• What is the problem/issue that requires public health action? [Context and aim]

The Sexual Health and Blood-borne Virus Program (SHBBVP) at WA DoH are responsible for the state-wide prevention and control of sexually transmissible infections (STIs) and blood-borne viruses (BBVs). Young people a priority population in the WA Sexually Transmissible Infections (STIs) Strategy 2024-2030 with the majority of chlamydia and gonorrhoea notifications being in people aged 15-29 years.

• 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]

WA DoH’s comprehensive response to reducing STIs and BBVs involves an intersectional, person-centred approach, with a focus on multisectoral partnerships and digital and data innovations. To ensure accessible prevention and testing services in WA use of online and site-based initiatives are required. Free online testing improves accessibility by decreasing financial, geographical and personal barriers to access, while site-based condom dispensers provide convenient and discreet access to safer sex hardware.

• How has this been used in practice? [Translational outcomes]

Effective sexual health programs aim to increase condom use as well as promote regular testing. To ensure that both messages are addressed condom dispensers provided to health and community organisations across WA have QR codes linking to the free online chlamydia and gonorrhoea testing service. Over the last 12 months, demand for online testing and condom dispensers through SHBBVP has increased with 726 tests being completed in 2023 (126% increase from 2022 [320] and an increase of 144% from 5-year average [297 tests]. These increases correlating with the introduction of QR codes on the 126 condom dispensers throughout the state, and the decrease in availability of bulk billing GPs and health clinics. Notable, number of Aboriginal people utilising the online test increased from 5 in 2022 (1.5% of tests completed) to 119 in 2023 (16.4% of tests completed). The test positivity rate has remained similar (10.5% in 2023 compared to 6.8% in 2022) demonstrating reach within communities at risk of STIs. Positivity rate: 76 positive notifications in 2023 an increase from 22. Positivity rate was highest in people under 25 (15.7%).

• What actions should we take in the future to address the problem/issue? [Future actions]

Next steps involve exploring options to make this service more accessible, such as removing the need to print the PathWest form. We are also working with services to support their service users in accessing the service, as well as more promotional materials. We also aim to continue providing condom dispensers and condoms to services around WA, with a focus on regional and remote locations.

• What is the problem/issue that requires public health action? [Context and aim]
Decisions made by leadership in disasters and emergencies must uphold public confidence and trust particularly in settings where resources are scarce or when decisions are perceived as unjust. Decisions that are perceived to be, or are unethical may erode public trust, result in moral injury to staff, and cause community division.
• 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]
To understand how decisions in disasters and emergencies are informed by ethics, a systematic literature review was conducted to determine what ethical guidance informs decision making in disaster and emergency. This study found evidence of ethical guidance to inform decision making in management in the humanitarian system, based on humanitarian principles. Evidence of the application of an ethical framework to guide or reference decision making was varied or absent in other emergency management agencies or systems.
• How has this been used in practice? [Translational outcomes]
This research has been published open access to inform disaster management policy makers and planners.
• What actions should we take in the future to address the problem/issue? [Future actions]
Development and validation of ethical frameworks to support decision making in disaster management practice is recommended.

Alcohol use during pregnancy causes harm to the fetus and the mother. On July 31, 2020, Australia and New Zealand mandated that alcoholic beverages packaged and labelled from 1 August 2023 display a government-prescribed pregnancy warning label. This study aimed to assess the uptake of this label and its placement on products after the policy implementation date.

Between August and November 2023, data collectors visited three liquor stores in Sydney representing three major alcohol retailers in Australia (Dan Murphy’s, Liquorland, and BWS) and photographed 3,488 unique products. The results showed that two-thirds (65%) of products displayed the mandatory pregnancy warning label. Across alcohol categories, beer (94%), premix drinks (93%), and cider (92%) generally displayed the mandatory pregnancy warning label, while half (50%) of spirits and two-thirds (68%) of wines showed the label. Across all products, the mandatory pregnancy warning label was largely contained to the back (87% of labels) or side (8% of labels) of the product.

Many products do not display a mandatory pregnancy warning label, which may be because they were packaged prior to the policy implementation date. Additionally, the lack of specific requirements for label placement has resulted in virtually none of the mandatory pregnancy labels being applied to the front of pack, which is where evidence suggests the label would be the most noticeable and have the largest impact in reducing alcohol purchasing.

As the mandatory pregnancy warning label is an important public health measure to signal the harms of drinking alcohol during pregnancy, alcohol retailers and policymakers should intensify their efforts to ensure more products display the mandatory pregnancy warning label, which may involve applying pregnancy warning stickers to products that do not currently display the label. Existing requirements should also be revised to ensure that the mandatory pregnancy warning label is more prominently displayed.

Cultural Safety in Sexual and Reproductive Health - Human Relations Program.

Young people from culturally and linguistically diverse backgrounds experience barriers accessing sexual and Reproductive health (SRH) information. Their attitude and beliefs are influenced by family and culture, however “silence’’ or topic being ‘taboo” is the main barrier to sexual health literacy.
Multicultural Health Support Service (MHSS), a program of CEH (Centre for Culture, Ethnicity & health), in collaboration with GenWEST, Cohealth, IPC Health, Maribyrnong City Council, and Western English Language School (WELS) have been participating in a program called Human Relations Programs for over 10 years. The partnership is a cornerstone of the program. The five-week program is delivered to newly arrived migrant and refugee students at the Western English language School (WELS) in Melbourne’s West. This program prepares students aged 14-18 for the transition to mainstream education and work. The program also creates a safe space to discuss various SRH topics with peers and in language using interpreters taking into consideration cultural and religious beliefs.
Partner organizations collaborate twice a year to deliver weekly workshops to students, engaging them in discussion and activities about sexual and reproductive health. The program provides young people with skills, knowledge, and resources to make informed decisions. These topics can be challenging for newly arrived young people, who are already contending with significant changes in their lives, in addition to the risks associated with confidentiality, safety, trauma and disclosure that come along with sexual and reproductive health education. The workshops are multilingual, and are delivered separately for boys and girls, with resources and referral pathways that students can follow up with.

Evaluation of this program demonstrates that participants gained improved knowledge and understanding of sexual and reproductive health in addition to increased confidence accessing the Australian healthcare system. This program exposes the need for SRH education at an early age as an early intervention.

Modern healthcare is characterized by rapid technological advancements that necessitate innovative approaches to address emerging challenges. Drug-drug interactions (DDIs) are one such important health challenge that pose a significant public health concern, resulting in increased risk of adverse drug events and heightened healthcare costs. This is further exacerbated by the huge demand on clinicians’ time and the varying levels of health literacy among patients. This study explores the potential of ChatGPT, a large language model driven by artificial intelligence (AI), to supplement the health literacy of patients with understanding possible DDIs in their medications.
We chose a patient-centric approach, crafting three standardized prompts that reflected patients’ perspective in a real-world healthcare setting. The relevant demographic details, diagnoses and prescribed medications from anonymized hospital records of 120 patients were input through these prompts into ChatGPT version 3.5, and the results compared against pharmacists’ responses to estimate the diagnostic efficiency of ChatGPT. Cohen's kappa coefficient, Fleiss’ kappa coefficient and area under the receiver operating characteristic (ROC) were calculated.
Patients included in the study were treated with a median of 11 medicines. Prompt variations influenced ChatGPT's responses, with a slightly higher sensitivity observed for prompts containing the term “drug interaction”. Low true positive and high true negative rates were demonstrated through confusion matrices. Cohen's kappa coefficient values ranged from 0.077 to 0.143, indicating minimal agreement between ChatGPT and pharmacists.
Thus, ChatGPT had limited success in DDI identification compared to human experts, and further refinement is essential before its deployment as a reliable DDI assessment tool. This study highlights the need for interdisciplinary collaboration between AI researchers, healthcare professionals and policymakers to develop AI solutions that prioritize health equity.

What is the problem/issue that requires public health action?
Digital preventive interventions can reach adolescents in everyday settings like social media. Previous research on recruitment compares social media to in-person strategies. It is unknown whether social media alone is effective to recruit adolescents to clinical trials. Our study evaluates the effectiveness of social media recruitment strategies and investigates reasons for non-participation in the Health4Me Study.

What do we know or have we learned to address this problem/issue, and how has this finding been derived?
Data included recruitment screening logs, social media advertisement data and participant characteristics (age, gender, body mass index [BMI], school attendance). Data were analysed using descriptive statistics and Chi-squared tests.

Within 12 months, 2369 expression of interest (EOI) forms were completed; of these 2166 participants (91.4%) heard about the study through social media. Among respondents, 927 (39.1%) were eligible and 390 (16.5%) enrolled. Seventeen recruitment ads (Facebook, Instagram) ran for 146 days total (range 2-18 days). Ads reached 408,077 unique accounts. Ads mostly reached those living in populous states (NSW, QLD, VIC) (75% of unique accounts) and females (43.5% of unique accounts). 25% of ads were delivered to uncategorised genders.

Differences in screening characteristics between eligible participants who did and did not enrol were found to be statistically significant for gender and recruitment method. Specifically, gender differences were significant (p=.02), with fewer males and more individuals in the 'other' category enrolling than expected. Additionally, the recruitment method was significant (p<.001), with fewer participants enrolling through Instagram than expected and more enrolling through other methods (e.g. word of mouth).

How has this been used in practice?
Virtual clinical trials have the potential to increase participation (given in-person services are limited) and reduce inequalities in healthcare. Social media ads were effective for recruiting adolescents which reached all states/territories, and hard-to-reach populations.

What actions should we take in the future to address the problem/issue?
Future action is needed to build trust regarding recruitment to clinical trials on social media, particularly among males. Co-creating clinical trial design and delivery, including recruitment strategies, are important to address this issue.

What is the problem requiring public health action?
There are growing calls for health professional graduates to understand and address the social determinants of health (SDoH) however, evidence of the most effective methodologies in SDoH education is lacking. Game-based learning offers a powerful approach to improve learner engagement in safe learning environments. The Australian Rural Health Game is a novel board game designed to support learners’ understanding of the SDoH contributing to health inequities.
What have we learned to address this problem?
The Australian Rural Health Game represents one year in fictional rural patients’ lives. Players select a patient profile and are exposed to risk and protective events throughout the game. At the end of the game, players determine whether their overall health has improved, deteriorated, or remained stable. Progress in the game is modulated by the SDoH and is supported by robust evidence to enrich the learning experience.
How has this been used in practice?
The Australian Rural Health Game has been integrated into the Sydney Medical School curriculum with the capacity to be further utilised in health professional education. The game is purposely designed to limit the agency of players and demonstrate the impact of the SDoH on players’ overall health and wellbeing. Robust discussion about the effects of the SDoH at the individual, community, and population level is generated by game play.
What actions should we take in the future to address the problem?
Innovative teaching strategies to enhance learner engagement with the SDoH are urgently needed to better prepare graduates and support action on health inequities. The Australian Rural Health Game offers a game-based learning strategy to enhance the quality of teaching and increase learner engagement with the SDoH. The Australian Rural Health Game will be made widely available as a tool in health professional education.

Context and aim
The Australian Food Standards Code regulates the use of nutrition- and health-related claims (hereafter ‘claims’) on food products in Australia. However, various claims are not covered by the Code, including general terms such as ‘natural’ or ‘healthy’ that, when displayed on food products, can mislead consumers about the nutritional quality of products. This study aimed to explore the prevalence of such non-regulated claims on packaged food products in Australia and to assess the healthiness of products displaying these claims.

Methods and analysis
This study used data from the 2023 Australian FoodSwitch database, a large nutrition composition database that contains nutrition information for ~28,000 packaged foods sold in five major supermarkets in Australia. We examined the use of claims that are not covered under the Food Standards Code. We excluded claims related to verified organisations (e.g., Vegan Certified). For all products, we estimated the Health Star Rating (HSR) and applied the NOVA food processing classification system.

Translational outcomes
Approximately 5,000 products (15% of all products) displayed non-regulated claims. Some products displayed multiple claims (range 0-4). The most prevalent non-regulated claims were ‘Natural’ claims, accounting for almost two-thirds of all assessed claims, followed by ‘diet-related’ claims (around one in five claims) and ‘healthy’ claims (around one in six claims). Approximately one-quarter of products that displayed claims received a HSR of <3.5 and around two-thirds were classified as ultra-processed by the NOVA classification system. The use of claims was most common in the ‘sugars, honey, and related products’, ‘beverage’ and ‘food for specific dietary use’ food categories.

Future actions
These findings demonstrate that non-regulated health- and nutrition-related claims are present on many packaged food products in Australia. Vague, unsubstantiated claims can be misleading, and therefore there is a need to develop policies to control the use of these marketing claims.

Preventive health measures are key to achieving a healthier Australia. Even though Australians have one of the longest life expectancies in the world, many are living with and suffering from chronic illness.
The vision of the National Preventive Health Strategy 2021-2030 (NPHS) is to improve the health and wellbeing of all Australians through prevention. It identifies 4 Aims and 7 Focus Areas under which are key measurable targets for 2030. This includes 2 key targets within the National Obesity Strategy 2022-2032 to reverse the prevalence of obesity in adults, and reduce overweight/obesity in children and adolescents.
This project aims to monitor all key targets from both strategies by building a monitoring dashboard. It explores changes in risk factors and health outcomes in the wider Australian population, with a focus on time trends and priority populations such as First Nations people, rural and remote areas, and socioeconomic areas.
Nationally representative data from a range of sources including the Australian Bureau of Statistic’s National Health Surveys, the Australian Institute of Health and Welfare, and the Department of Health and Aged Care were analysed, collated and visualised. The latest available data was compared against the baseline data for each target. Compared to baseline: daily smoking decreased by 3.2%; Australians ≥15 years undertaking no physical activity has decreased; adults living with obesity remain steady, and the proportion eating enough fruit and vegetables has decreased.
This information has been translated to an interactive dashboard providing a comprehensive visualisation and information platform for key stakeholders to review changes in the Aims and Focus Areas of the strategies.
Ongoing collection and analysis of data, as and when it becomes available, is important to ensure comprehensive and timely updates to a monitoring platform for guiding the implementation of public initiatives.