2B: Innovations in Global and Community Health
Tracks
Track 2
| Wednesday, September 17, 2025 |
| 9:00 AM - 10:30 AM |
| Henry McCabe Room |
Overview
Rapid Fire Presentations
Speaker
Ms Katharina Engel
Phd Student
Deakin University
Collaborative Leadership and Systems Change in LGBTIQA+ Health: Scoping Review Insights
Abstract
Background: Amid polarisation and persistent health inequities affecting LGBTIQA+ communities, community-engaged systems approaches (SAs) offer promising pathways to address complex, interconnected determinants. This presentation, focusing on the role of collaboration and leadership in SAs, draws on findings from a broader scoping review examining their underexplored application to LGBTIQA+ health and wellbeing.
Methods: A systematic search of seven health and social science databases identified peer-reviewed English literature on SA implementation with LGBTIQA+ communities. Two researchers independently screened articles. Data were analysed using reflexive thematic analysis, and study quality was assessed using the CASP Checklist and SQUIRE 2.0 Guidelines. The review followed PRISMA guidelines.
Results: From 2,086 unique records and 99 full texts screened, eight articles were included: four qualitative studies (three using systems science methods, one a program evaluation) and four describing systems-wide program implementation. Diverse collaborations was a key component of LGBTQIA+ SAs. Interdisciplinary teams engaged stakeholders across the systems and LGBTIQA+ community members to inform, co-design, implement, and lead SAs. Leadership commitment to collaboration and community support was critical to enabling systems change. Supportive, adaptive, and strategic leadership emerged as a further key theme in fostering sustainable change. However, gaps remained in intersectional representation, transparency of engagement, and the implementation of participatory leadership, despite its emphasis.
Conclusions: The findings underscore that meaningful systems change depends on strong collaborations and inclusive leadership. Advancing LGBTIQA+ equity requires SAs governed by participatory leadership and genuinely inclusive, interdisciplinary, and system-wide stakeholder engagement at all stages to build long-term relationships. Future SAs should comprehensively, meaningfully and intersectionally involve LGBTIQA+ communities, including in governance, to enhance community ownership and power-sharing. Leadership should expand diverse support mechanisms, foster capacity-building, ensure inclusive communication, and promote cross-system advocacy. SAs need to stay responsive to evolving needs and strategically manage tailored, sustainable, and multi-component interventions.
Methods: A systematic search of seven health and social science databases identified peer-reviewed English literature on SA implementation with LGBTIQA+ communities. Two researchers independently screened articles. Data were analysed using reflexive thematic analysis, and study quality was assessed using the CASP Checklist and SQUIRE 2.0 Guidelines. The review followed PRISMA guidelines.
Results: From 2,086 unique records and 99 full texts screened, eight articles were included: four qualitative studies (three using systems science methods, one a program evaluation) and four describing systems-wide program implementation. Diverse collaborations was a key component of LGBTQIA+ SAs. Interdisciplinary teams engaged stakeholders across the systems and LGBTIQA+ community members to inform, co-design, implement, and lead SAs. Leadership commitment to collaboration and community support was critical to enabling systems change. Supportive, adaptive, and strategic leadership emerged as a further key theme in fostering sustainable change. However, gaps remained in intersectional representation, transparency of engagement, and the implementation of participatory leadership, despite its emphasis.
Conclusions: The findings underscore that meaningful systems change depends on strong collaborations and inclusive leadership. Advancing LGBTIQA+ equity requires SAs governed by participatory leadership and genuinely inclusive, interdisciplinary, and system-wide stakeholder engagement at all stages to build long-term relationships. Future SAs should comprehensively, meaningfully and intersectionally involve LGBTIQA+ communities, including in governance, to enhance community ownership and power-sharing. Leadership should expand diverse support mechanisms, foster capacity-building, ensure inclusive communication, and promote cross-system advocacy. SAs need to stay responsive to evolving needs and strategically manage tailored, sustainable, and multi-component interventions.
Biography
Katharina M. Engel is a graduate researcher at Deakin University with an interdisciplinary and international background spanning health promotion, journalism, coaching, project management, and advocacy. Her PhD focuses on improving access to primary healthcare for young LGBTQIA+ people in rural and regional South-West Victoria using co-design and systems science. She holds a Master of Public Health and has received several academic awards, including the Berni Murphy thesis award for the presented research.
Katharina’s research interests lie in inclusive, mixed-methods approaches to complex health inequities, combining public health, human rights, and systems thinking. She brings professional expertise and lived experience together to offer a compassionate and nuanced perspective. Guided by her values of equity, diversity, sustainability, and collaboration, she is committed to empowering marginalised communities and contributing to more inclusive and supportive systems.
Dr Kim Kiely
Lecturer
University Of Wollongong
Examining inequalities in disability-free life expectancy between migrant and non-migrant Australians
Abstract
Background:
There is limited evidence on healthy longevity among migrant populations in Australia. This study examined disability-free life expectancy among migrants by their language first spoken, age at migration, and gender.
Methods:
4951 respondents (ages 50+; 47.4% men, 52.6% women) from the Household Income and Labour Dynamics in Australia (HILDA) were followed annually from 2001. Mortality data were obtained from the National Death Index and family reports. Migrant groups were defined by language first spoken (English versus Other) and age at migration (age < 25, age ≥25) and compared to Australian born persons. Disability was defined by self-reported limiting long-term condition or impairment. Mobility limitations were defined by the SF-36 physical functioning sub-scale. Interpolated Markov-chain multistate models were used to estimate transitions between health states and calculate disability-free life expectancies.
Results:
Men for whom English was not their first language and migrated to Australia after the age of 25 had longer life expectancy but also more years lived with disability than Australian-born men. In contrast, native English-speaking men who migrated after age 25 had the longest disability-free life years and fewest years lived with disability. Women for whom English was not their first language and migrated to Australia after the age of 25 had the fewest years lived disability free and the most years lived with disability compared to all other groups.
Conclusion:
These findings indicate heterogeneity in migrant health expectancies when disaggregated by gender, language, and acculturation, providing evidence of both a healthy migrant effect and health disadvantage. Notably, health disadvantage was most prominent among women who were not native English speakers and who migrated during adulthood.
There is limited evidence on healthy longevity among migrant populations in Australia. This study examined disability-free life expectancy among migrants by their language first spoken, age at migration, and gender.
Methods:
4951 respondents (ages 50+; 47.4% men, 52.6% women) from the Household Income and Labour Dynamics in Australia (HILDA) were followed annually from 2001. Mortality data were obtained from the National Death Index and family reports. Migrant groups were defined by language first spoken (English versus Other) and age at migration (age < 25, age ≥25) and compared to Australian born persons. Disability was defined by self-reported limiting long-term condition or impairment. Mobility limitations were defined by the SF-36 physical functioning sub-scale. Interpolated Markov-chain multistate models were used to estimate transitions between health states and calculate disability-free life expectancies.
Results:
Men for whom English was not their first language and migrated to Australia after the age of 25 had longer life expectancy but also more years lived with disability than Australian-born men. In contrast, native English-speaking men who migrated after age 25 had the longest disability-free life years and fewest years lived with disability. Women for whom English was not their first language and migrated to Australia after the age of 25 had the fewest years lived disability free and the most years lived with disability compared to all other groups.
Conclusion:
These findings indicate heterogeneity in migrant health expectancies when disaggregated by gender, language, and acculturation, providing evidence of both a healthy migrant effect and health disadvantage. Notably, health disadvantage was most prominent among women who were not native English speakers and who migrated during adulthood.
Biography
Dr Kiely has a joint cross-faculty position in the University of Wollongong School of Mathematics and Applied Statistics and School of Social Sciences where he teaches data science, applied biostatistics, and epidemiological methods in public health programs. Dr Kiely’s research adopts a contextualised perspective to healthy ageing across the life-course. He draws on theory and methods of life course epidemiology, social psychiatry, and gerontology to inform strategies to promote ageing well. He is co-chair of the NSW division of the Australian Association of Gerontology.
Dr Amanda Alderton
Research Fellow
RMIT University
Mapping the neighbourhood with young children and caregivers: findings and reflections
Abstract
Early childhood (0-8 years) represents a key opportunity for improving wellbeing across the life course. Early child development is shaped through the social determinants of health, including cities and neighbourhoods, which require multisectoral action (e.g., health, education, urban planning). However, we lack an in-depth understanding of the neighbourhood features that promote optimal early childhood outcomes. Further, relationships between families’ experiences of place, space (i.e., spatial scales), and behaviours (e.g., families’ selection and use of services) are not well understood.
The Early Childhood Data to Decisions project is a mixed methods study conducted in Melbourne, Australia, funded by VicHealth. It aims to identify neighbourhood features important for early child development. It was underpinned by a children’s rights perspective and was designed to involve children in discussions about issues that affect them. A secondary aim was to pilot-test the use of Public Participation Geographic Information Systems (PPGIS) – a digital mapping technique –with young children (ages 4-8 years), supported by their primary caregivers. PPGIS enables the collection of spatially-referenced experiences of place to inform urban planning. To our knowledge, this is the first study to use PPGIS with young children. We complemented PPGIS with other child-centred methods (e.g., drawing activity).
We faced considerable challenges in recruitment, both situational and systemic. To meet families’ preferences, we adapted our methods to online participation. Eight caregivers (five with usable data) and four children (three with usable data) participated in PPGIS. On average, young children mapped two important places each, the most frequently mapped being parks and shops. Caregivers identified 23 neighbourhood destinations as important to their child’s wellbeing, the most frequently mapped being libraries and playgroups. Young children required considerable assistance with PPGIS, and substantial investment in pilot-testing is needed. Our experience reinforced the importance of face-to-face data collection with children to avoid caregiver-driven responses.
The Early Childhood Data to Decisions project is a mixed methods study conducted in Melbourne, Australia, funded by VicHealth. It aims to identify neighbourhood features important for early child development. It was underpinned by a children’s rights perspective and was designed to involve children in discussions about issues that affect them. A secondary aim was to pilot-test the use of Public Participation Geographic Information Systems (PPGIS) – a digital mapping technique –with young children (ages 4-8 years), supported by their primary caregivers. PPGIS enables the collection of spatially-referenced experiences of place to inform urban planning. To our knowledge, this is the first study to use PPGIS with young children. We complemented PPGIS with other child-centred methods (e.g., drawing activity).
We faced considerable challenges in recruitment, both situational and systemic. To meet families’ preferences, we adapted our methods to online participation. Eight caregivers (five with usable data) and four children (three with usable data) participated in PPGIS. On average, young children mapped two important places each, the most frequently mapped being parks and shops. Caregivers identified 23 neighbourhood destinations as important to their child’s wellbeing, the most frequently mapped being libraries and playgroups. Young children required considerable assistance with PPGIS, and substantial investment in pilot-testing is needed. Our experience reinforced the importance of face-to-face data collection with children to avoid caregiver-driven responses.
Biography
Dr Amanda Alderton is a Vice Chancellor’s Postdoctoral Research Fellow in the School of Global, Urban and Social Studies. Drawing on her experience as a classroom teacher, Amanda works across disciplines including public health, health geography, urban studies, and developmental psychology. She holds a PhD in Global, Urban and Social Studies (RMIT University) and a Master of Public Health (University of Melbourne).
Dr Alderton’s research seeks to understand the causes and consequences of mental health inequities: disparities in mental health between population groups that arise not through biology, but due to unequal living conditions, and are therefore preventable and unjust. Her research interests also include the study of neighbourhood effects, the built environment, place-based interventions, and positive mental health. Her research ultimately aims to identify how place-based approaches can address mental health inequities during critical windows of development (e.g., early childhood, adolescence) to improve mental health across the life course.
Prof Inge Petersen
Research Professor
Centre For Research In Health Systems, University Of Kwazulu-natal, South Africa
Closing the implementation gap in Global Mental Health. Lessons from South Africa
Abstract
Background: The treatment gap for mental health conditions continues to be a challenge in global mental health. Implementation of these evidence-based innovations in real-world settings remains slow, with recommendations for closing the know-do implementation gap largely based on data from high-income settings.
Aim: Based on a practice case study in South Africa, share methodological lessons on the implementation and scaling up of an evidence-based integrated package of care for common mental health conditions in primary health care.
Method used in the case study: A learning health system approach was used for implementation and scale-up. Learning collaboratives using existing fora within the local Department of Health at the mico-, meso- and macro-levels were leveraged. Continuous Quality Improvement methods using routinely collected service data at the micro- and meso-levels within a learning site were used alongside iteratively collected implementation research data. Collectively these data were used to iteratively co-refine innovations and implementation strategies culminating in policy changes and implementation strategies for broader scale-up by the macro learning collaboratives.
Lessons: Cultural brokerage and sharing of resources aided building trusting and equitable relationships between researchers and implementers, enabling a culture of mutual learning; leveraging existing multilevel learning collaboratives enabled ongoing collaborations beyond research funding cycles, promoting sustained research and capacity building support for broad scale-up of innovations; the use of routine service data in conjunction with implementation research data and a bottom-up co-refinement process emerged as key enablers of ownership of innovations, and policy changes for implementation at scale. Ensuring real (as opposed to tokenistic) equity of people with lived experience in multi-stakeholder learning collaboratives was a challenge, and remains an ongoing challenge in global mental health given high levels of stigma and marginalization.
Aim: Based on a practice case study in South Africa, share methodological lessons on the implementation and scaling up of an evidence-based integrated package of care for common mental health conditions in primary health care.
Method used in the case study: A learning health system approach was used for implementation and scale-up. Learning collaboratives using existing fora within the local Department of Health at the mico-, meso- and macro-levels were leveraged. Continuous Quality Improvement methods using routinely collected service data at the micro- and meso-levels within a learning site were used alongside iteratively collected implementation research data. Collectively these data were used to iteratively co-refine innovations and implementation strategies culminating in policy changes and implementation strategies for broader scale-up by the macro learning collaboratives.
Lessons: Cultural brokerage and sharing of resources aided building trusting and equitable relationships between researchers and implementers, enabling a culture of mutual learning; leveraging existing multilevel learning collaboratives enabled ongoing collaborations beyond research funding cycles, promoting sustained research and capacity building support for broad scale-up of innovations; the use of routine service data in conjunction with implementation research data and a bottom-up co-refinement process emerged as key enablers of ownership of innovations, and policy changes for implementation at scale. Ensuring real (as opposed to tokenistic) equity of people with lived experience in multi-stakeholder learning collaboratives was a challenge, and remains an ongoing challenge in global mental health given high levels of stigma and marginalization.
Biography
Professor Inge Petersen is a Research Professor and Director of the Centre for Research in Health systems at the University of KwaZulu-Natal, South Africa, as well as Visiting Professor at the Global Health Institute, University College London and Honorary Professor at the Knowledge Translation Unit, Department of Medicine, University of Cape Town. She has extensive expertise in health systems strengthening for integrated primary health care and community health, with an emphasis on mental health care in low- and middle-income countries
Mr Masum Billah
Phd Candidate
Southern Cross University
Health promotion needs of refugees in high-income countries: A systematic review
Abstract
Background
Refugees are screened for communicable diseases when they arrive in their host country. Noncommunicable diseases (NCDs) and risky health behaviours may be overlooked or developed after arrival, and the implications these pose for health promotion are not well understood. This systematic review examines the health promotion needs of refugees in high-income countries HICs, specifically addressing smoking, nutrition, alcohol consumption, and physical activity (SNAP) behaviours and exploring relevant health promotion interventions.
Methods
We searched four electronic bibliographic databases: MEDLINE, CINAHL, PsycINFO, and Web of Science. Original research papers focusing on adult refugees in English were included, covering at least one SNAP behaviour and published between 2000 and 2022. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Due to high heterogeneity, we followed a narrative synthesis approach to analyse the findings. The study protocol is registered with PROSPERO (reference no. CRD42023391942).
Results
Refugees had high rates of smoking, alcohol consumption, nutritional disorders, and physical inactivity. Men had a higher prevalence of smoking and alcohol consumption than women, suggesting gender-disproportionate NCDs. Length of stay, nativity, and post-traumatic stress disorder (PTSD) influenced SNAP behaviours and are likely to contribute to developing heart disease, lung cancer, diabetes, hypertension, and overweight/obesity. Culture and language-sensitive health materials, educational campaigns, cessation aids, cooking workshops, alcohol counselling, and free sports and physical activity sessions were largely successful health promotion interventions.
Conclusion
Despite significant heterogeneity across study designs and outcome measures, robust evidence demonstrates that NCDs and chronic conditions are affected by the SNAP health risk behaviours and related promotion interventions in HICs. Future public health policies should follow the Ottawa Charter’s protocols, emphasising multisectoral collaboration and coordination for better interventions by engaging relevant stakeholders. Future studies should apply co-design methods and more longitudinal designs with refugee communities. Health professionals and other support personnel should follow evidence-informed measures.
Refugees are screened for communicable diseases when they arrive in their host country. Noncommunicable diseases (NCDs) and risky health behaviours may be overlooked or developed after arrival, and the implications these pose for health promotion are not well understood. This systematic review examines the health promotion needs of refugees in high-income countries HICs, specifically addressing smoking, nutrition, alcohol consumption, and physical activity (SNAP) behaviours and exploring relevant health promotion interventions.
Methods
We searched four electronic bibliographic databases: MEDLINE, CINAHL, PsycINFO, and Web of Science. Original research papers focusing on adult refugees in English were included, covering at least one SNAP behaviour and published between 2000 and 2022. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Due to high heterogeneity, we followed a narrative synthesis approach to analyse the findings. The study protocol is registered with PROSPERO (reference no. CRD42023391942).
Results
Refugees had high rates of smoking, alcohol consumption, nutritional disorders, and physical inactivity. Men had a higher prevalence of smoking and alcohol consumption than women, suggesting gender-disproportionate NCDs. Length of stay, nativity, and post-traumatic stress disorder (PTSD) influenced SNAP behaviours and are likely to contribute to developing heart disease, lung cancer, diabetes, hypertension, and overweight/obesity. Culture and language-sensitive health materials, educational campaigns, cessation aids, cooking workshops, alcohol counselling, and free sports and physical activity sessions were largely successful health promotion interventions.
Conclusion
Despite significant heterogeneity across study designs and outcome measures, robust evidence demonstrates that NCDs and chronic conditions are affected by the SNAP health risk behaviours and related promotion interventions in HICs. Future public health policies should follow the Ottawa Charter’s protocols, emphasising multisectoral collaboration and coordination for better interventions by engaging relevant stakeholders. Future studies should apply co-design methods and more longitudinal designs with refugee communities. Health professionals and other support personnel should follow evidence-informed measures.
Biography
Masum Billah is currently pursuing his PhD in the Faculty of Health Science at Southern Cross University, New South Wales, Australia, sponsored by the Australian Commonwealth Government Research Training Program (RTP) Scholarship. He has been serving as a Senior Lecturer in the Department of Sociology at East West University, Dhaka, Bangladesh.
Mr Masum obtained Master degree in Public Health in Disasters from Karolinska Institute, Sweden, and the University of Oviedo, Spain funded by the Erasmus Mundus Scholarship of the European Commission. He also completed Honours and Master degree in Sociology at the University of Dhaka, Bangladesh.
His research focuses on risk behaviours (SNAP), health promotion, non-communicable diseases, and psychiatric epidemiology. Masum has a good number of publications with good impact factors in internationally recognised journals and considerable citations. He has also presented research papers as a presenter, discussant, and speaker at international conferences, congresses, and seminars.
Miss Xinyi Zhang
Phd Student
The George Institute For Global Health
Identifying Walkability Indicators for Older People in Hong Kong: A Photovoice Study
Abstract
Background:
Walking is critical for healthy ageing because of the importance of physical activity to health, and in the broader context of transportation. However, most walkability measures do not consider the older person's perspective. To address this gap, we are developing a new walkability metric co-designed with older people.
Aims:
As a first step, this study aims to identify what elements of walkability affect older people's walking experience in Hong Kong.
Method:
This study uses a participatory ‘Photovoice’ approach that combines photography and storytelling to capture the lived experience of participants. Participants (n=30, >65 years, Hong Kong residents) recorded their feelings over a two-week period while walking through their usual environment using photographs and voice or text. GPS features in smart phones were used to record their walking paths. Each participant identified 5 areas that made them feel comfortable or uncomfortable while walking, and explained these during one-to-one interviews. A researcher assisted them to compile an Analytic Hierarchy Process table to rank the importance of the walkability elements.
Results:
Preliminary results indicate that environmental features such as footpath design, accessibility to steep areas through elevators and ramps, provision of handrails, rest areas, signage containing easy to understand information and the general visual amenity are important to older pedestrians. Key elements associated with walkability for older people appear to be path levelling, step alternatives and design and signage.
Conclusion: The preliminary findings indicate older people consider safety and ease of walking/access in their local environments to be more important than land use elements often more strongly considered in many existing measures of walkability. The ranked lists of walkability elements generated through this study will be used to deliver an older-person centric walkability metric. Ultimately, we hope this work can contribute to enhanced understanding of what constitutes an age-friendly city.
Walking is critical for healthy ageing because of the importance of physical activity to health, and in the broader context of transportation. However, most walkability measures do not consider the older person's perspective. To address this gap, we are developing a new walkability metric co-designed with older people.
Aims:
As a first step, this study aims to identify what elements of walkability affect older people's walking experience in Hong Kong.
Method:
This study uses a participatory ‘Photovoice’ approach that combines photography and storytelling to capture the lived experience of participants. Participants (n=30, >65 years, Hong Kong residents) recorded their feelings over a two-week period while walking through their usual environment using photographs and voice or text. GPS features in smart phones were used to record their walking paths. Each participant identified 5 areas that made them feel comfortable or uncomfortable while walking, and explained these during one-to-one interviews. A researcher assisted them to compile an Analytic Hierarchy Process table to rank the importance of the walkability elements.
Results:
Preliminary results indicate that environmental features such as footpath design, accessibility to steep areas through elevators and ramps, provision of handrails, rest areas, signage containing easy to understand information and the general visual amenity are important to older pedestrians. Key elements associated with walkability for older people appear to be path levelling, step alternatives and design and signage.
Conclusion: The preliminary findings indicate older people consider safety and ease of walking/access in their local environments to be more important than land use elements often more strongly considered in many existing measures of walkability. The ranked lists of walkability elements generated through this study will be used to deliver an older-person centric walkability metric. Ultimately, we hope this work can contribute to enhanced understanding of what constitutes an age-friendly city.
Biography
Xinyi Zhang
PhD Candidate, The George Institute for Global Health, University of New South Wales (UNSW)
Xinyi Zhang holds an academic background in urban planning and is currently pursuing doctoral research on age-friendly urban environments. Her work focuses on redefining walkability from the perspective of older adults by employing participatory methods such as photovoice, GIS-based spatial analysis, and mixed-methods research.
She collaborates with The George Institute for Global Health and The Chinese University of Hong Kong to bridge design thinking with public health and urban policy. Her research aims to inform inclusive planning practices and promote walkable environments that better meet the needs of ageing populations.
Ms Madeline Cairns
Engagement Manager
BreastScreen Victoria
BreastScreen Victoria’s Multicultural Project: increasing access through language and culture
Abstract
BreastScreen Victoria’s (BSV) Multicultural Project was a state-wide initiative aimed at increasing breast screening participation among women from culturally and linguistically diverse (CALD) backgrounds. The project addressed key barriers such as language, cultural stigma, and low health literacy, which made access breast screening difficult.
In Victoria, more than one in four people speak a language other than English at home. CALD women were under-screened compared to the general population, a gap that widened during COVID-19. Launched in 2021 with funding from the Victorian Department of Health, the Multicultural Project focused on culturally safe, inclusive, and accessible care.
A key aspect of the project was the Bilingual Engagement team, which consisted of staff fluent in multiple languages who worked directly with multicultural communities. The team provided support throughout the entire screening journey, from initial contact to attending appointments. They spoke in-language forming trusted relationships to break down barriers.
Tailored engagement activities included in-language SMS reminders, outbound calls, group bookings with interpreters, culturally tailored videos, and attendance at multicultural community events in areas with low screening rates.
From 2021 to 2024, the project:
• Helped over 3,500 women book a screen
• Delivered more than 60 group sessions with interpreters
• Conducted 119 education and workforce training sessions
• Attended 51 community events
The in-language SMS campaign became embedded in BSV’s operations, and the suite of translated resources was expanded in collaboration with the Communications team. A partnership has also been established with TAFE institutes to co-design and deliver AMEP (Adult Migrant English Program) modules, ensuring that breast health education is integrated into the learning of newly arrived migrants.
By 2024, we achieved 95% of our multicultural participation target. This Project demonstrated the impact of culturally responsive care and offered a strong model for improving health equity. It has also strengthened our partnerships with multicultural organisations making us more strategic in reaching potential clients.
In Victoria, more than one in four people speak a language other than English at home. CALD women were under-screened compared to the general population, a gap that widened during COVID-19. Launched in 2021 with funding from the Victorian Department of Health, the Multicultural Project focused on culturally safe, inclusive, and accessible care.
A key aspect of the project was the Bilingual Engagement team, which consisted of staff fluent in multiple languages who worked directly with multicultural communities. The team provided support throughout the entire screening journey, from initial contact to attending appointments. They spoke in-language forming trusted relationships to break down barriers.
Tailored engagement activities included in-language SMS reminders, outbound calls, group bookings with interpreters, culturally tailored videos, and attendance at multicultural community events in areas with low screening rates.
From 2021 to 2024, the project:
• Helped over 3,500 women book a screen
• Delivered more than 60 group sessions with interpreters
• Conducted 119 education and workforce training sessions
• Attended 51 community events
The in-language SMS campaign became embedded in BSV’s operations, and the suite of translated resources was expanded in collaboration with the Communications team. A partnership has also been established with TAFE institutes to co-design and deliver AMEP (Adult Migrant English Program) modules, ensuring that breast health education is integrated into the learning of newly arrived migrants.
By 2024, we achieved 95% of our multicultural participation target. This Project demonstrated the impact of culturally responsive care and offered a strong model for improving health equity. It has also strengthened our partnerships with multicultural organisations making us more strategic in reaching potential clients.
Biography
Madeline Cairns | Breast Screen Victoria |
Engagement Manager | Consumer & Community Engagement | Aboriginal Health | Multicultural Outreach | Project Leadership
Madeline Cairns is a dedicated Engagement Manager with a strong focus on improving access to essential health services for Aboriginal and Culturally and Linguistically Diverse (CALD) communities. With extensive experience in consumer engagement, program development, and stakeholder collaboration, she leads initiatives that enhance inclusivity and cultural safety in healthcare.
In her role at BreastScreen Victoria (BSV), Madeline drives key engagement strategies, ensuring that diverse communities have equitable access to screening services. Overseeing multicultural engagement, forging partnerships with AMES, community groups, and health networks to strengthen outreach and participation. Her expertise spans stakeholder engagement, strategic program delivery, and advocacy for healthcare equity
Madeline is passionate about building meaningful community partnerships, amplifying consumer voices, and driving initiatives that create lasting impact in public health.
Miss Mintar Hongtumrong
Master Degree Student
Mahidol University
Access to Gender-Affirming Hormone Therapy among Transgender Individuals in Thailand
Abstract
This mixed-methods research aimed to explore access to gender-affirming hormone therapy (GAHT) among transgender and gender-diverse individuals in Thailand. The objectives were: (1) to examine patterns of hormone service utilization, (2) to understand transgender individuals’ lived experiences in using hormones, and (3) to analyze factors associated with access to hormone therapy. A convergent parallel design was employed, integrating quantitative and qualitative data to provide a holistic view.
The quantitative strand analyzed anonymized secondary data from 479 transgender individuals using descriptive and inferential statistics. Key variables such as gender identity, age, income, region of residence, and health insurance status were found to be significantly associated with the type of healthcare facility accessed—general versus LGBT-specific facilities. For instance, trans women, younger individuals, and those with comprehensive insurance coverage were more likely to access LGBT-specific clinics.
The qualitative strand involved in-depth interviews with transgender individuals who had used hormones for more than six months. Using Levesque’s healthcare access framework, themes emerged around structural barriers such as affordability and service concentration in urban areas, as well as enabling factors like peer-led information sharing and self-navigation of care.
Findings from both strands demonstrate the influence of socioeconomic, geographic, and systemic determinants on GAHT access and suggest the need for equitable, gender-sensitive, and decentralized services tailored to transgender needs in Thailand.
The quantitative strand analyzed anonymized secondary data from 479 transgender individuals using descriptive and inferential statistics. Key variables such as gender identity, age, income, region of residence, and health insurance status were found to be significantly associated with the type of healthcare facility accessed—general versus LGBT-specific facilities. For instance, trans women, younger individuals, and those with comprehensive insurance coverage were more likely to access LGBT-specific clinics.
The qualitative strand involved in-depth interviews with transgender individuals who had used hormones for more than six months. Using Levesque’s healthcare access framework, themes emerged around structural barriers such as affordability and service concentration in urban areas, as well as enabling factors like peer-led information sharing and self-navigation of care.
Findings from both strands demonstrate the influence of socioeconomic, geographic, and systemic determinants on GAHT access and suggest the need for equitable, gender-sensitive, and decentralized services tailored to transgender needs in Thailand.
Biography
Mintar Hongtumrong is a master’s student (2023–present) in the Medical and Public Health Social Sciences program at a university in Thailand. Holds a Bachelor’s degree in Public Health (2013–2017). Professional experience includes involvement in various public health and policy-related research projects, particularly those addressing health equity and access. Current research focuses on access to gender-affirming hormone therapy among transgender and gender-diverse populations in Thailand. Research interests include inclusive health systems, social determinants of health, and reducing structural barriers for marginalized communities.
Mr Ayal Debie Tefera
PhD Student
Flinders University
Effective Coverage of Antenatal Care Service Utilisation in Ethiopia: A Spatial Analysis
Abstract
Abstract
Background: Approximately 800 women die every day due to pregnancy and childbirth-related causes. In response to the high maternal deaths, countries have individually and/ or collectively committed to achieving universal health coverage (UHC) by 2030. Effective coverage is a key metric for tracking progress in service provision of UHC. This study aimed to assess the magnitude of effective coverage of four or more antenatal care visits (ANC4+) and its spatial distribution in Ethiopia.
Methods: We estimated the effective coverage of ANC using the Ethiopian Mini-Demography and Health Survey (EMDHS) 2019 and Ethiopian Service Provision Assessment Plus (ESPA+) 2021–22 data. A total weighted sample of 3,617 pregnant women in EMDHS 2019 and 659 health facilities in ESPA+ 2021-22 were eligible for this analysis. Crude coverage was calculated from the EMDHS, while a quality index was calculated from the ESPA+ data. We also analysed the spatial distribution of effective coverage of ANC4+ to assess the geographic variations.
Results: The overall crude and effective coverage of ANC4+ were 41.5% and 21.7%, respectively, with the lowest in the Somali region and the highest in Addis Ababa. The overall quality of ANC was 52.3% with the lowest in Gambela and the highest in Benshangul-Gumuz region. The spatial distribution of effective coverage of ANC4+ revealed significant geographic disparities, with highest coverage clustering in Addis Ababa and central and northeast parts of Oromia, and the lowest clustering in Somali and Gambela regions.
Conclusion: This study revealed that the effective coverage of ANC4+ was low due to a substantial low achievement in the crude coverage of ANC4+ and quality of care. Highest clustering of effective coverage of ANC4+ occurred around the capital city of the country and lowest coverage was observed in pastoral communities. Therefore, geographic-specific intervention strategies should be designed to improve access and quality of ANC services.
Keywords: Antenatal Care, Ethiopia, Effective Coverage, Spatial Analysis
Background: Approximately 800 women die every day due to pregnancy and childbirth-related causes. In response to the high maternal deaths, countries have individually and/ or collectively committed to achieving universal health coverage (UHC) by 2030. Effective coverage is a key metric for tracking progress in service provision of UHC. This study aimed to assess the magnitude of effective coverage of four or more antenatal care visits (ANC4+) and its spatial distribution in Ethiopia.
Methods: We estimated the effective coverage of ANC using the Ethiopian Mini-Demography and Health Survey (EMDHS) 2019 and Ethiopian Service Provision Assessment Plus (ESPA+) 2021–22 data. A total weighted sample of 3,617 pregnant women in EMDHS 2019 and 659 health facilities in ESPA+ 2021-22 were eligible for this analysis. Crude coverage was calculated from the EMDHS, while a quality index was calculated from the ESPA+ data. We also analysed the spatial distribution of effective coverage of ANC4+ to assess the geographic variations.
Results: The overall crude and effective coverage of ANC4+ were 41.5% and 21.7%, respectively, with the lowest in the Somali region and the highest in Addis Ababa. The overall quality of ANC was 52.3% with the lowest in Gambela and the highest in Benshangul-Gumuz region. The spatial distribution of effective coverage of ANC4+ revealed significant geographic disparities, with highest coverage clustering in Addis Ababa and central and northeast parts of Oromia, and the lowest clustering in Somali and Gambela regions.
Conclusion: This study revealed that the effective coverage of ANC4+ was low due to a substantial low achievement in the crude coverage of ANC4+ and quality of care. Highest clustering of effective coverage of ANC4+ occurred around the capital city of the country and lowest coverage was observed in pastoral communities. Therefore, geographic-specific intervention strategies should be designed to improve access and quality of ANC services.
Keywords: Antenatal Care, Ethiopia, Effective Coverage, Spatial Analysis
Biography
Ayal Debie Tefera is a third-year PhD student at Flinders University, Australia, pursuing a thesis titled “Measuring Maternal Healthcare Services Toward Universal Health Coverage in Ethiopia: Continuity of Care, (In)Equity, Effective Coverage, Financing and Responsiveness.” His research interests include health systems research across national, regional, and global contexts, maternal and child health epidemiology, and health policy analysis. Prior to his PhD, he worked in the Department of Health Systems and Policy at the University of Gondar, Ethiopia. He has authored over 40 peer-reviewed journal articles.
Mr Zelalem Azene
PhD Student
University of Wollongong
Perinatal Intimate Partner Violence and Breastfeeding Outcomes: A Systematic Review and Meta-Analysis
Abstract
Abstract
Background: Intimate partner violence (IPV) adversely affects both maternal and child health, particularly during the perinatal period—a time of heightened vulnerability. However, the impact of maternal IPV exposure on breastfeeding outcomes remains understudied, with existing evidence being inconsistent. This systematic review and meta-analysis aimed to synthesise current findings on the association between perinatal IPV (P-IPV) and breastfeeding outcomes.
Methods: A comprehensive literature search was conducted across PsycInfo, Scopus, Web of Science, Medline, Cochrane, JBI EBP, CINAHL, Informit, and PubMed between June 15 and August 2, 2024. Peer-reviewed observational studies examining the association between P-IPV and breastfeeding outcomes—such as early initiation, exclusivity, and duration—were included. Heterogeneity was assessed using the Cochrane Q test and I² statistic. Publication bias was evaluated through funnel plot inspection and Egger’s test at a 5% significance level. A random effects model was used to compute pooled adjusted odds ratios (AORs) and 95% confidence intervals (CIs).
Results: Nineteen observational studies published between 2007 and 2024, encompassing 347,706 mother-child pairs, met the inclusion criteria; 17 were included in the meta-analysis. Pooled analysis of nine studies showed that P-IPV was significantly associated with delayed breastfeeding initiation (AOR: 1.36; 95% CI: 1.14–1.63). Both physical (AOR: 1.20; 95% CI: 1.02–1.42) and psychological IPV (AOR: 1.38; 95% CI: 1.09–1.74) negatively affected timely breastfeeding initiation. Additionally, nine studies showed that women exposed to P-IPV had higher odds of not exclusively breastfeeding (EBF) at six months (AOR: 1.50; 95% CI: 1.21–1.85), with significant effects observed for both physical (AOR: 1.52; 95% CI: 1.18–1.95) and psychological IPV (AOR: 1.56; 95% CI: 1.39–1.76).
Conclusion: Perinatal IPV significantly affects breastfeeding initiation and exclusivity. The findings highlight the need for trauma-informed screening and early interventions to support affected women during the perinatal period.
Background: Intimate partner violence (IPV) adversely affects both maternal and child health, particularly during the perinatal period—a time of heightened vulnerability. However, the impact of maternal IPV exposure on breastfeeding outcomes remains understudied, with existing evidence being inconsistent. This systematic review and meta-analysis aimed to synthesise current findings on the association between perinatal IPV (P-IPV) and breastfeeding outcomes.
Methods: A comprehensive literature search was conducted across PsycInfo, Scopus, Web of Science, Medline, Cochrane, JBI EBP, CINAHL, Informit, and PubMed between June 15 and August 2, 2024. Peer-reviewed observational studies examining the association between P-IPV and breastfeeding outcomes—such as early initiation, exclusivity, and duration—were included. Heterogeneity was assessed using the Cochrane Q test and I² statistic. Publication bias was evaluated through funnel plot inspection and Egger’s test at a 5% significance level. A random effects model was used to compute pooled adjusted odds ratios (AORs) and 95% confidence intervals (CIs).
Results: Nineteen observational studies published between 2007 and 2024, encompassing 347,706 mother-child pairs, met the inclusion criteria; 17 were included in the meta-analysis. Pooled analysis of nine studies showed that P-IPV was significantly associated with delayed breastfeeding initiation (AOR: 1.36; 95% CI: 1.14–1.63). Both physical (AOR: 1.20; 95% CI: 1.02–1.42) and psychological IPV (AOR: 1.38; 95% CI: 1.09–1.74) negatively affected timely breastfeeding initiation. Additionally, nine studies showed that women exposed to P-IPV had higher odds of not exclusively breastfeeding (EBF) at six months (AOR: 1.50; 95% CI: 1.21–1.85), with significant effects observed for both physical (AOR: 1.52; 95% CI: 1.18–1.95) and psychological IPV (AOR: 1.56; 95% CI: 1.39–1.76).
Conclusion: Perinatal IPV significantly affects breastfeeding initiation and exclusivity. The findings highlight the need for trauma-informed screening and early interventions to support affected women during the perinatal period.
Biography
Zelalem Azene is a PhD student at the University of Wollongong, Australia, and an Assistant Professor of Reproductive and Child Health at the University of Gondar, Ethiopia. His doctoral research focuses on the impact of intimate partner violence on maternal and child health. He holds a BSc in Midwifery and an MPH from the University of Gondar, earned in 2015 and 2018, respectively. Zelalem has authored over 40 peer-reviewed publications and serves as an Academic Editor for PLOS ONE and an Editorial Board Member for BMC women's Health and related BMC series journals. His research interests include gender-based violence, maternal and child health, and global health equity.
Dr M Tasdik Hasan
Phd Fellow; Assistant Lecturer
Monash University, Melbourne, Australia
Beyond Broadcast: Co-Creating a Mental Health Movement Through Mass Media in Bangladesh
Abstract
In early 2023, Shurokkhay Manoshik Shashtho (Caring for Your Mental Health)—a pioneering digital mental health initiative—was launched by Channel 24, a leading mainstream television broadcaster in Bangladesh. As the first primetime television program in the country dedicated entirely to mental health, the initiative represents a major milestone in destigmatizing mental health discourse in a context marked by silence, systemic neglect, and a treatment gap exceeding 90%. Co-hosted by a team comprising globally trained digital mental health researchers, public health professionals, and a medical doctor, the weekly program integrates science communication, digital storytelling, and inclusive dialogue to engage broad audiences with mental health knowledge.
Each of the 106 episodes is informed by a consultative process and features curated discussions with mental health professionals, researchers, advocates, and individuals with lived experience. The show addresses a wide range of mental health issues—including adolescent wellbeing, dementia, parenting, disability, gender and sexuality, refugee mental health, and climate-induced psychological stress. Special emphasis is placed on amplifying marginalized voices, such as those of transgender individuals, persons with disabilities, and climate-vulnerable communities, positioning the initiative as an inclusive and rights-based public health intervention.
In a country of over 180 million people and fewer than 500 trained mental health professionals, 'Shurokkhay Manoshik Shashtho' provides an urgently needed platform to raise awareness, counter stigma, and promote digital and community-based solutions. Its public engagement has been substantial, garnering over 717,000 YouTube views, 35 million impressions, and more than 41,000 hours of watch time, with a rapidly growing audience via Channel 24’s 14.8 million subscribers. The initiative also supports academic and policy discourse, featuring sessions from national and international conferences and collaborating with institutions such as the National Institute of Mental Health–Bangladesh, Moner Bondhu, Psycure Organisation, Public Health Foundation Bangladesh, Planetary Health Academia, and the eMental Health International Collaborative (eMHIC).
This initiative transcends conventional talk shows, operating as a digital mental health intervention at the intersection of mass media, public engagement, and global mental health. By centering lived experiences and evidence-based discussion, it demonstrates how locally rooted, scalable media platforms can advance population-level mental health literacy and policy dialogue in low- and middle-income countries.
Each of the 106 episodes is informed by a consultative process and features curated discussions with mental health professionals, researchers, advocates, and individuals with lived experience. The show addresses a wide range of mental health issues—including adolescent wellbeing, dementia, parenting, disability, gender and sexuality, refugee mental health, and climate-induced psychological stress. Special emphasis is placed on amplifying marginalized voices, such as those of transgender individuals, persons with disabilities, and climate-vulnerable communities, positioning the initiative as an inclusive and rights-based public health intervention.
In a country of over 180 million people and fewer than 500 trained mental health professionals, 'Shurokkhay Manoshik Shashtho' provides an urgently needed platform to raise awareness, counter stigma, and promote digital and community-based solutions. Its public engagement has been substantial, garnering over 717,000 YouTube views, 35 million impressions, and more than 41,000 hours of watch time, with a rapidly growing audience via Channel 24’s 14.8 million subscribers. The initiative also supports academic and policy discourse, featuring sessions from national and international conferences and collaborating with institutions such as the National Institute of Mental Health–Bangladesh, Moner Bondhu, Psycure Organisation, Public Health Foundation Bangladesh, Planetary Health Academia, and the eMental Health International Collaborative (eMHIC).
This initiative transcends conventional talk shows, operating as a digital mental health intervention at the intersection of mass media, public engagement, and global mental health. By centering lived experiences and evidence-based discussion, it demonstrates how locally rooted, scalable media platforms can advance population-level mental health literacy and policy dialogue in low- and middle-income countries.
Biography
Tasdik is a global mental health researcher and physician, currently completing his PhD at Monash University. His research focuses on digital mental health and underserved communities, particularly co-designing digital tools to support the mental health of deaf populations. Recognised as one of eight global digital mental health innovators by the Mental Health Commission of Canada, he also contributed to Bangladesh’s National Mental Health Strategic Plan (2020–2030). With over 100 publications in leading journals, his work combines global mental health theory and systems thinking to address mental health challenges in low-resource settings. Dr. Tasdik’s contributions span research, mentorship, and policy advocacy. He trains early-career researchers globally and works closely with media, ministries, and policymakers to promote mental health. His recognitions include the New Voices in Global Health Award, The Lancet Prize, the Fukuoka Student Award, and the Digital Mental Health Leadership Excellence Award. He champions inclusive, community-driven mental health solutions.
Dr Shirin Jahan Mumu
A/Lecturer
Western Sydney University
Formal Dementia Care for CALD Communities in Australia: A Scoping Review
Abstract
Introduction
Dementia is an intractable condition which presents unique challenges in culturally and linguistically diverse populations due to facing barriers to effective care. In Australia, despite the availability of formal care services, generalised care models frequently fail to address the CALD community’s cultural, linguistic and spiritual needs, delaying proper condition management. Understanding these factors is crucial to devising and effectuating culturally appropriate care schemes.
Objectives
To systematically map and evaluate existing literature on dementia care for Australia’s CALD communities, identifying research gaps, and disseminating evidence, to inform culturally safe policy and practice.
Methods
A comprehensive search was conducted on culturally appropriate formal dementia care provisions for the Australian CALD population using Joanna Briggs’ scoping review methodology (2004). Primary literature from 2015 to 2025 was sourced from MEDLINE, CINAHL, Embase, PsycInfo, and Scopus. Studies on prevention, acute care, undiagnosed dementia, and caregivers were excluded. Covidence supported screening and data extraction. Thematic analysis was used to identify the obstacles and improvement strategies in formal dementia care.
Results
Of 518 studies, 10 studies on formal dementia care for Australian CALD communities met the inclusion criteria, revealing two key themes and several subthemes. The first theme outlined key Issues encountered in formal dementia care, including sociocultural barriers, communication difficulties, knowledge and awareness gaps, systemic barriers, restricted access and technology limitations, and diverse care needs. The second theme proposed strategies of developing culturally tailored resources, language support, increasing encouragement and accessibility, workforce development, community education, and policy advancements.
Discussion
Despite the individualised nature of dementia care, CALD communities share common challenges to accessing formal care services. Addressing cultural and systemic obstacles through tailored care frameworks, resource development, and ongoing professional training can enhance accessibility. Further research is required to better understand the specific needs of each ethnic community to create a truly person-centered care approach.
Dementia is an intractable condition which presents unique challenges in culturally and linguistically diverse populations due to facing barriers to effective care. In Australia, despite the availability of formal care services, generalised care models frequently fail to address the CALD community’s cultural, linguistic and spiritual needs, delaying proper condition management. Understanding these factors is crucial to devising and effectuating culturally appropriate care schemes.
Objectives
To systematically map and evaluate existing literature on dementia care for Australia’s CALD communities, identifying research gaps, and disseminating evidence, to inform culturally safe policy and practice.
Methods
A comprehensive search was conducted on culturally appropriate formal dementia care provisions for the Australian CALD population using Joanna Briggs’ scoping review methodology (2004). Primary literature from 2015 to 2025 was sourced from MEDLINE, CINAHL, Embase, PsycInfo, and Scopus. Studies on prevention, acute care, undiagnosed dementia, and caregivers were excluded. Covidence supported screening and data extraction. Thematic analysis was used to identify the obstacles and improvement strategies in formal dementia care.
Results
Of 518 studies, 10 studies on formal dementia care for Australian CALD communities met the inclusion criteria, revealing two key themes and several subthemes. The first theme outlined key Issues encountered in formal dementia care, including sociocultural barriers, communication difficulties, knowledge and awareness gaps, systemic barriers, restricted access and technology limitations, and diverse care needs. The second theme proposed strategies of developing culturally tailored resources, language support, increasing encouragement and accessibility, workforce development, community education, and policy advancements.
Discussion
Despite the individualised nature of dementia care, CALD communities share common challenges to accessing formal care services. Addressing cultural and systemic obstacles through tailored care frameworks, resource development, and ongoing professional training can enhance accessibility. Further research is required to better understand the specific needs of each ethnic community to create a truly person-centered care approach.
Biography
Dr Shirin Mumu is an associate lecturer in public health in School of Health Science at Western Sydney University. Dr. Shirin earned a PhD in public health epidemiology from WSU. She also has master's degrees in population sciences and food and nutrition science. Her research focuses on prevention of noncommunicable diseases, validating measurement tools, and nutritional epidemiology. Dr Shirin has a record of research articles published in internationally renowned journals. Dr. Shirin has taught undergraduate and postgraduate university courses for over ten years. This program will boost her research career and create new health and well-being research prospects.
