The North Eastern Public Health Unit (NEPHU) serves a population of approximately two million people in north east Melbourne. NEPHU has partnered with Women’s Health In the North, Women’s Health East, the North Western Melbourne Primary Health Network and 1800 My Options with an aim to increase equitable access to early medical abortion (EMA).

A lack of access to abortion healthcare is associated with a range of poor health and social outcomes for women and gender diverse people. Recent changes to EMA prescribing requirements have the potential to increase prescribing within primary care settings. This has not necessarily resulted in an equitable increase in access for patients. Three local government areas in the NEPHU catchment were identified with poor access to EMA and were targeted in the intervention described.

An email and postal mailout were distributed to 142 GP clinics in June 2024, to encourage and support those clinics to increase access to EMA for their patients. Evidence-based information about EMA, and options for increasing access were included. First, clinics were encouraged to access free training to become an EMA provider. Secondly, EMA providers were encouraged to publicly list their service on 1800 My Options, a service providing geo mapped information about the location of sexual and reproductive health services in Victoria. Thirdly, clinics were encouraged to provide patients with information about how to access other services, for example, via 1800 My Options. Posters and other collateral were included.

The initial mailout resulted in five additional clinics registering with 1800 My Options, which represented an increase of 50% across the target areas. Follow-up engagement (late 2024) will include phone calls to Practice Managers in selected clinics, to seek feedback on interest in EMA provision, a public listing on 1800 My Options, and any barriers. Insights gained will inform future work.

Gender-affirming care is a crucial part of preventive healthcare for young people experiencing gender dysphoria, significantly enhancing mental health, reducing suicidality, and supporting positive social development. Despite its benefits, this area of healthcare has become heavily politicised in Australia, influenced by discussions and movements that occur here and internationally. The findings of the UK’s Cass Review have been referenced in these discussions to question access to this care for young people in Australia. The Cass Review—intended to assess a specific model of gender-affirming care within the UK—has been cited in ways that may impact policy, even though its recommendations align with Australia’s established model, which prioritises holistic, evidence-based, multidisciplinary support as best practice.
While even research into the efficacy of gender-affirming care has been politicised, there is a significant body of work that shows that gender-affirming care, including social affirmation, puberty blockers, and hormone therapy, reduces anxiety, depression, and other mental health challenges for young trans and gender-diverse people. Offering this care early supports young people’s capacity to thrive within school, family, and community settings, aligning with preventive healthcare principles.
This politicisation has distorted public perception, with media and debate often citing the Cass Review without recognising its UK-specific context. High-profile cases and inconsistent policies in Australia further complicate equitable access, particularly in rural and conservative regions. This presentation will address the public health implications of restricted access to gender-affirming care, emphasising that Australia’s model aligns with the best practices highlighted in the Cass Review.
By exploring these dynamics, public health professionals will gain insights into the essential role of gender-affirming care as preventive healthcare and be equipped to advocate for policies that uphold young people’s access to affirming, evidence-based support.

Introduction:
Immediate postpartum (<24 hours) is a very critical time when high maternal death occurs. In Ethiopia, approximately 80% of deaths due to postpartum haemorrhage occur during the first 24 hours after childbirth. Antenatal care (ANC) is crucial in improving maternal and fetal outcomes. Evidence shows the effect of ANC on health facility childbirth and postpartum care services use; however, ANC's impact on healthcare-seeking behaviour for immediate postpartum complications has not been studied yet. Thus, this study examined the effect of adequate ANC on healthcare-seeking behaviour for immediate postpartum complications.
Methods: Six-week postpartum follow-up survey data from Performance Monitoring for Action (PMA) in Ethiopia were used, and 750 weighted women who were reported immediate postpartum complications preserved for this analysis. Multilevel-modified Poisson regression analysis and an adjusted prevalence ratio (aPR) with a 95% confidence interval were used. Further Propensity Score Matching (PSM) analysis was employed. Average treatment effect on treated (ATT) with 95% CI was used to report the effect of adequate ANC on healthcare seeking for immediate postpartum complications.
Results: The findings show that adequate ANC (4+) contacts showed an 18% increase in the prevalence of seeking healthcare for immediate postpartum complications (aPR=1.18, 95% CI: 1.02, 1.39, p=0.030). Further PSM analysis revealed that the average treatment effect of women who had adequate ANC visits was 14% (ATT = 0.14, p=0.009) higher probability of having healthcare-seeking behaviour for immediate postpartum complications compared with women who had inadequate ANC.
Conclusion: Adequate ANC use positively affects healthcare-seeking behaviour for immediate postpartum complications. During ANC, healthcare providers can empower women to recognise complications during the postpartum period and the need to take care-seeking actions, ultimately improving maternal and neonatal outcomes. Thus, strategies and interventions for healthcare-seeking after childbirth obstetric complications should focus on enhancing adequate ANC.

Keywords: Antenatal care, postpartum, complications, healthcare seeking

Patients on public health waitlists exhibit complex modifiable risk profiles despite high levels of preventability. These risk factors contribute to the development and exacerbation of chronic diseases and can lead to surgical complications and poorer surgical outcomes.

The Way to Wellness (WTW) service supports public patients in improving their health and wellbeing while on Queensland Health waiting lists. WTW aims to help Queenslanders understand their health risks (via a risk assessment) and initiate positive behaviour changes through brief advice on improving overall health. Patients are supported in creating an action plan for the month ahead and offered referrals to evidence-based behaviour modification programs.

WTW is an innovative and efficient model of care that leverages access to public waiting lists to offer participation in the service via SMS. WTW transforms an everyday health system interaction into an opportunity for behaviour change, capitalising on the ‘teachable moment’ and waiting period to unveil a broader discussion about overall health and wellbeing and opportunities for reducing health risks and changing behaviour.

Since 2019, WTW has supported over 7,100 patients, of whom 79% were recruited via SMS invitation directly from the waitlist (orthopaedic or gynaecology surgery). The risk assessment data has quantified the complex risk profile of these patients, underscoring the need for intervention. Most patients (87%) report making positive changes in at least one health area. In addition, 4,000+ referrals were made to partner programs and services offering ongoing support and sustainable behaviour change.

Leveraging existing health system data streams has facilitated engagement with priority patient groups to drive holistic discussions on preventive health. As a universal pre-surgery optimisation model, WTW complements existing targeted and intensive pre-surgical care. Future development will seek to deliver an adapted model to other priority patients on medical waitlists whose condition would benefit from controlling for modifiable risk factors.

In 2021, the New South Wales (NSW) Government funded the innovative Safeguards Teams Program (STP) to provide an acute rapid response recovery-focused, trauma-informed brief intervention for 5–17-year-old children and young people (CYP) presenting with acute mental health crises. As part of this, clinicians provide CYP with eight weeks of interventions, followed by researchers' mixed-method evaluation of the intervention. Clinicians providing interventions and researchers investigating multicultural populations in Australia experience considerable challenges. These challenges are magnified in populations involving CYP experiencing mental health issues. However, the clinicians and researchers’ ‘voices’ via their experiences and reflections are significantly understudied. As a result, little is known about the challenges and ways forward. Based on the clinicians’ and researchers’ self-reflections and experiences in three time periods (e.g. pre, during, and post-intervention and data collection) of the STP. Using mixed-method evaluation, this paper reflexively ascertained substantive, methodological, and logistical issues that emerged during three time periods of data collection and service provision among CYP in South Western Sydney Local Health District, Australia. It also highlights how the challenges can be navigated and reduced, ensuring staff and CYP’s safety and psychological and emotional well-being. This paper may inform discussion about providing MH crisis interventions for CYP and evaluating them using mixed-method designs so that clinicians and research staff can more effectively provide MH crisis interventions and evaluate various models of care targeting CYP globally. This paper also has important implications for enhancing staff and CYP’s safety and psychological and emotional well-being.

Problem: Males do not always consider themselves as relevant when discussing pregnancy planning. This issue must be addressed to achieve effective preconception policy to support the involvement of male partners and, therefore, improve preconception gender equity.

What you did: The research team planned focus groups including reproductive age men to explore their perceptions regarding male’s roles and responsibilities during preconception. Recruitment was modelled on previous successful research projects conducted by the team in Australia and overseas. It occurred over five months through social media targeting men of reproductive age residing in Australia. The recruitment advertisement included a link to an online screening instrument to verify participant eligibility.

Results: Focus groups were originally intended to be conducted in person in regional and capital cities, but lack of responses, despite regionally targeted recruitment strategies, resulted in the focus groups being shifted online. Even so, only two focus groups were finally conducted. The initial focus group included five participants, only one participant was confirmed by the team to meet eligibility criteria. In the following session, participants who did not meet the eligibility criteria were removed from the online group. Overall, eight participants attended the sessions, and more than half were not willing to operate their camera or to provide meaningful contributions to the content. Preliminary findings reveal a lack of awareness among males toward their preconception contribution to pregnancy and offspring outcomes. However, limited genuine and meaningful responses undermined the data rich environment sought during focus groups.

Lesson: Social perceptions of gender in preconception care may challenge the recruitment of male participants and be a significant barrier to developing a meaningful evidence-base and effective policy for preconception. Therefore, the social perceptions and awareness of gender roles and responsibilities in preconception health should be further explored to inform future successful engagement of men in preconception health research and to direct future preconception policy to bridge the preconception gender divide.

Introduction: Type 2 Diabetes Mellitus (T2DM) has been highly prevalent among Middle Eastern Arab (MEA) communities in Australia. Our systematic review identified 20 interventions aimed at T2DM prevention in MEA populations, yet none were conducted in community pharmacy settings. This research gap presented an opportunity to explore the potential of pharmacies as accessible, community-based platforms for delivering preventive health services. The study aimed to co-design a culturally tailored T2DM prevention intervention in collaboration with MEA stakeholders and community pharmacists, exploring their perceptions and assessing pharmacists' cultural intelligence (CQ) to ensure engagement readiness.

Methods: A mixed-methods approach was employed. Quantitative data were collected using the Cultural Intelligence Scale (CQS) to assess the CQ levels of participating pharmacists. Semi-structured interviews were conducted with healthcare providers and MEA community stakeholders to gather qualitative insights into current T2DM prevention practices and their readiness for culturally tailored interventions. Workshops involving these groups were held to co-design the intervention, with bilingual (English and Arabic) support provided to ensure full participation. Recruitment targeted 20 participants, divided equally between healthcare providers and MEA community stakeholders.

Results: The quantitative analysis highlighted baseline CQ levels among pharmacists, showcasing their capacity to engage with MEA cultural aspects. Qualitative findings from interviews revealed key barriers and enablers to T2DM prevention, as well as the perspectives and experiences of stakeholders. Workshops facilitated the collaborative development of culturally relevant intervention strategies tailored to the MEA community.

Conclusion: This research contributed valuable knowledge on integrating cultural intelligence into healthcare interventions and demonstrated the role of co-design in developing culturally tailored public health strategies. The outcomes provided insights that can inform future T2DM prevention programs and policies, benefiting the MEA community and serving as a model for other culturally diverse populations.

Introduction: The Hearing Services Program (The Program) in Australia has been a cornerstone of hearing health prevention for decades. However, its evolution within a complex political landscape necessitates continuous evaluation and improvement. We analysed three semi-randomly chosen reviews of the Program to identify trends, gaps, and opportunities for enhancement, with a focus on sustaining long-term preventive action.
Methods: We conducted a thematic analysis of three historical Program reviews, comparing key takeaways to the current state of the program. This presented issues and opportunities for improvement, informing the development of a 5-point participant improvement framework which prioritises participants at the heart of the program.
Results: Our analysis revealed persistent challenges in equitable access, and long-term prevention strategies. Findings included:
• Inconsistent focus on participant-centered outcomes
• Gaps in holistic support and accessibility
• Inequities in service provision for vulnerable populations
• Short-term funding cycles hindering sustainable prevention
• Political influences affecting program priorities.
A discussion paper with our findings was published.
Our findings advocate for reframing prevention activities as long-term commitments rather than ongoing reviews, thus fostering an environment that prioritises participant needs and promotes sustained action for health equity. This analysis not only underscores the importance of strategic collaboration but also serves as a roadmap for future initiatives in the hearing health landscape, urging stakeholders to work together towards meaningful change.

Introduction
Addressing childhood obesity is a global priority. Current data estimates that almost one in four children (24%) in New South Wales are overweight or obese. To address this priority area, NSW Health mandates that clinicians conduct Routine Growth Assessments (RGAs) for children aged 0-16 years in clinical services like Oral Health. Guidelines suggest using the 5As framework for RGAs (Ask & Assess, Advise, Assist and Arrange), to support the provision of preventive care. Despite this, completion rates remain low. We aimed to explore the implementation of RGAs, identifying barriers and enablers in Oral Health services.

Methods
We employed an exploratory qualitative study within a pragmatic methodological framework. An experienced qualitative researcher conducted semi-structured interviews online via MS Teams with oral health clinicians and managers, each lasting 30-50 minutes. Codebook thematic analysis was used to analyse data, with findings mapped to the Theoretical Domains Framework.

Results
Thirteen Oral Health clinicians and managers working in urban and rural settings participated in an interview. Their experience ranged from 1.5-33 years, and RGA compliance rates in the preceding 12 months ranged from <20% to >80%. A number of barriers and enablers were identified for the implementation of RGAs. Key enablers included support from management and physical resources aiding RGAs, as well as clinician confidence and knowledge. Key barriers included clinicians’ concern of a negative impact (due to weight being a sensitive topic), and doubts regarding the alignment of RGAs within the Oral Health scope of practice. The identified barriers and enablers affected implementation of RGAs throughout the 5As framework.

Conclusion/s
Findings indicate that while the initial assessment step (Ask & Assess) is commonly undertaken, barriers in subsequent stages hinder full implementation, particularly discussions around weight and referral. Strategies to strengthen preventive health initiatives need to consider and support clinicians across the 5As framework.



Note
Interviews with Community Health clinicians on the same topic have just finished and will be presented alongside the Oral Health data at the conference.

Health insurance is essential in reducing or eliminating the financial constraint to accessing maternal health services caused by out-of-pocket payments. Also, it has a beneficial effect in minimizing maternal and child mortality. However, limited studies in Cambodia examined the association between health insurance coverage on antenatal care (ANC) utilization. Therefore, this study has examined the effect of health insurance coverage on ANC utilization in Cambodia. We utilized data from the 2021–2022 Cambodia Demographic and Health Surveys (CDHS), analyzing a total sample of 3,162 weighted women who gave birth within two years. Multiple logistic regression model using STATA V17 to assess the association between health insurance coverage with women who attended four or more ANC visits. About 24.9% of the women had health insurance coverage during 2021–2022. Most (86.1%) of women attended four or more ANC visits. Women with health insurance coverage were statistically significantly associated with attending four or more ANC visits with an adjusted odds ratio (AOR = 1.6; 95% CI: 1.1–2.4). Other factors significantly associated with attending four or more ANC visits include women with higher education (AOR = 3.1; 95% CI: 1.2–7.7), secondary education (AOR = 2.3; 95% CI: 1.5–3.5), richest households (AOR = 3.2; 95% CI: 1.5–6.8), and richer households (AOR = 1.9; 95% CI: 1.2–2.8). Pregnant women with health insurance coverage who had completed at least secondary education and had a better wealth index were more likely to attend at least four ANC visits. Thus, providing health insurance coverage and improving women’s economic and educational may be essential to improving women's access to maternal health services in Cambodia.

Keywords: Health insurance, Antenatal care utilization, Pregnant women, Cambodia