children located in areas of socio-economic challenge. Family-based interventions are a potential way to increase children's physical activity, but many existing programs do not fully represent the perspectives or lived experiences of the communities they serve.

This study describes the co-design of a culturally acceptable family-focused intervention in south west Sydney. South west Sydney is a low socioeconomic diverse region with nearly half the population born overseas. Levels of children’s physical activity in this region are particularly low and are of concern.

As part of a larger project to address physical inactivity in this region, three co-design workshops with parents and children from various cultural backgrounds, including Vietnamese and Arabic-speaking groups were held to investigate the viewpoints of local families on their desired culturally acceptable, family-focused physical activity program. These workshops were the first step towards creating an inclusive intervention tailored to the requirements of south west Sydney. The workshops explored potential key program features using visual prompts and group activities to co-create programs based on their own experiences.

This presentation will describe the co-design with community and data analysis findings of the workshops such as the cost, location, duration, preferred activities and family involvement that will be considered in the development of the family-based physical activity program. This approach enables community voices into public health planning to inform inclusive heath programs. This strategy acknowledges that effective inclusion involves more than just program delivery, but also who gets to decide the course of action in the first place.

Aim
To assess the association of physical activity (PA) and muscle strengthening activities with depression in persons with type 1 (T1D) and type 2 diabetes (T2D).

Methods
Adults with diabetes (n=3075; mean age 57.6 years, 45.3% female), participated in 2022 cross-sectional Australian National Diabetes Audit (ANDA). Participants reported the amount of moderate or vigorous intensity PA in a usual week (categorised as never/rarely, <150 minutes per week and ≥150mins/week) and participation in muscle-strengthening activities (Yes/No). Depression was identified through clinician diagnosis or prescribed pharmacotherapy for depression. Multivariable logistic regression models, stratified by diabetes type and adjusted for socio-demographics, behavioural and clinical factors, assessed the association of PA and muscle-strengthening activities with depression.

Results
The prevalence of depression was 20.7% in T1D and 21.6% in T2D participants. Rarely or never engaging in PA was reported by 22.7% persons with T1D and 43.3% of those with T2D. Engagement in muscle strengthening activities was reported by 17.1% of persons with T1D and 21.1% of those with T2D. In the fully adjusted models and compared with persons reporting rarely/never engagement in PA, the odds of depression were lower in persons with T1D and T2D who reported activity of more than 150 minutes per week (OR (95%CI): T1D: 0.64 (0.42, 0.98); T2D: 0.70 (0.53, 0.95)). The odds of depression were also lower in persons with T2D who engaged in PA of less than 150 minutes per week (OR (95%CI): 0.73 (0.56, 0.94)). No association was observed between participation in muscle-strengthening activities and depression in people with T1D and T2D.

Conclusion
Engaging in higher levels of moderate or vigorous PA were associated with a lower prevalence of depression in persons with T1D and T2D. Integrating higher levels of PA into the routine diabetes care may help reduce depression in persons living with T1D and T2D.

Background/Aim
Aboriginal people continue to experience disproportionately higher rates of Type 2 diabetes (T2DM) and obesity than non-Indigenous Australians. Despite the global effectiveness of very low-energy diet (VLED) programs in reducing glycated haemoglobin (HbA1c) through weight loss, there is limited research on their efficacy specifically for Aboriginal people. We aimed to examine the feasibility of a VLED and lifestyle intervention in an Aboriginal population and to explore participants' perceptions of the intervention.

Method
A single-arm feasibility study was conducted among 18-65-year-old Aboriginal adults with a BMI≥27kg/m2 and a T2DM diagnosis within the last six years in a remote community in Central Australia, followed by a qualitative phase. This included a 12-week VLED (shakes) taken three times daily, followed by food reintroduction, weight maintenance and regular exercise. The primary outcome measures were changes in HbA1c and BMI from baseline to subsequent phases. Semi-structured interviews were conducted with one VLED participant, five service providers and four clinic clients to explore their experiences. Quantitative data were summarised descriptively, and qualitative data were analysed thematically.

Results
Five participants enrolled in the program; however, none adhered to the prescribed VLED regime or attended weekly clinic appointments. Mean (SD) HbA1c and BMI were 9.3(2.89) and 47.14(9.09), respectively. Key themes emerged around low engagement with program—driven by cultural, motivational and systemic barriers including lack of family involvement and inflexible program design—and limited awareness of T2DM management including knowledge gaps and perceived barriers to future use of injectable treatment.

Conclusion
The intervention was perceived as unlikely to be effective unless culturally responsive, co-designed adaptations are considered—prioritising relationships, family inclusivity and communal cohesion, ensuring accessibility to everyone. This research underscores the importance of community-led, cross-sector collaboration in addressing social determinants of health. Co-designing diabetes care with stakeholders is crucial for enhancing engagement and outcomes in Aboriginal communities.

Aboriginal Governance, data sovereignty and cultural appropriateness
Central Australian Aboriginal Congress (Congress) is an Aboriginal community-controlled health service, governed by a Board elected by the Aboriginal community.

For over 50 years, Congress provided health services and advocacy for Aboriginal people in the struggle for justice and equity. Since that time, Congress has developed a comprehensive, holistic and culturally-responsive primary health care service for Aboriginal people living in Mparntwe (Alice Springs), and nine remote communities: Amoonguna; Ntaria (Hermannsburg); Wallace Rockhole; Ltyentye Apurte (Santa Teresa); Utju (Areyonga); Mutitjulu; Imanpa; Kaltukatjara (Docker River); and Yulara.

Today, we are one of the most experienced Aboriginal primary health care services in the country, a strong political advocate for the health of our people, and a national leader in improving health outcomes for all First Nations.

All research carried out by Congress or in which Congress participates is approved by the Congress Board in strict accordance with the principles of Aboriginal data sovereignty and cultural responsiveness.

Chronic disease is a major contributor to the health gap between First Nations people and non-Indigenous Australians.[1] Effective management of these conditions can lead to better health outcomes, increased quality of life and longer lifespans.[2] However, managing chronic disease often requires individuals to adhere to ongoing treatment plans and lifestyle changes, which can be difficult to maintain. Primary healthcare providers play an important role in improving health outcomes, particularly by supporting people to manage their chronic conditions with Chronic Disease Management (CDM) plans. More than half of First Nations people usually attend a mainstream general practice for their healthcare needs.[3] However, there is limited information about how widely CDM plans are used for First Nations people in this setting. This study used de-identified medical record data from 79 mainstream general practices across New South Wales, Queensland, and Victoria, covering 7,457 Aboriginal and/or Torres Strait Islander clients. Data analysis will examine how frequently CDM plans are utilised for First Nations people living with chronic disease. The study will also explore both client and practice-level factors that may influence the uptake and review of these care plans. The findings aim to improve understanding of how care planning tools are used in mainstream general practice and inform ways to strengthen chronic disease care for First Nations people.

1. Australian Institute of Health and Welfare. Australian Burden of Disease Study: Impact and Causes of Illness and Death in Aboriginal and Torres Strait Islander People 2018. 2022: Australian Institute of Health and Welfare.
2. Reynolds, R., et al., A systematic review of chronic disease management interventions in primary care. BMC family practice, 2018. 19(1): p. 1-13.
3. Australian Bureau of Statistics, National Aboriginal and Torres Strait Islander Health Survey 2018–19. 2019, Australian Bureau of Statistics Canberra, Australia.

The research team recognises the knowledge and strengths of Aboriginal and Torres Strait Islander peoples in determining what is best for the health and wellbeing of their Communities. Aboriginal leadership is ensured through representation in the Investigator team as Chief Investigators of the research grant, and an Aboriginal Reference Group which has oversight over all aspects of the research. The Aboriginal Reference Group is comprised of 8 members (including authors TR, BD, TH, MG) and provides relevant cultural perspectives, guidance and direction to the research. The Aboriginal Reference Group have been engaged in the project from development and are involved in all aspect of the research from project design to review, interpretation and dissemination of data. The research team and Aboriginal Reference Group have co-developed Data Use and Authorship guidelines for the project. Data Stewardship is undertaken by the Aboriginal Reference Group, providing oversight and approval for the use and dissemination of data arising from the research project. This work was undertaken as part of a broader research project which was also reviewed and approved by the University of Newcastle Aboriginal Health Research Community Panel. This Panel is comprised of a diverse group of local Aboriginal and/or Torres Strait Islander community members with expertise to provide essential cultural and community oversight to research. The review process ensures research is ethically sound, culturally appropriate, and has real potential to benefit the local Aboriginal and Torres Strait Islander community. This research was approved by the Aboriginal Health and Medical Research Council Ethics Committee (1969/22). The research has been conducted in accordance with the Australian Institute of Aboriginal and Torres Strait Islander Studies’ (AIATSIS) Code of Ethics for Aboriginal and Torres Strait Islander Research.