Planetary Health is a social, transdisciplinary movement that examines and understands the human impacts on Earth's natural systems, human health, and, ultimately, all life on Earth. A pilot program providing experiential learning opportunities for young African Australians was designed to engage an underrepresented demographic in this movement. The pilot program offers the opportunity to explore Planetary Health meaningfully in a localised context. Initial activities included community outreach to identify interested participants and tailor the program to their needs. These consultations resulted in a series of participatory workshops addressing various elements of Planetary Health based on the Planetary Health Education Framework; topics covered include sustainable food systems, biodiversity, and the relationship between climate change and mental health. Participants' experiences were documented through model development and student sense-making sessions. The lessons learned, developed models, and proposed next steps will be discussed to facilitate ongoing engagement and policy development with this marginalised group.

The issue
Research done by the NSW Department of Communities and Justice (DCJ) in 2022 uncovered over 8000 families who are deeply entrenched in DCJ systems, with extensive and frequent and interactions with justice and community services.
They are families who have intergenerational engagement and are entrenched within our systems. Starting from early interactions with the child protection system, there are recognised patterns of becoming young people leaving out-of-home care (OOHC) who are more likely to have contact with the juvenile and criminal justice systems, to require public housing and specialist healthcare as adults, and to have children who are placed in OOHC starting the cycle for the next generation.
DCJ recognised that by only working with individuals, with little visibility of needs and strengths of the wider family, this would only perpetuate the cycle of disadvantage for our most vulnerable families and communities across NSW.
Approach
One Mob One Job is a long-term service and system transformation that is Aboriginal-led, delivering a new and different model of service for these families. One Mob One Job has embedded Aboriginal ways of knowing, being and doing, with the understanding that Aboriginal ways are holistic, family-centred and address the social determinants of health and wellbeing for all individuals, families and communities. The transformation also prioritises place-based decision making, currently working in two locations with the view to expand to five locations by June 2025.
Early lessons
Early learnings from the transformation include the pervasiveness of the impacts of colonisation and systemic racism, the inherent resilience of communities, and most importantly, the need for truthhearing. The lessons from the transformation in the two locations point to a complete reversal of historical approaches from trying to fit communities to solutions, to building solutions to, and indeed from, communities.

The 2021 census found that 29% of Australia’s population were born overseas and 22% of households speak a language other than English. Compared to the general Australian population, people from Culturally and Linguistically Diverse (CALD) communities have lower participation rates in the bowel, breast and cervical cancer screening programs than the national average. Addressing this disparity requires targeted interventions tailored to the unique barriers faced by CALD communities.

In 2022, Cancer Council NSW (CCNSW) commissioned an evidence check into screening interventions in Australia and comparable countries that addressed barriers for participation among CALD groups. The review highlighted co-design as critical approach to engage with CALD communities. Co-design fosters trust, collaboration, and meaningful engagement, allowing for tailored interventions to align with cultural contexts, enhancing acceptance and effectiveness of messaging.

CCNSW trained six community facilitators to deliver cervical, bowel and breast cancer screening workshops in Mandarin, Cantonese, Arabic and Vietnamese. These workshops educated CALD communities on the importance of cancer screening and provided support to access these services. The targeted communities represented the largest CALD groups in Australia and the workshops were delivered across Western Sydney where significant populations of the target communities reside.

Each workshop was co-designed with peak community organisations and champions. Facilitators participated in capacity building training seminars led by CCNSW, enhancing their screening knowledge and facilitation skills. The workshops reached participants in a culturally safe and appropriate way, and pre and post evaluation demonstrated significant improvements in understanding of the national screening programs, the benefits of screening, eligibility criteria and how to access these programs.

Looking to the future, it’s clear that co-design will always be a critical element in successfully connecting with CALD communities. CCNSW will continue to use findings from our evidence check to trial new and innovative ways of community engagement to inform best practice.

Context & Aim: There is good evidence that time in nature is associated with better child health, including physical activity, eating habits, sleep and emotional wellbeing. However, there has been a significant shift from active, outdoor nature-based activities to more passive sedentary indoor activities. The Nature Play & Grow program aims to assess the feasibility, acceptability and potential efficacy of an intervention to promote connectedness to nature in young children.
Methods & Research Findings: Families enrolled in a pregnancy cohort study (The ORIGINS Project) were invited to participate in the Nature Play & Grow program. The program consisted of eight weekly 60-minute outdoor group sessions held at local parks. Parents were also asked to complete eight weekly 15-minute online modules which focused on the core themes of outdoor play, healthy eating, physical activity and child development. Twenty-five families with children aged between 3 and 3.5 years were enrolled in the pilot program. Feedback from the parents indicated they valued the opportunity to connect with other children and families and to visit parks in their local area. The majority of families reported that they had planned to spend more time out in nature, and many had repeated the activities from the program.
Translational Outcomes: The Nature Play & Grow program shows promising results with regards to feasibility, acceptability, and the potential positive impact on health behaviours. This information is crucial to inform the development of evidence-based recommendations and practices regarding the promotion of healthy lifestyles in children through connectedness to nature.
Future Actions: A larger scale trial is currently underway to test the effectiveness of this program in the community in collaboration with Nature Play WA Inc and local council authorities in Western Australia.

Context: Unhealthy dietary behaviour is associated with several adverse health outcomes. However, individual dietary choices don’t solely rely on the eating habits of individuals but are influenced by multiple factors including access to and affordability of healthy food options in the community where they live.

Aim: This study aimed to identify the social determinants of dietary behaviours at a priority community in Australia.

Methods: We utilised community listening (a component of community organising) to explore community members’ narratives and experiences about the factors shaping their dietary behaviour in a low socioeconomic, multiethnic community of Inala located in Southwest Brisbane of QLD, Australia. We listened to the voices of community members, health professionals, social workers, teachers, and community service providers. Consultation sessions and field notes were analysed using thematic analysis. The determinants of dietary behaviour resulting from the analysis were categorised under the lens of the Socioecological model.

Findings: 168 participants shared their stories through the project. They identified personal interest in healthy eating, knowledge of healthy food and preparation; and time constraints for healthy food preparation as individual-level (microsystem) determinants of dietary behaviour. Family support, parental influence, and commitments were identified as social-environment level (mesosystem) determinants. Availability of fresh fruits and vegetables, backyard farming and ubiquity of fast-food outlets were identified as physical-environment (exo-system) determinants; and cost of living, inculturation and dissatisfaction with health practitioners as policy level (macrosystem) determinants.

Future actions: We learnt that dietary behaviours in priority communities are influenced by several micro, meso and macro determinants. Future community-based initiatives aimed at promoting healthy eating should therefore extend beyond individual behavioural change initiatives and consider the influence of other socioecological factors. Community-focused approaches informed by the understanding of local (contextual) social determinants of health can be useful in addressing those factors and contributing towards healthy eating in priority communities.

Context and aim: Asthma affects nearly 339 million people worldwide (Global Asthma Network, 2019) and is a leading cause of paediatric hospitalisations (Kenyon et al., 2014; Vicendese et al., 2014). Asthma Australia aims to reduce asthma hospitalisations (Asthma Australia, 2024) therefore, strategies for asthma management need to be informed by the system(s) related to asthma. The Creating Collective Solutions (CCS) process is a systems-based approach uniting different actors to agree on areas of action and identify solutions (Fauville et al., 2018; McHugh et al., 2018). This study aimed to bring stakeholders together to identify and agree upon solutions that could be implemented to help children with asthma to live their best life.

Methods and analysis/research findings: A working group of 8 stakeholders developed a ‘trigger question’ (“What can we do as a community to support children aged 5-9 years living with asthma on NSW to live their best life?”) that was distributed to stakeholders identified by the working group. Stakeholders were asked to list up to 5 actions in response to the trigger question. Over 230 people responded, generating 441 actions. The responses were categorised using the Social Determinants of Health model, leaving 344 unique actions. A workshop was hosted with 20 professionals from 9 stakeholder groups. The workshop featured 68 rounds of voting to reach consensus on 12 actions pictured in an Action Map. The Action Map linked actions demonstrating interrelations between the identified solutions. Improved access to asthma educators would make other actions (e.g. correct techniques and carrying inhalers) easier. Small teams co-designed solutions that emphasised improvements in asthma education and access to materials, ensuring culturally appropriate materials are available.

Translational outcomes: The CCS process has led to a broader needs assessment in NSW including support for children with asthma from non-English speaking communities. This involves continuous consultation with stakeholders, including non-English speaking carers of primary school aged children with asthma.

Future actions: This CCS considered asthma at a State level and future work is needed within PHN or place-based areas to identify actions that can be then be implemented at a local level to prevent hospitalisations for people aged 5-9 years.

Context and aim: Military bases are required to provide meals to support diners to meet nutritional requirements within allocated resources (Berry & Deuster, 2017). Strategies to address eating behaviours need to be informed by identifying and understanding the needs and preferences of diners. The World Health Organization recommends that segmentation be applied to improve health and wellbeing. Research has identified that preferences differ between segments and segments respond differently to one-size-fits all programs (Dietrich et al., 2015). This study demonstrates preferences for a healthy eating intervention that can be applied in a workplace setting. This study explains how all participants can be allocated into segments to identify program preferences and aims to reveal if identified program preferences vary by segment.

Methods and analysis/research findings: Three co-design sessions were conducted with 73 Australian Defence Force (ADF) early career personnel to uncover solutions to encourage healthy eating at the military base. Participants were allocated into three segments using a short sorting tool (Carins et al., 2022). The aim of co-design sessions was to gain insights on preferred solutions. Analysis revealed that preferences and co-designed programs differed between the segments. The findings indicate that segment 1 preferred holistic advice on health from experts, segment 2 favoured with information on improving productivity and how to cook healthy meals, and segment 3 preferred tailored solutions to improve physical performance.

Translational outcomes: The insights from theoretical testing and co-design were combined with previous research and evidence indicating best practice to build a pilot program. The program focussed on capability and aimed to increase knowledge, skills, and consumption of healthy foods.

Future actions: The effectiveness of intervention approaches that are informed by segments will be tested. Field trials will be used to test whether an intervention catering to segment preferences can outperform a one-size-fits-all intervention approach. A field trial will permit a direct test of the utility of segmentation, and it will enable costs and benefits to be calculated to understand whether additional value is obtained from full application of segmentation.

Compared to the Australia-born population, migrants, and refugees, especially those who have settled in Australia for more than 10 years and have low English proficiency, have higher prevalence of several long-term chronic health conditions. The Ethnic Communities Council of Queensland (ECCQ) has been delivering a culturally tailored adaptation of My Health for Life, a lifestyle modification program, funded by the Queensland Government and delivered by the Healthier Queensland Alliance, aimed at targeting Queenslanders who are at high risk of cardiovascular disease, diabetes, and stroke. The cultural adaptation of the program aims to combat the gap in health outcomes through providing chronic disease prevention education in language to diverse communities and supports them through their behaviour change.

The Adult Migrant English Program (AMEP) is a free service provided by TAFE QLD to support migrants and humanitarian entrants in improving their English language skills and has also become a key partnership with the delivery of the program by ECCQ. This partnership leverages the strengths of both sectors to address the unique challenges faced by migrants, enhancing their health outcomes. Over the last 3 years, ECCQ has successfully delivered 31 programs to AMEP classes across Queensland to over 650 participants. The integration of these spaces ensures that communities receive information that is understandable and relevant to their needs. Language barriers are a significant impediment to accessing healthcare, understanding medical advice, and engaging in health-promoting behaviours. By embedding health education within English language classes, migrants can learn about health topics in a context that enhances comprehension and retention. This dual and collaborative approach empowers communities and equips them with critical health knowledge, leading to improved health literacy, enhancing individual outcomes, fosters a sense of community, and contributes to the broader goal of building healthier, more inclusive communities.

What is the problem/issue that requires public health action?
In recent years, complex health and social challenges relating to relationships and sexuality education (RSE) topics have become common in public conversation. From statistics regarding alarmingly high rates of violence against women, the newly mandated consent curriculum, LGBTIAQ+ rights, through to the Voice referendum. Young people (YP) today are the most socially aware generation, yet our educational contexts have not kept up to support them. RSE can play a central role to fill this gap as it aims to prepare YP to live safe, productive and fulfilling lives in a world where sexually transmissible infections, unintended pregnancies, sexually explicit material, gender inequality and unwanted sexual experiences pose serious risks to their well-being.

What do we know or have we learned to address this problem/issue, and how has this finding been derived?
For over twenty years, the Sexual Health and Blood-borne Virus Program (SHBBVP) at WA Department of Health (DoH) has been implementing a holistic approach to RSE. This is achieved through funding RSE related contracts, initiatives and resources aimed at improving the knowledge, awareness and behaviours of YP, parents and educators. WAs approach is informed by the International Technical Guidance on Sexuality Education (UNESCO), and Health Promoting Schools Framework (WHO) which ensures a holistic, inclusive and impactful approach.

How has this been used in practice?
The holistic RSE approach has involved supporting YP, parents and teachers through a range of innovative and dynamic strategies. These include the creation of physical and digital resources, teacher training programs, grant initiatives and the funding of clinical and education service providers. Beyond this, key stakeholders in RSE across government and non-government sectors have been brought together to create the WA RSE Advisory Group which supports the strategic direction and collaboration of RSE in the state.

What actions should we take in the future to address the problem/issue?
While there is still a plethora of opportunity to expand and develop RSE in WA, the holistic approach used to tackle complex health and social challenges relevant to YP in WA can act as an exemplar implementation strategy.

What is the problem/issue that requires public health action? [Context and aim]
For people living with neurological conditions maintaining good nutrition is a priority. However, cognitive issues and impaired motor skills are often experienced. These can compromise the ability to procure, prepare and cook healthy meals which can negatively impact their nutritional intake and quality of life. Strategies that support continued independence with activities of daily living are vital for self-efficacy and mental wellbeing. This project aimed to co-design a weekly meal box service tailored specifically for those with neurological conditions to reduce burdens around meal preparation, improve nutrition and provide a solution.
What do we know or have we learned to address this problem/issue, and how has this finding been derived? [Methods and analysis/research findings]
Two co-design workshops were held, one with consumers living with a neurological condition and one with neurological healthcare providers and industry stakeholders. Participants shared their perspectives on hopes, fears, ideal meal box contents, access methods, and other key features through discussions and group activities. Thematic analysis highlighted that both groups valued practical simplicity as the top priority. Important features included the need for easy ordering and delivery, visually guided recipes using pre-prepped ingredients, dietary accommodations, and the inclusion of nutritional information.
How has this been used in practice? [Translational outcomes]
The findings, plus on-going consumer conversations have informed the development of a prototype meal box in collaboration with an industry partner. The resulting prototype will be pilot tested for marketable feasibility and acceptability with a small number of volunteer neurological community families before further refinement.
What actions should we take in the future to address the problem/issue? [Future actions]
Once optimized through pilot testing, the meal box will progress to further evaluation in a randomized controlled feasibility study. Continued participatory research is needed to iteratively improve the meal box design based on feedback from the neurological community. Ultimately, a customizable meal box service addressing different neurological conditions should be established to enable broad access to this nutritional support intervention.

People living with Huntington's Disease (HD) face significant nutritional challenges, including motor, cognitive, and swallowing difficulties, leading to malnutrition, weight loss, and poor quality of life. This project will evaluate, for the first time, the feasibility and effects of a co-designed meal box solution on nutritional intake and quality of life in individuals with early HD.
Adhering to GCP, CONSORT, and TiDieR guidelines, this study will evaluate the feasibility and nutritional effects of a tailored meal box for HD families. Beginning with a two-week observational period followed by a two-week intervention, fifteen HD families will receive meal boxes containing ingredients for 28 servings. Feasibility metrics, encompassing process and resource indicators, will monitor participant referral, eligibility, enrolment, completion rates, adherence, retention, and attrition rates. Communication effectiveness and financial implications will also be assessed to ensure cost-effectiveness. Scientifically, participant experience, trial burden, and compliance will be assessed through qualitative interviews and the SF-S12 Short Form questionnaire, with adverse events meticulously documented. Nutritional intake will be quantitatively analysed using a 3-day food diary and FoodWorks® version 10 software to evaluate the meal box’s effectiveness in improving dietary health among HD families, considering both its benefits and associated costs. Additionally, all management aspects such as staff time, recruitment timelines, and study startup activities will be carefully costed to ensure financial transparency throughout the study.
Co-designed with input from the neurological community and HD stakeholders, including individuals with lived experience and healthcare professionals, this study aims to provide essential feasibility and preliminary efficacy data. Positive outcomes could lead to rapid implementation within the neurological community through our industry partner, You Plate It.
Positive outcomes from this feasibility study will pave the way for a randomised controlled trial (RCT) on the effects of the meal box solution in a larger HD population. Favourable findings in a larger RCT will set the stage for discussions on inclusion of the meal box solution on the NDIS. Success of the meal box solution will facilitate its translation for individuals with more severe disease and other neurological conditions.

Childhood obesity is a growing public health concern, and early childhood education and care (ECEC) services play a crucial role in promoting healthy eating habits. In Australia, the National Quality Standard (NQS) includes an element on healthy eating promotion. Services can be rated as 'meeting' or 'exceeding' the NQS, with exceeding indicating high quality practice. However, little is known about how authorised officers assess and rate ECEC services against this element, the challenges they face, and their professional development needs. This study aimed to explore these issues and examine the impact of a training intervention on officers' assessment practices and understandings.

A pre-post survey design was used to gather data from 44 authorised officers in Western Australia before and 9 officers after a one-day training session on assessing healthy eating environments. Key findings include: Variability in the time allocated to assessing Element 2.1.3 (range: <10 min to >1 hour). Focus on documentary evidence rather than educator practices and mealtime environments. Strong interest in further training and support (72% pre, 78% post), particularly around exceeding practice and efficient observation techniques. The post-survey showed that officers provided concrete examples of exceeding practice and found the training beneficial.

The findings suggest developing clear guidelines and examples of exceeding practice, providing regular nutrition/food-specific training for officers, and advocating for adequate resourcing and time allocation for quality assessment processes. Future actions include conducting further research, encouraging collaboration between stakeholders, and developing targeted resources and training. A collaborative and evidence-based approach is recommended to support the creation of healthy eating environments in ECEC settings.