Introduction: Unhealthy food and drink advertising creates environments that normalise harmful products and undermine public health. Advertising unhealthy products on government property directly contradicts governments’ responsibilities to protect the health of its citizens, yet unhealthy product advertising on public transport remains widespread. City of Melbourne is committed to creating a healthier city, but requires State Government leadership to implement regulations that restrict unhealthy product advertising on public transport. To help build a case for State Government regulation, we examined the scale of unhealthy advertising on public transport in the City of Melbourne, and community attitudes toward regulation.

Impact: An audit of 3600 advertisements observed across six major train stations and surrounding tram and bus stops in Melbourne found 60% of all food and drink advertisements promoted unhealthy food and drinks. This illustrates the extent to which visitors, commuters and residents in Melbourne are being exposed to unhealthy product advertising. Intercept surveys with 300 public transport users and a series of focus groups revealed widespread concern about unhealthy food and drink advertising, and strong public support for regulation of unhealthy advertising on government property.

Application: These findings provide robust evidence to inform advocacy for State Government regulation of unhealthy advertising on government property. The audit quantified the extent of unhealthy product advertising across Melbourne’s public transport network, while user perspectives highlighted strong public support for government action to prioritise health and create healthier cities.

Action: This work underscores a clear policy opportunity to implement mandatory restrictions on unhealthy food and drink advertising across government owned public transport infrastructure. These insights are being used to inform City of Melbourne’s leadership of coordinated advocacy, calling on the Victorian Government to introduce statewide restrictions on unhealthy product advertising across the public transport network.

Weight bias is widespread in healthcare services and there is increasing evidence that healthcare professionals hold internalised and externalised negative attitudes and stereotypes about larger-bodied people. Peninsula Health staff and higher-weight patients (n=30) were surveyed in 2021 regarding their experience providing and receiving care for those over 100kg in an inpatient setting. The results identified that staff would like training on non-weight bias care and patients would like staff to be aware of trauma informed care. Using a co-design approach, an online education package was developed in 2025-26 and promoted for all staff (n=7500) to complete. Interviews were undertaken with consumers and staff (n=11) to design course content, informed by lived experience. The education package provides an understanding of how weight stigma and weight bias impact health outcomes and provides evidence-based, practical strategies and approaches to provide safe, equitable, size-inclusive care. The course was reviewed by experts in the field and tested by consumer and staff advisors. Evaluation of the course will include completion rate, feedback from staff, targeted focus groups, and patient and staff surveys. The course is now live and being actively promoted in the health service.

Background:
Residents of regional towns in Australia face a higher risk of cardiovascular disease, hypertension and obesity than those in metropolitan areas. Walking is the most accessible form of physical activity, and effective means of preventing chronic diseases. However, economically disadvantaged communities may be trapped in a cycle of inadequate footpaths, excessive vehicle speeds and poor-quality walking infrastructure. Whether this ‘double disadvantage’ exists in New South Wales (NSW) and where it is spatially located remains unclear.

Aims:
This study examines the spatial association between factors impacting pedestrian activity levels such as pedestrian infrastructure and socio-economic status in NSW.

Method:
This study employed the Pedestrian Level of Service (PLOS) regression model proposed by Landis et al. (2001) to score pedestrian infrastructure across 567,001 road segments covering the entire state of New South Wales, extracted from OpenStreetMap (OSM). This model assigns PLOS scores based on road type designation. A three-step Exploratory Spatial Data Analysis (ESDA) methodology—comprising global spatial autocorrelation, local spatial clustering analysis and spatial lag regression—was used to examine associations with the Index of Relative Socio-economic Disadvantage (IRSD) published by the Australian Bureau of Statistics (ABS). Sensitivity analyses were conducted to address potential limitations in assigning PLOS scores by road type.

Results:
The study found higher socio-economic disadvantage is associated with poorer pedestrian infrastructure in New South Wales. Further, areas facing dual disadvantages are not evenly distributed geographically across New South Wales but are mainly concentrated regional areas. Ares with the greatest concentration of dual disadvantage were on the North Coast and along the border with Victoria.

Conclusion:
This study has identified a clear spatial co-location between the level of pedestrian infrastructure services, as measured using PLOS and socio-economic disadvantage in NSW, and has pinpointed the regions where this association is concentrated. This indicates priority areas for policy intervention.

Background
Disposable e-cigarettes now dominate the Australian vaping market, generating a growing stream of hazardous waste containing lithium-ion batteries, heavy metals, and nicotine residue. Despite increasing regulatory attention to vaping among young people, the evidence base for how users dispose of devices, and whether any waste management strategy can change this, remains largely uncharacterised. Universities, as health-promoting environments, represent a critical site for both exposure and intervention.
Methods
A rapid review was conducted following Cochrane Rapid Reviews Methods Group guidance, with reporting informed by PRISMA 2020. Four databases were searched (Embase, MEDLINE, Scopus, Global Health), supplemented by reference list screening. Two independent reviewers conducted title/abstract and full-text screening. Narrative synthesis was used given study heterogeneity.
Results
Eight studies met inclusion criteria, spanning six countries and multiple study designs. Disposal in general household waste dominated across all contexts (46-85%). Recycling remained consistently low (5-17%), and 21-32% of users stored devices at home due to uncertainty about correct disposal pathways. A persistent knowledge-practice gap was identified: despite high environmental awareness, most users still disposed incorrectly, and higher educational attainment did not predict better disposal. Structural barriers, absent collection infrastructure, inadequate manufacturer guidance, and regulatory gaps, were the primary drivers. No included study empirically evaluated the effectiveness of any waste management strategy.
Conclusion
The absence of evaluated interventions is itself a key central finding. The evidence consistently points toward structural solutions: dedicated collection infrastructure and extended producer responsibility are the most recommended approaches, yet neither has been tested. Australia has no domestic evidence in this space. This gap directly justifies community-based trials of dedicated vape waste collection infrastructure as a denormalisation and health-promoting environments intervention, and highlights the need for implementation research embedded within community settings.

At NCN Health, a small rural health service in northern Victoria, the health promotion manager and allied health educator are shifting deficit-focused attention away from rural health inequity to perspectives which are strengths-based. They have adopted community enablement strategies to heighten and utilise the strengths, resources and skills of rural communities.
To apply this approach, they use cross sector collaboration and consultation in the design and development of locally responsive programs. Key strategies include embedding of allied health student placements to grow rural workforce pipelines. Multidisciplinary partnerships actively include parents, schools, preschools, Maternal and Child Health Nurses, school nurses, community members, and the local rural health workforce. This approach enhances local capacity, fosters shared ownership of initiatives and increases possibilities for sustainable gains in health outcomes. The team additionally partner with the Rural Health Academic Network, from the local university department of rural health, to build the evidence base and to disseminate and translate their results.
The projects where the approach has been actioned include priority public health needs and local service gaps. These have been practical, scalable strategies such as, evaluation of the Chill Skills program to support emotional regulation and well-being in primary school aged children. This led to capacity building in offering local facilitator training and scaling in local schools. Another was an inter-generational approach to foster dementia friendly communities. This led to pre-school visits in the aged care facility and a replicable model developed as a social work student community development project. Ongoing partnership work over 2026 is investigating youth sexual health awareness, education and condom access. The local Shire youth councillors are providing their expertise for this project. A new initiative under exploration is traineeships in allied health assistance for local school leavers. This aims to grow our local workforce and offer place-based career pathways.

Background: Foodservice settings (e.g., cafés, kiosks, restaurants) are increasingly recognised as important environments for supporting both population and planetary health. Maintaining health-promoting and environmentally sustainable practices often requires ongoing monitoring and implementation support. Existing monitoring tools primarily focus on nutritional quality of food offerings, with limited integration of environmental sustainability considerations. Café Scout is an in-store monitoring and implementation support tool developed for foodservice settings. Updating the tool to assess ‘double-win’ practices that benefit both human and planetary health could facilitate more comprehensive monitoring and implementation support. This study aimed to identify environmental sustainability measures developed for foodservice settings to explore opportunities for integrating these into Café Scout.

Methods: A scoping review was conducted to identify instruments assessing environmental sustainability of foodservice outlet practices aimed at influencing customer food purchasing behaviour (i.e., in-store marketing). Medline Complete, Global Health, and Environment Complete were searched for studies published between 2010 and 2026. Data were charted according to the ‘4Ps’ of marketing (product, placement, promotion, price).

Results: Sixteen instruments were included. All instruments assessed ‘Product’-related practices, most commonly the availability of environmentally sustainable ‘indicator’ foods and drinks (e.g., organic and plant-based options). Promotion-related practices were assessed in nine instruments, while price (n=2) and placement (n=1) measures were less common. Most instruments included at least one measure related to ‘double-win’ practices, commonly related to product availability and portion sizes. Opportunities for incorporation into Café Scout included measures related to sustainable indicator foods and drinks, portion sizes, packaging, and sustainability-focused product promotion.

Conclusions: Current approaches to monitoring sustainability in foodservice settings provide limited attention to broader food retail practices that can influence customer purchasing beyond product availability. Future work should focus on developing actionable and validated sustainability-related measures across all marketing domains.

What if every Local Government could instantly see, understand, and track their community food environment? Poor food environments are consistently linked to diet-related disease and health inequities. Yet Australia lacks the national infrastructure needed to routinely monitor these environments or support evidence-based local action. In contrast, some jurisdictions in the UK have used food environment mapping and geospatial metrics to restrict new fast-food outlets within walking distance of schools, or in areas already saturated with fast-food outlets. We want similar policies in Australia, but currently Australian decision-makers lack comparable, routine, quantifiable data on food access.

The Australian Food Atlas was developed to fill this critical gap. Developed with Local Governments, the platform draws on official food business registration data to generate comprehensive insights into local food environments. We conducted a pilot in Western Australia which mapped more than 15,000 food businesses across 32 metropolitan Perth Local Government Areas. Building on insights and user input from the pilot, the Atlas has now been expanded throughout WA and will soon be available for Victoria, with the long-term vision of achieving full national coverage to generate the most comprehensive, policy-relevant picture of food access ever created in Australia. The Atlas uses validated nutrition-focused classifications, geospatial analytics, and AI-enabled processing for address validation and classification of hundreds of thousands of food businesses. The platform presents tailored dashboards (e.g., fast-food outlets, fruit and vegetable access) and many policy-ready indicators, such as number of outlets within 800m. User surveys will be administered this year to evaluate usability and impact, to further refine and improve the platform.

By making local food environments visible, measurable, and comparable, the Australian Food Atlas provides the infrastructure needed to support healthier and more equitable communities.

Access to fresh fruit and vegetables (F&V) is foundational to health, yet people living in regional and rural Australia face persistent structural barriers including geographical location, lengthy food supply chains, and food environments that preference commercial gain over community need. Living in agricultural production regions does not guarantee equitable access to F&V. Loddon-Campaspe, a major agricultural hub in central Victoria (~250,000 people), experiences disproportionately high rates of non-communicable disease associated with poor F&V intakes.

Co-designing how locally produced F&V are distributed is an underexplored lever for improving health equity. This project works with communities across six local government areas in Loddon-Campaspe to investigate F&V distribution and identify opportunities for improvement across health, equity, environmental sustainability, and economic viability.

This presentation will share the project’s program logic, partnership model, and preliminary findings from Phase One. Drawing on store-based audits of F&V availability, quality, and affordability, and analysis of ~25,000 resident records from the Healthy Loddon Campaspe Active Living Census, Phase One will establish the equity and health evidence base informing co-design. Supply chain mapping and environmental and economic assessment of distribution chains are underway, with Group Model Building workshops planned for late 2026. Together, these will produce a systems-level picture of how food moves from growers to households, and where leverage points for change exist.

Early engagement with interest-holders has highlighted the complexity of regional and rural F&V distribution, and that producers, distributors, community organisations, and local governments are seeking simpler and more affordable alternatives. By providing a co-design mechanism to align their goals, this project will offer a replicable model for enhancing F&V distribution – with implications for policy, procurement, and community-led food system governance across regional and rural Australia.

Background: An unbalanced diet is a leading contributor to disease burden, and our food retail environments drive dietary choices. Food manufacturers and distributors decide what to develop, stock, and promote to food retailers. This systematic scoping review aimed to address the primary research question: Which political-legal, economic, social, and technological (PEST) factors within the food system influence global food manufacturer and distributor decisions to distribute, develop, and promote healthier food and drinks?
Methods: We synthesised worldwide, primary, English language peer-reviewed and grey literature qualitative studies published across multiple databases between Jan 2000 and Dec 2025, containing perspectives of food suppliers representing large-, medium- and small-businesses, reflecting on experiences of hypothetical or actual, and mandated or voluntary, strategies to develop, reformulate, sell, and/ or promote healthier products. Systems influences on health-promoting strategies were synthesised thematically according to political-legal, economic, social, and technological factors.
Findings: 33 studies across 24 countries were included, spanning strategies like healthier product development (e.g., reduced salt, sugar, or fat), health-promoting pricing strategies, and improved nutrition information (e.g., nutrition labelling or guidelines). Of the studies, 28 reported social, 25 reported economic, 22 reported political-legal, and 12 reported technological factors. Our results suggested suppliers change when it becomes commercially rational. Enforceable mandates and reduced compliance burden prompted changes. Access to technology, food technologists, and external support reducing the cost of changes enabled change. Having formal, collaborative agreements backed by supplier-acceptable evidence, was associated with industry onus of responsibility attitudes and subsequent health-promoting changes.
Conclusions: Profit-seeking, which encourages excessive consumption, is at odds with health. Therefore, regulation is necessary, applied fairly across firms, to counter expected commercial behaviour driving overconsumption. Key policy features may include clearer nutrition targets across key product categories, paired with support for product innovation and responsible promotional strategies, to reverse current market determinants stifling change.

Unhealthy food and drink advertising influences food preferences and consumption, making it a priority for public health policy interventions. WA local governments are exploring adopting policies to restrict unhealthy food and drink advertising on government-owned assets such as bus shelters, billboards, and street furniture. During policy implementation, multiple users (i.e. street furniture providers, advertising agencies, and local governments) will rely on the Food Advertising Classification Tool (FACT) to understand whether advertisements are permitted or restricted.

FACT is a rigorous, transparent, and practical classification system designed to consistently assess outdoor food advertising. It includes 18 food categories and extensive examples of permitted and restricted products. However, end-user testing demonstrated that the technical burden of navigating the tool sometimes led to decisions inconsistent with the intended classification criteria.

To improve implementation and policy compliance, we developed an AI-powered conversational implementation assistant using Google Gem. The assistant enables users to ask natural-language questions about whether a proposed advertisement is permitted by FACT. It provides immediate guidance, synthesizing all information from the relevant sections of FACT in responses. The assistant is programmed to rely exclusively on FACT and to clearly indicate when it cannot answer a question.

By embedding FACT into an accessible AI interface, the assistant has the potential to make implementation easier, improve consistency in decision-making, and increase confidence among users responsible for applying food advertising restrictions in real-world settings. To support broader institutional adoption, the prototype will transition from the restricted Gemini Gem environment to an enterprise cloud framework (e.g., Vertex AI or equivalent). This transition will eliminate user authentication constraints and establishes a secure, public-facing digital utility suitable for broad user rollout. This project demonstrates how AI can support implementation of complex public health policy tools that may otherwise be difficult to interpret, inconsistently applied, or under-used in practice.

Problem:
According to the 2022-23 National Aboriginal and Torres Strait Islander Health Survey, 41% of households experienced food insecurity due to a lack of money. Households in remote areas were more likely to experience food insecurity (51%) than households in non-remote areas (40%).

What we did:
Outback Stores supports the management of remote community stores by improving food affordability and availability, nutrition and community services. Currently, 13 of Outback Stores’ managed locations provide meals for students through the School Nutrition Program (SNP).
The SNP supports the provision of breakfast, morning tea and lunch to students across the Northern Territory. The National Indigenous Australians Agency covers operational expenses, whilst parents/ carers cover food costs. The program aims to improve health outcomes, school attendance and learning, whilst also creating employment opportunities for local Aboriginal and Torres Strait Islander peoples.
Outback Stores uses streamlined processes to implement this program at scale. This includes a standardised menu developed in consultation with remote communities, store operational guides, working with suppliers to source meals, and assisting participating stores through support groups.

Results:
Across the financial year 2025, Outback Stores supported the provision of 68,879 meals across 13 schools. This is an increase from early program implementation, with Outback Stores providing 50,458 meals across 11 schools in financial year 2022. There has also been an increase in demand for similar programs within other jurisdictions.

Lessons:
Overall, the SNP contributes to reducing food insecurity in remote communities by providing students with daily access to nutritious meals. With an increase in demand for this program, there is a need for nationally consistent guidelines for extending the SNP across Australia.
Unfortunately, inequities exist through the program structure relying on parents to fund food provision. More work needs to be done to support equitable school food program access for remote communities.

Creating healthy food environments is a priority for improving population nutrition and reducing chronic disease. The North Eastern Public Health Unit (NEPHU) works collaboratively to improve the health and wellbeing of the population living in north-east Melbourne. In areas of new urban growth and development, such as Melbourne’s outer northern suburbs, the establishment of healthy food retail outlets lags, whilst fast food outlets rapidly proliferate.

A model that describes the full spectrum of contemporary fruit and vegetable retail outlet types has the potential to support communities, retailers, local government planners and other stakeholders to envision, plan and create healthier food environments.

To create such a model, we first reviewed existing approaches to categorising food retail outlets. An existing classification system (Needham et al.) was identified and adapted.

Four retail outlet types that sell fruit and vegetables (major supermarket, minor supermarket, green grocer and cultural grocer) were adopted from the Needham model. Five additional contemporary and emerging fruit and vegetable retail outlet types were then added to create a new model (social supermarket, food hub, large scale public market, farmers market, and fruit and vegetable box scheme). A primary definition was determined for each outlet type, and a series of additional descriptors developed and applied (ownership type, length of supply chain, funding source, staffing, accessibility, target demographic and environmental footprint).

Two additional descriptors were explored (pricing strategy and turnover) but were not included as evidence to populate these was limited and inconsistent.

A comprehensive fruit and vegetable retail outlet model may support local governments, stakeholders and communities to better understand and consider the full spectrum of fruit and vegetable retail outlet types, to inform planning to improve equitable access to healthy food. Further work to understand the economic feasibility of outlet types will further enhance the utility of the model.

In the last ten years, the prevalence of eating disorders in Australia has increased by 21% (1). Up to 70% of pre-school children (3-5 years) report body dissatisfaction; including food restriction and wanting to be thinner (2-4). Learning environments are central to the development of negative and positive weight attitudes (3). The aim of this study was to complete a needs assessment (NA) to inform an intervention to address educator knowledge and access to weight-inclusive resources in Early Childhood Educational Settings (ECES).

The NA was completed via online survey and in-person interviews of ECES staff (n=11) in the Frankston and Mornington Peninsula local government areas. The 12-month pilot trialled over 36 resources promoting sensory learning, neutral food language and body diversity in ECES. At pilot completion (n=28) services were included in the analysis.

Results indicated that fundamental National resources used for ECES curriculum included weight-stigmatising language, and limited awareness of these issues amongst educators. Evaluation of the pilot after one year of implementation found 77% of participating ECES (n=22) engaged with the provided resources. Of these, 80% reported a change in body talk, and 94% reported an increase in neutral food language. Recommendations have led to the development of a new website, with the project to be expanded across the catchment in 2026.

This NA and pilot demonstrate that ECES can successfully implement weight-inclusive information to change language and body talk in their settings.

We thank Monash University and Deakin University students for their dedicated efforts on this project.

References
1. Deloitte Access Economics. Paying the Price. Butterfly Foundation. 2024
2. Damiano SR, et al. J Eat Disord. 2015; 3:16
3. Tatangelo G, et al. Body image. 2016. 9. 86-95
4. Spiel E, et al. Body image 2012. 9. 524-7

Nutrition is a social determinant of health, and pivotal in the rehabilitation and recovery of individuals accessing residential Alcohol and Other Drug (AOD) support services. These settings present a powerful window of opportunity for people to improve their food literacy and health outcomes, during and beyond recovery. Through engagement with AOD services, Your Community Health (YourCH) identified a gap in nutrition-specific support for AOD services and an opportunity to improve food literacy and recovery outcomes.

In response, the YourCH Nourishing Environments for Recovery (NE4R) program was created to build nutrition knowledge and skills of staff in the AOD services sector. NE4R has progressed beyond dietitian-led workshops to the collaborative co-development with AOD services, creating specialised nutrition e-learning modules and workshops for embedding into organisational training.

During program co-development AOD staff reported a lack of knowledge and skills in food literacy and low confidence in supporting participants in AOD recovery services to improve nutrition outcomes. Therefore, NE4R has been specifically designed to strengthen staff and organisational capacity to create supportive social and physical environments that respond to the nutrition needs of participants during all stages of recovery.

NE4R is an example of an innovative integration of YourCH primary health services (dietetics) and health promotion into community settings, demonstrating how a settings-based approach can effectively be put into practice to support a specific population group. By integrating nutrition supports within AOD settings, NE4R not only enhances individual health outcomes but also contributes to achieving health equity and fostering community wellbeing.

We must reclaim the skies from the mega-rich. The stars and constellations are not as visible as they once were, as light pollution from below and above obscures the visibility of the cosmos. As outer space and space travel become the playthings of billionaire moguls, most people are losing the primary direct access that they have to celestial knowledge- what we can see with the naked eye.

In this ideas in action presentation, I will outline how light pollution from urban glow and megaconstellations is obscuring humanity's access to outer space and impacting negatively on biopsychosocial health through disruptions to circadian rhythms and chronic illness stemming from poor sleep, as well as harming wildlife, the environment and the ecosystem. Over 15,000 satellites litter the cosmos (10,000 of which come from Elon Musk’s Starlink system), which disrupts cultural knowledge for Indigenous people globally. The benefits of this do not outweigh the harms.

I propose that radical and simple solutions are required, from actively addressing massive wealth inequalities and the disproportionate political power of wealthy elites, through to preserving dark sky sanctuaries and regulating light pollution from cities. Whilst there are measures that individuals can take, I will suppose that public health should have more coercive power to mandate how organisations, wealthy corporations and institutions use artificial light and outer space.

I argue that a general principle of limiting individual liberty in the name of public and global health is ethically justified. The skies should be considered the collective property off all humankind, not something that can be pilfered by wealthy elites and used as their private property.

I conclude with the actionable roles that public health can take at global and nationals levels in reclaiming the skies.