Introduction
Access to health information and services is migrating to technological systems that are becoming exponentially more complex. Yet, a growing digital divide prevents equitable access to the benefits of these technologies. Digital health literacy challenges are complex for people experiencing vulnerable living circumstances, especially in times of extreme weather events that impinge on human health. The aim of this project was to use the Ophelia (Optimising Health Literacy and Access) process to investigate the digital health literacy strengths and challenges for people living in high-risk housing contexts (social housing, public housing, community housing, caravan parks, and homelessness) to co-design strategies for equitable community-based solutions that address the health prevention and care needs of the residents.

Methods
Surveys using the eHealth Literacy Questionnaire (eHLQ) with health, climate change and demographic questions were collected from 204 residents in Melbourne’s Eastern suburbs. Hierarchical cluster analysis identified 11 clusters, representing different patterns of digital health literacy strengths and challenges experienced when utilising health technology. Semi-structured interviews (n=13) provided substance for vignettes representing the human stories behind the statistical clusters. The vignettes were used in 9 workshops with 18 health professionals and 21 residents to generate ideas to address the challenges.

Results
Preliminary analysis of workshop ideas indicates community endorsement of solutions at multiple political levels, including systems of government-support service interactions, service-service interactions, and service-community interactions. Solutions include changes to governance standards, training and delivery models, and referral system methodologies for improved co-ordination between previously disparate entities.

Conclusion
The solutions generated in this research stem directly from the experiences of high-risk housing residents and the health professionals who serve them. Thus, these solutions have the potential to address the pertinent digital health accessibility barriers and be welcomed by high-risk housing residents and the people and services already working to improve their health.

Introduction: Following an extensive review of grants funding approaches within preventive health, the Healthy Tasmania Fund (Tasmanian Department of Health) redesigned their grants programs. One aspect of the redesign included the non-competitive grant scheme ‘Lift Local’ which offered $20,000 to each of the 29 Tasmanian local councils in 2023-2024 to undertake health and wellbeing planning and the establishment of a Local Government Health and Wellbeing network. This study evaluated how the grants and network was building healthy environments, empowering communities and creating responsive systems for preventive health.

Methods: A mixed-methods, case study approach was adopted (March 2023-September 2024). To do this, grant application documents were reviewed, semi-structured interviews were conducted with representatives from seven councils and the grants administrative team, observations were conducted at nine workshops and a survey on grant acceptability was disseminated. Descriptive and thematic analysis informed by the Healthy Tasmania Five-Year Strategic Plan Research and Evaluation Framework was undertaken.

Results: Twenty of the 29 councils proposed using the grant to develop a health and wellbeing plan, with the remaining running activities identified in existing council plans. Twenty-three of the councils had a community-wide focus, while six targeted specific community groups (e.g., Youth). Twenty-three councils incorporated community consultation, with councils undertaking more comprehensive consultation than usual. Interviews with councils revealed that the non-competitive nature of the grants facilitated cross-council collaboration, which was supported by a formalised council network. Administrative team members explained the non-competitive grant structure aimed to support a sustainable approach to prevention and “equity approach” to funding.

Conclusions: This novel approach to funding grants in a non-competitive manner has many positive outcomes, including building local council capacity to embed health and wellbeing in policies, enabling councils to develop plans reflective of community needs and priorities, and supporting more sustainable preventive health action.

Background: Aboriginal people in Australia experience inequity in outcomes across the cancer spectrum, including prevention, screening, diagnosis, and treatment. We sought to review the existing literature to identify Western Australian (WA) Aboriginal-specific cancer research articles, to guide future priorities in Aboriginal cancer prevention and education, research and policy advocacy.
Methods: Multiple databases were searched using relevant terms to identify articles that were published between 2000-2024 and that involved WA research into cancer and Aboriginal people. A total of 90 articles were selected based on eligibility criteria and were reviewed; key themes were identified through an iterative coding process.
Results: Key themes included disparities in cancer screening and treatment access, cultural barriers in healthcare delivery, systemic resource limitations, and health inequities and the need for culturally sensitive care. Findings highlight the importance of strengthening Indigenous healthcare workforce capacity and provision of peer support services to improve community trust and engagement in cancer care services. There is very limited research in the prevention space to address inequity in cancer acknowledging the complex interaction between individual, community, and structural factors that impact Aboriginal cancer outcomes.
Conclusion: WA Aboriginal-specific cancer research across the spectrum of screening, diagnosis, treatment, and end-of-life care offers recommendations for ways forward to improve equity of cancer outcomes. Investment is needed to implement culturally tailored health promotion to reduce cancer risk factors and screening initiatives. Additionally, investment is needed in Aboriginal support services for patients and carers; this could be provided through Aboriginal cancer navigators. Navigator programs can provide education and cross the interfaces between primary care and cancer treatment services, respecting Aboriginal customs and preferences. This presentation will discuss actions to improve equity in cancer outcomes for Aboriginal people in WA and the need for a holistic, culturally sensitive approach.

Introduction:
Type 2 Diabetes (T2D) significantly affects Māori and Pasifika women in Australia with increasing mortality rates and complications. Despite the need for culturally tailored initiatives to enhance T2D prevention and management, the efficacy of co-designed interventions remains underexplored. This study evaluated the Pasifika Women’s Diabetes Wellness Program (PWDWP), a co-designed intervention to improve self-management and reduce T2D complications among Māori and Pasifika women [1]. The program implementation was assessed using the RE-AIM® Framework and talanoa methodologies [2].

Methods:
The 24-week quasi-experimental intervention included 50 women (25 in the intervention and 25 in the control group). The intervention group received usual care plus five educational workshops with a hardcopy program booklet (journal, recipe book, factsheets and health check passbook), three virtual clinical consultations, six virtual support groups and weekly motivational SMS messages. The control group received their usual care, a program booklet with written materials (journal, recipe book, fact sheets and health check passbook), motivational SMS messages and a Talanoa workshop. Clinical outcomes (HbA1c, body-mass index (BMI), and Problem Areas in Diabetes (PAID)) were measured at baseline, weeks 12 and 24 weeks by trained Pasifika health and community researchers. Outcome differences were analysed using bivariate tests and mixed regression models with a 5% significance level.

Results:
Fifty participants (mean age 57 years) completed the program, with 20% identifying as Fijian, 18% as Samoan, and 14% as Māori. Baseline clinical metrics were comparable across groups. Mixed-effects regression analysis revealed that age and perceived program usefulness were significantly associated with reduced HbA1c levels (p=0.031). While BMI and PAID scores decreased over 24 weeks, differences between groups were not significant (p=0.021).

Conclusion:
Using co-designed culturally tailored programs embedded in talanoa methodologies can reduce poor health outcomes among Maori and Pasifika women with type 2. Integrating culturally appropriate strategies is crucial for effective T2D management among these communities.

Community Permissions and Impact:
The program's impact was grounded in active community engagement, with Māori and Pasifika communities involved throughout the research, and with community permission, honouring women's voices with cultural sensitivity. This reciprocal approach strengthened trust, fostering an environment of cultural safety, respect, and engagement.

Introduction

The Pasifika Women’s Diabetes Wellness Program (PWDWP), co-designed with Māori and Pasifika communities in Queensland, is a culturally responsive intervention aimed at improving health outcomes for women with type 2 diabetes (T2D) [1]. Central to this program was the production of talanoa digital stories (using reciprocal storytelling in a cultural space) to document women’s lived experiences with a focus on health-promoting behaviours.

Method

Over a 24-week period, the PWDWP utilised digital narratives to document the journeys of five Māori and Pasifika women from culturally diverse backgrounds. Talanoa was central to this approach which served as a core strategy to demystify and overcome cultural shame associated with T2D, encouraging women to navigate their cultural spaces (vā), whānau (family) support, and spirituality as important drivers of health and wellbeing.

Results
Digital storytelling created a supportive cultural environment (vā) that emphasised collective wellness and empowered women and their families. By sharing their stories, women reflected on health journeys, celebrated successes, and learned from their challenges, fostering motivation for self-care, reducing isolation and enhancing agency over their health. The program’s culturally grounded approach, integrating education, peer support, digital storytelling and talanoa methodologies, contributed to improving the health outcomes of women in the program.
Conclusion

Digital stories are powerful tools in diabetes self-management, capturing culturally resonant narratives that align with the values, experiences, and community support systems of Māori and Pasifika women. Recognising family networks, spirituality, and collective wellbeing reinforces positive health behaviours and strengthens cultural identity, fostering resilience and a sense of community. The success of the PWDWP is attributed to creating culturally safe spaces, promoting whānau (family) support, and incorporating spirituality, all enhanced through digital storytelling and Indigenous methodologies.

Community Permissions and Impact
The program's impact was grounded in active community engagement, with Māori and Pasifika communities involved throughout the research. Co-led by Pasifika health workers and community researchers, PWDWP prioritised community permission, honouring the women’s voices with cultural sensitivity. This reciprocal approach strengthened trust, fostering an environment of cultural safety, respect, and engagement.

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.
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 prioritises place-based decision making, currently working in two locations with the view to expand to five locations by June 2025.
Early insights 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.