Physical activity is a key modifiable risk factor for the prevention of many chronic diseases. However, between 2013 and 2021, only half of Victorian adults aged over 18 years met the recommended levels of physical activity, with levels also declining in children. Innovative alternatives to traditional, structured sport are needed to ensure Victorians meet the guidelines to gain health benefits.
Alternate leisure settings (ALSs) have been recognised as a place to provide fun and social physical activity options for families, children and young adults, and are consequently a great opportunity to influence and support the communities’ health. Examples of these settings include dance and aerial studios, trampoline centres, children’s play centres, theme parks among others. They represent an under-utilised environment for preventative health efforts. Therefore, the aim of this research project was to explore the suitability of ALSs as a place for health promotion action.
A design-thinking methodology was used to co-design a pilot project with community members and alternate leisure settings through a research survey and focus group, to improve the health and wellbeing environments of ALSs in three local government areas in south-east Melbourne. Research surveys identified barriers to accessing ALSs were low levels of inclusivity and accessibility to the local community, a lack of healthy food options, and high entry fees. Consequently, two priority health areas were identified; healthy eating and inclusion.
Four ALSs were engaged in the pilot including: a dance studio, an aerial studio, a children’s farm and a play centre. These settings were encouraged to create action plans to either improve their healthy eating environment or increase their inclusivity and accessibility. Engaged settings also had access to an incentive voucher program funded by VicHealth which aimed to understand whether low entry fees would lead to an increase in visitations and sustained retention from community members. Three hundred community members accessed the engaged settings using the incentive voucher program over a 10 month period.
Evaluation of the pilot project including interviews, surveys and focus group findings will be presented, and recommendations on the suitability of alternate leisure settings for health promotion action will be discussed.

As a dynamic and unified concept of health, Māori (Indigenous people of Aotearoa NZ) entities and organisations are embarking on strengths-based approaches to influence and impact human health across the lifespan. This project encouraged the improvement of physical wellbeing through culturally responsive modes of activity among kaumātua (Māori elders) while also enhancing holistic methods of wellbeing through intentional intergenerational cultural knowledge exchange opportunities. This presentation gives an insight into one specific service provider Turanga Health, Gisborne, New Zealand highlighting the success they experienced throughout this project.

The project is grounded in Kaupapa Māori and participatory research that involved a partnership of six Māori social-health service providers and university researchers from four universities in Aotearoa New Zealand. The project prioritises a te ao Māori/Māori worldview and epistemology and uses mātauranga Māori/Māori knowledge systems to establish how the differing activities were experienced by kaumātua and the kaumātua service providers. The study findings include key correlates of five wellbeing indicators grounded in the Te Whare Tapa Whā model: sense of purpose, social support and relationship quality, exercise frequency, and proficiency with Māori cultural practices.

The engagement process of the He Huarahi Tautoko programme demonstrates that when a project centres the needs and aspirations of kaumātua and kaumātua service providers key aspects of health, wellbeing, physical function, and culture important for kaumātua can be realised. By providing activities that fostered and encouraged a symbiotic method of culturally responsive physical activity coupled with cultural knowledge exchange assisted in wellbeing beyond the physical while ameliorating some of the negative harms created from our colonial history.

This current study illustrates key issues for kaumātua wellbeing. Most certainly, physical activity was a core component of this project, but a significant factor was the cultural integration prescribed by kaumātua themselves. By integrating te reo Māori (Māori language), tikanga (traditional practices) and mātauranga Māori (Māori knowledge) kaumātua experienced a reduction of social isolation, cultural dissonance, disruption of intergenerational transference of knowledge, and language loss which, ultimately, will benefit and lead to healthier outcomes for kaumātua.

In Australia, the prevalence of early childhood developmental vulnerability at school entry is higher in Indigenous than non-Indigenous children. Characteristics of children, parents, and the built-environment have been used to predict developmental vulnerability in Indigenous Australian children, but the role of neighbourhood social fragmentation has not been previously studied. Thus, we examined the relationship between neighbourhood social fragmentation and developmental vulnerability, comparing this between Indigenous and non-Indigenous Australian children.

Method: We cross-sectionally analysed data from 287,135 five-year-old children in 2330 Statistical Area 2 (SA2) from the 2021 Australian Early Development Census (AEDC). AEDC measures five domains of early development: physical health and wellbeing, social competence, emotional maturity, language and school-based cognitive skills, and communication skills and general knowledge. The primary outcome was having developmental vulnerability in one or more of these domains. Social fragmentation was measured using the Australian National Social Fragmentation Index, which includes people living <1 year in their neighbourhood, privately rented households, single-person households, nonfamily households, unmarried persons, households with school-aged children, recent immigrants arrived <1 year, immigrants arrived >15 years ago, residents living >5 years in the neighbourhood, and people who volunteer.
Results: The two-level (children within SA2) logistic regression models (controlling for child, parent, and neighbourhood sociodemographic and socioeconomic factors) showed that children in more socially fragmented neighbourhoods had a significantly higher likelihood of developmental vulnerability (Odds Ratio 1.02, 95% confidence interval 1.01–1.03). However, this effect was much more pronounced in Indigenous (OR 1.07, 95% CI 1.04-1.10) than non-Indigenous Australian children (OR 1.02, 95% CI 1.01-1.03).
Conclusion: Our findings highlight the importance of addressing neighbourhood social fragmentation to reduce developmental vulnerability and promote equality in educational and health outcomes between Indigenous and non-Indigenous Australian children. Community programs, better housing policy, and built-environment planning may enhance social cohesion and improve early childhood development.

The AEDC is funded by the Australian Government Department of Education, Skills, and Employment. The Data Management Agency only gave us permission to use the 2021 AEDC de-identified data for research purposes. We were not permitted to (could not) contact the relevant Indigenous Australian children and families.

Context and aim
Engaging with the community is more than a tick box on a funding application, it is a vital and valuable way to ensure that policy and research outputs lead to tangible changes and optimal outcomes. Lived experience and community member involvement is imperative to ensuring that we develop policies, programs and research that address the needs of people as they see and experience them.
Methods and analysis
Through our recent experiences in developing public health policies and guidelines that aim to address the needs of people affected by cancer, involving lived experience and community in our policy development process has resulted in several key learnings. This includes the need for collaboration to identify and involve interested people with lived experience and community members, tailored approaches and increased flexibility for engagement to match the topic being addressed, and providing multiple feedback avenues to ensure that people feel comfortable sharing their thoughts and experiences.
Translational outcomes
An example of community engagement that we have trialled is the use of a Community Reference Group for the development of a Navigation in Cancer Care Policy. We selected members to ensure a diversity within the group including people who had been diagnosed with cancer, carers and people who had experience of both, which was a strength of the group. Other strengths included appointing a Community Co-Chair, and having clear Terms of Reference before forming the group to ensure that all involved were appropriately informed of what to expect. This led to an engaged and enthusiastic group who played an important role in guiding the development of the policy, ensuring it is reflective of their needs and experiences.
Future actions
This presentation will share our successes and challenges to highlight how researchers, policymakers and program managers can involve community in the design and development of policy and programs, to ensure that engagement with community remains genuine, modern and agile, prioritising participation that adds value to the community and the work.

Context and aim: LGBTQA+ (lesbian, gay, bisexual, trans, queer/questioning, asexual and other diverse sexualities and genders) young people are up to six times as likely to report thinking about suicide, engaging in suicidal behaviour and/or having made a suicide attempt, compared to their heterosexual and cisgender peers. This population also experiences many barriers to accessing safe and inclusive mental health care. Thus, there is urgent need for services to engage in appropriate and inclusive suicide prevention practices for this population.

Methods and analysis: We developed a set of guidelines outlining best practice for suicide prevention in LGBTQA+ young people within clinical and community settings using the Delphi consensus method. Two panels of experts (research/clinical professionals, and LGBTQA+ youth aged 14-25 with lived experience of suicidal thoughts/behaviour) rated action statements regarding their relative importance in preventing suicide among LGBTQA+ young people. 290 items were included covering the following key areas: i) general principles for creating an affirming and inclusive environment for LGBTQA+ young people, ii) assessing suicide risk and working with suicidal LGBTQA+ young people, iii) Considerations for specific LGBTQA+ populations and iv) advocating for LGBTQA+ young people. The guidelines are the first of their kind and provide practical guidance to service providers.

Translational outcomes: We are developing, trialling and evaluating a training program on the guidelines in 2024. The evaluation of the training will include an auditing and implementation framework for service providers. This presentation will describe the development of the guidelines, provide an overview of our implementation plan and preliminary results.

Future actions: We anticipate these guidelines to have high applicability within a variety of community and clinical settings, broadly improving the support provided to LGBTQA+ young people. Systemic change is needed to incorporate LGBTQA+ content within all public health and health (including medicine and psychology) training programs.

What is the problem/issue that requires public health action?

In an information-rich world, sexual health is increasingly complex with critical analysis a key skill to determine what is real and accurate. Young people (YP) who are ‘digital natives’ often receive education and healthcare by ‘digital immigrants’. This poses challenges in understanding the landscape of intimate relationships for YP and how they navigate healthcare.

YP are disproportionately affected by sexually transmissible infections (STIs) and women of reproductive age are key in addressing congenital syphilis cases that can result in lifelong disability or death. Over the past 10 years, Australian diagnoses of gonorrhoea have doubled, syphilis have tripled, and chlamydia rates increased.¹

What do we know or have we learned to address this problem/issue/and how has this finding been derived?

Condoms remain highly effective at preventing STIs and regular testing is crucial. Combatting stigma and discrimination and illustrating sexual health as part of general health and wellbeing is vital for YP to feel safe to talk to their partners and health professionals about their sexual behaviours and health needs.

Around 61% of year 10 – 12s are sexually active, yet only 13% agree that STI testing is common among their friends and only 39% knew where to get tested2. GPs were YP’s most trusted source of accurate sexual health information (78%) yet only 31% report they had spoken to a GP about sexual health. ²
Disease-focused, fear-based initiatives of the past have left a devasting impact. Addressing raising STI rates requires a far more comprehensive approach that develops respectful relationships, health literacy and help-seeking skills that empower young people to have healthy, pleasurable sexually active lives.

How has this been used in practice?

The Western Australian Department of Health’s (DoH) comprehensive sexual health response uses a partnership approach with non-government and government organisations to implement prevention, education, integrated clinical care, workforce development, surveillance, research and evaluation initiatives across the state. This includes of a suite of websites (with free online testing, free condoms and ‘ask a question’ tools), hardcopy resources, campaigns, and training opportunities specifically aimed at YP.

What actions should we take in the future to address the problem/issue?

High-value sexual health requires continued investment in:
• comprehensive relationships and sexuality education
• youth friendly accessible services
• Medicare coverage
• innovative digital models for testing and care
• youth voice in public health initiatives
• policy and law reform
• collaborative approaches across sectors.