BACKGROUND: Low parental health literacy is linked to less engagement in preventative health care and poorer child health outcomes. Despite this, very few health literacy interventions exist for new parents, and none are systematically implemented within health systems across Australia. This study aimed to co-design and evaluate a health literacy intervention for parents, with a focus on effectiveness and implementation outcomes.

METHODS: We employed an iterative co-design process engaging consumers, Child and Family Health nurses and managers, Multicultural Health staff and Bilingual Community Educators to co-design the health literacy program and a flexible suite of implementation resources. The program was tested, first, in a two-stage multi-centre feasibility study using an eight-group pre-test post-test design, followed by an effectiveness-implementation hybrid trial using a cluster-randomised design involving parents >16 years with children aged 4-26 weeks.

RESULTS: The co-designed program (Parenting+) comprised 4x2-hour education sessions in which transferable health literacy skills (e.g. skills to navigate the health system and critically appraise health information) were embedded within health topics of interest to new parents (e.g. childhood development; immunisation; nutrition and physical activity). Two rounds of pilot testing (n=87) indicated that the program is acceptable to new parents, has good retention (93%), and can improve health literacy skills. Since 2022, we have enrolled 537 participants across Western Sydney and South Western Sydney Local Health Districts; 99% identified as female (mothers) with a mean age (± SD) of 33 (± 4.5) years. The majority (86%) of participants were first-time parents and 71% were born in Australia. Analysis is currently underway with further trial results to be presented at the conference.

CONCLUSION: Parenting+ aligns with the strategic vision of the First 2000 Days Framework and has the potential to be embedded and implemented in both a long-term and statewide capacity by Child and Family Health services.

Introduction:
Initiatives targeting child health behaviours including nutrition, activity and sleep are important to support healthy growth in early childhood and prevent obesity. Despite the increase in research, initiatives rarely reach real world settings, referred to as the research to policy and practice gap. TOPCHILD-Policy is developing practical tools to address this, by tailoring evidence, collated from initiatives targeting child health behaviours in the first 1000 days. This project aimed to co-design a child health behaviour evidence-base dashboard to support adoption of evidence-based decision making in practice settings.

Methods:
Living lab methodology was used to conduct a series of five online co-design workshops (60-90 minutes). Recruitment involved purposeful sampling following anticipated next-user mapping, and invited potential participants (e.g. policy officers, program managers in the Australian early years system) via email. Workshop topics (e.g. content, functionality, design, prototype feedback and implementation) informed iterative development of the prototype alongside workshops by a software developer. Data collection included transcripts, online whiteboards and surveys. A rolling analysis took place using a pragmatic qualitative descriptive approach. Quantitative data were analysed as frequency counts.

Results:
There were 17 participants registered for one or more workshops. To date, data have been collected from 3 of 5 workshops, with attendance of 8-10 participants per workshop (n=13). Categories identified from analyses included desired uses (e.g. to identify, adapt or plan an evidence-informed initiative), desired content (e.g. evidence summaries, case studies), desired functions (e.g. search and filtering evidence to meet needs) and design of the dashboard (e.g. simple layout, intuitive). Final workshops will explore prototype feedback and identify barriers and enablers to use of the dashboard.

Conclusion:
Co-designing a dashboard tailored to next-user needs, enables implementation of evidence-informed initiatives that promote child health behaviours. Further investigation of user-testing, prior to pilot trials in practice settings will evaluate adoption of evidence.

Introduction: Children and young people have a right to have a say in decisions that impact them, and evidence suggests better outcomes can be achieved by involving them in policy, research, and practice. However, persistent barriers to incorporating their views to inform action remain, and include: insufficient capacity and/or capability to engage young people directly, absence of a database of existing consultation, and failure to link consultation to tangible action.
Methods: To elevate young voices and empower decision-makers to take action, we collated scientific and grey literature of child and youth qualitative consultation undertaken in Australia from 2018-2023, in a narrative-style review. Reports with a holistic approach to wellbeing were prioritised to reduce thematic bias. We applied ARACY's child and youth wellbeing framework, The Nest, to structure key findings according to theme and developmental stage. Our key findings were lifted based on recurrence across reports or relevance to traditionally less heard demographics. We engaged our youth advisory group to support us in refining the key findings and link them to specific policy asks and actions. This will be coupled with a strategic launch of summary and technical reports, ensuring emphasis on the policy asks and actions.
Results: Based on the themes emerging from the consultation pieces reviewed, and feedback from the youth advisory group, six key areas of action emerged:
1. Give children the best start in life
2. Cultivate positive mental health
3. Prioritise the environment
4. Enhance wellbeing literacy
5. Foster belonging and connectedness
6. Embed children’s voice
Conclusion: These six key actions can inform priorities for policy and practice now, and should be coupled with ongoing efforts to empower, elevate, and embed young voices in policy, practice, and research across all sectors.

Problem
Australian young people aged 12-24 must be supported to achieve optimum health and wellbeing. Evidence-based prevention and early intervention strategies, coordinated within and across sectors, are needed to modify risk and protective factors, increase health and wellbeing literacy, and encourage early help-seeking in young people to reduce Australia’s health burden. Young people receive far less investment per capita than other groups.

Methods
The PHAA Child and Youth Special Interest Group developed an evidence-based Youth Health and Wellbeing Policy with input from PHAA members, interns and young people (Health Hive).

Results
Implementing this policy can enable Governments, policymakers and program managers, PHAA members, and media to promote young people’s health and wellbeing.

The key policy positions are that Governments should:
1. Understand and address the social determinants that impact on health and wellbeing;
2. Strengthen wellbeing promotion and prevention strategies for young people, with priority for young people belonging to a range of marginalised groups;
3. Resource healthcare and wellbeing programs and services and respond to the level of need, severity and complexity among young people experiencing health problems; and
4. Support and encourage young people to engage in policy, research, program and resource development.

Lessons
Inequalities facing young people in Australia must be addressed through healthcare, police and justice, education and welfare systems. Young people and their families, particularly those from marginalised groups, experience challenges accessing health services and navigating health systems. Systematic implementation of our policy will help protect the cultural and identity rights of Aboriginal and Torres Strait Islander peoples and embed principles of inclusion regarding people with diverse genders, sexualities, and sex characteristics, cultural backgrounds, and abilities through an intersectional lens. This policy recognises that young people should be supported as active agents in decision-making on important public issues that affect them and their future.

Introduction: Breastfeeding represents one of the most important modifiable health behaviours for early life and offers health benefits for both mother and child. Guidelines recommend infants are exclusively breastfed until around 6 months of age, with the continuation of breastfeeding to 12 months and beyond. Despite significant government investment and priority given to improving breastfeeding rates in Australia, breastfeeding rates remain stagnant, indicating a need for further innovation. The aim of this systematic review was to explore the effectiveness of parent targeted digital health interventions on breastfeeding behaviours during the first 2000 days (i.e. birth to 5 years).
Methods: A systematic search of seven electronic databases was conducted up to April 2024. Eligible studies were randomised controlled trials of digital health interventions delivered to parents of healthy children aged under 5 years (i.e. birth to 5 years). Studies were included for review if they measured breastfeeding status/duration.
Results: A total of 6927 articles underwent title and abstract screening, 214 full text studies were assessed for eligibility, and 35 were included in the review. Most of the interventions were mhealth interventions (n=28, 80%), whereby the intervention was delivered via a mobile app, text message or phone call. The duration of included studies ranged between 7 days to 12 months. Most of the interventions were directed at mothers, however 7 studies included co-parents and/or other primary support figures. Fifteen (42%) studies found digital health interventions significantly improved at least one breastfeeding outcome compared with control.
Conclusion: Early exploration of data indicates that digital health interventions represent a promising opportunity for linking parents to evidence-based breastfeeding education and support, however further exploration of their impact on breastfeeding behaviour is required. A meta-analysis of the included studies is planned, with the expectation that results will be ready to present by April 2025.

Background
Optimal nutrition during the first 2,000 days of a child's life is critical for lifelong growth and development, a priority recognised by the Victorian Government. Long day care services (LDCs) play a vital role, providing young children 50-70% of their daily nutrition. With over 205,000 children in 2,032 LDCs across Victoria, there is an opportunity to implement sustainable, embedded strategies that promote healthier food environments and support child wellbeing over the long term.

Description
A comprehensive needs analysis identified the need for increased support for LDC cooks through the health promotion workforce to enhance the provision of nutritious foods in these settings. In response, the Healthy Eating Advisory Service developed an initiative Cooks Connect to empower health promoters in delivering network sessions for LDC cooks. Cooks Connect includes webinars for health promoters, training for cooks, co-designed resources, infoline support and regular community of practice sessions. The uptake and feedback of Cooks Connect in 9 Victorian locations highlights the benefits of employing co-design principles, ensuring that solutions are tailored to the diverse contexts of various LDCs, while also providing the necessary long-term support through an existing local workforce that engages with LDCs.

Significance
This initiative, co-designed with end users and grounded in identified needs, aims to create resources that will enhance and sustain engagement and ultimately increase the number of LDCs offering healthier foods. It exemplifies how the synergistic combination of policy and practice, through collaborative, evidence-based approaches, can enhance early childhood nutrition. Furthermore, this model demonstrates how embedding preventive health services and activities into core government strategies, policy and funding agreements can lead to lasting improvements in child nutrition and wellbeing, contributing to a healthier future for all children in Victoria.

Acknowledgement: The Healthy Eating Advisory Service is delivered by National Nutrition Foundation, with support from the Victorian Government.

Australia has the highest rate of skin cancer in the world, with two in three Australians diagnosed in their lifetimes¹. Despite this, in 2023, 9 in 10 young Australians had a suntan².

Research found ‘unhelpful attitudes’ (including ‘I look more attractive with a suntan’ and ‘I look sick without a suntan’) were the strongest driver of poor sun protection behaviours amongst Australians 18-30². These attitudes are driven by bad social norms reinforced by social media, influencers, celebrities and media.

Action was needed to combat these pro-tanning attitudes and drive up the use of sun protection.

In the summer of 2023/24 Cancer Council and the Australian Government launched the first national skin cancer prevention campaign targeting young Australians in over a decade.

The campaign leveraged third-party voices (influencers, youth media publications and culturally relevant fashion and music brands) trusted by the audience to make sun safety aspirational, question suntanning norms and dismantle the unhelpful attitudes to drive behaviour change and increase the use of sun protection.

The campaign launched with pockets of influential voices tapping into trends to normalise sun protection before expanding the pool of third-party voices using their platforms to question suntanning trends. With the target audiences' attitudes softened by the people they trust, branded advertising was introduced to remind and reinforce behaviour change.

The campaign reached 92.4% of the audience with recall amongst almost 9-in-10 young Australians.

This exceptional recall was largely attributed to the use of third-party voices, and resulted in substantial shifts in attitudes, beliefs and intentions and an average 47.3% increase in those mostly or always using sun protection (amongst those who recalled multiple campaign elements).

This first of its kind public health campaign demonstrates the opportunities for innovative, integrated campaigns and the use of third-party voices to drive behaviour change in public health.




1. Australian Institute of Health and Welfare 2016, Skin cancer in Australia, AIHW, Canberra.

2. WhereTo, (2023) Skin Cancer Prevention Research Report, Internal report prepared for Cancer Council Australia