Background: The Coronavirus disease 2019 (COVID-19) pandemic and prevention measures impacted health behaviours like physical activity (PA) and sedentary behaviour (SB). This systematic review aimed to explore the effect of COVID-19 restrictions on PA and SB in older adults, incorporating all of the latest evidence.

Methods: A systematic search was conducted on Medline, Embase, CINAHL, PsycINFO and Scopus from inception to April 1st, 2024. Studies were included if they measured PA and/or SB changes during the COVID-19 pandemic in older adults and compared to a period with minimal severity restrictions or no restrictions.

Results: 120 studies were included, 118 measuring PA and 46 measuring SB. The majority of evidence was from Europe and Asia, high income countries, in community-dwelling populations, included both sexes, and assessed PA and SB by self-report. 27% of studies reported no change in PA, while half reported a decrease in PA. The majority reported an increase in SB (79.5%) during COVID-19. The majority of studies reported no significant associations of gender (65%), education (77%), marital status (57%) and household income (100%) with changing PA. Half of studies investigating age and living situation reported no association with change in PA during the pandemic. One study found a higher proportion of urban participants decreasing PA compared to rural participants. Few studies investigated correlates of SB and among those that did, there was conflicting evidence on age and gender. Living alone was associated with higher odds of increased SB during periods of pandemic restrictions.

Conclusion: The evidence indicates that people tended to decrease or not change their PA, and increase their SB during the COVID-19 pandemic. There were few sociodemographic factors that were associated with PA, SB or changes in activity behaviour during the pandemic in older adults.

Problem: One in three Australians live with lung disease or lung cancer. There are many preventable risk factors that can lead to, or exacerbate poor lung health, such as climate change, tobacco smoke, e-cigarettes, occupational dust exposure, and more.
What you did: Lung Foundation Australia (LFA) advocates for policies that will improve and protect the lung health of all Australians. One tool we use to enhance our political advocacy efforts is through empowering and supporting our community to advocate for change. LFA provides training and support to people in the community to advocate for policy change on issues that will improve lung health.
Results: We have trained and supported our advocates through a variety of advocacy activities including attending events at parliament house to talk to ministers. A case study will be shared of an advocate who was supported by LFA to share her story with politicians and departmental staff in relation to new federal tobacco addiction legislation. She shared how the policy change had benefited her, and what her hopes were for the future of tobacco and vaping control.
Lessons: Utilising the voice of those in the community is a powerful advocacy tool that raises awareness of issues and helps politicians and governments to understand what is important to the people. Through working with community advocates we have gained an understanding of the benefits (e.g. increases awareness of issues, humanises the issues, increases advocacy efforts for NGOs who have limited resources), challenges (e.g. working with a community that may be living with lung disease and therefore may have limitations on their capacity to engage, sustained investment and resources for supporting and developing a relationship with the advocates), and lessons (e.g. understanding the story and interests of the individual, tailoring opportunities, differing levels of support required for advocates).

Introduction: Influencing health public policy is a core function expected of health promotion practitioners to improve environments supportive of health equity. Theories of the policy process provide an evidence-informed understanding of how to navigate the complex policy-making environment. However, little is known about whether current health promotion practitioners are aware of these theories or understand them.

Methods: Health promotion practitioners were purposely recruited to the study with the option to forward the research invitation to relevant networks. Eligible participants self-identified as tertiary educated in health promotion and were currently employed in a health promotion role in Queensland, Australia. Eligible practitioners provided written consent to participate in an individual, online, semi structured interview. Data were analysed using reflexive thematic analysis.

Results: Ten health promotion practitioners participated in the research, representing government and non-government organisations. Most practitioners were unable to recall any theories of the policy process although they could implicitly demonstrate understanding of the complexities of the policy process in practice. Practitioners involved in the study noted that they learned about policy process theories during their formal education but were unable to recall specific details. Learning on-the-job was moreso reported as contributing to understanding of the policy process.

Conclusion: Health promotion practitioners currently learn how to navigate policy processes through relevant practice experience. It is proposed that an increased understanding of policy process theory will support greater impact in the practice of navigating complex policy environments. An increased focus on tertiary education curriculum that applies theories of the policy process to practice contexts is recommended, along with the creation of formal opportunities for experienced practitioners to mentor others less exposed to the policy making environment.

Clinicians working in primary care settings see a wide range of conditions within their consultations and are therefore well placed for a settings-based approach to health promotion and preventative health initiatives. Politicians recognise the importance of primary care and increasingly designate their roles in national health initiatives, preventative care models and activities to reduce avoidable hospital presentations.

However, due to the wide range of conditions seen within primary care settings, workforce challenges and short consultation times it is challenging for clinicians to be able to participate to their full capacity.

National commentary contends that primary care clinicians are experiencing increasing pressures to understand multiple national and local health initiatives and apply them within their practice.

HealthPathways is a clinical reference tool for primary health professionals that provides information on assessment, management and referral options for a range of conditions. The clinical pathways are written by GPs with local subject matter experts and are focused on the scope of care within a general practice setting.

In 2020 a Quality Assurance Audit of the ACT & SNSW HealthPathways site investigated whether clinical pathways

conformed to best practice guidelines and health literacy principles

aligned with the WHO’s principles of integrated care and

included patient information that was inclusive and culturally appropriate.

The audit found that HealthPathways provided a valuable point of care tool to support GPs in their provision of care and had the potential to support clinician confidence in managing common conditions.

We contend that HealthPathways has the potential to support clinician confidence in participating in preventative health initiatives.

HealthPathways is an accepted tool for primary health clinicians and could be better leveraged as a singular point of information to

respond to policy changes

and enable primary health clinicians to better deliver preventative care.

Problem
The sexual health promotion profession has a responsibility to provide sexual health education through innovative approaches. Meeting the sector where they’re at during COVID-19 meant moving capacity building health education into the online space and producing high quality, accessible content.

What we did
The Caddyshack Project in the Illawarra Shoalhaven Local Health District (ISLHD) pivoted from face-to-face health education to utilising online platforms to increase reach and engagement with the workforce which came with many benefits including reduced costs. On The Couch (OTC) is produced as a free ticketed online series with video recordings available on YouTube and podcast episodes on Podbean. OTC is a collaboration with experts, practitioners, authors, advocates, and influencers who explore current social themes, sex positive topics and share stories and insights that matter. A formal evaluation of OTC and competitive analysis is in progress.

Results
Initial internal comparative data shows registration and attendance to OTC increased by 60% since moving to an online model. In 2020 and 2021, an average of 55 participants registered and attended across 18 online OTC recordings compared to an average of 14 participants attending the same number of face-to-face education sessions in 2018 and 2019. This led to an increase in engagement on social media channels. In 2022 compared to 2019 the engagement rate on Facebook increased by 4.2% and Instagram increased by 7.56% reaching 26,000 users. Geographical boundaries are no longer a barrier for attendance with OTC in 2022 reaching a broader audience across NSW, nationally and internationally with a 54% increase of registrations from outside of ISLHD compared to 2019.

Lessons
The sector is engaging in and embracing online education content through live attendance, views of video recordings on YouTube and downloads of the podcast on Podbean, demonstrating the sustainability and reach of this expanding online model.

Disclosure of Interest Statement:
None

Background
Volunteering has been shown to positively impact the physical and mental health of both volunteers and recipients through social interaction, support, and physical activity. Physiotherapists, as health professionals, are uniquely positioned to design and promote physical activity programs, thereby improving community health outcomes. This study aimed to explore current volunteering practices among Australian physiotherapists and investigate the potential for future recruitment in promoting physical activity programs.
Methods
A national survey was conducted among physiotherapists who are members of the Australian Physiotherapy Association (n = 520). Multiple logistic regression analyses were performed to evaluate the associations between physiotherapists’ characteristics and their volunteering status, with results presented as odds ratios (OR) and 95% confidence intervals (CI).
Results
Most respondents were Australian born (95%) and female (54%). Half of the respondents (50%) were current volunteers, and nearly all (94%) expressed willingness to volunteer their professional skills in the future, with a preference for face-to-face interactions (60%). Characteristics associated with current volunteering included older age (45-54 and 55+), formal employment (full- or part-time), clinical roles, and rural work experience. Key facilitators for volunteering were finding a suitable activity or field of interest (27%) and having available spare time (21%). The main motivators were helping others (85%) and family involvement (62%). Preferred volunteering areas included community events (88%), physical activity promotion (84%), and group education/health promotion (82%). Most respondents agreed that community members need help (88%) and that volunteering makes a significant difference (83%).
Conclusion
Physiotherapists are highly motivated to volunteer and recognize the substantial impact of their contributions on community health. By leveraging their professional skills, physiotherapists can play a crucial role in promoting physical activity and improving health outcomes. This study identifies volunteering deficits that need further insights and targeted programs to enhance engagement and effectiveness of volunteer contribution to public health.

ABSTRACT
Introduction
Hepatocellular carcinoma (HCC) is the leading liver cancer and liver-related death in the world. In Vietnam, hepatitis B was found to be the most common disease in patients with cirrhosis and HCC. However, there is still a lack of population-based, high-quality studies for assessing the risk factors and epidemiology of cirrhosis and HCC in this country. Therefore, the aim of the study was to evaluate the risk factors of HCC in Vietnamese populations.
Methods
The study design was a retrospective cohort study, with a total of 12,476 visits from 4,445 patients with cirrhosis at Nghe An Tropical Diseases Centre, Vietnam, recruited from April 2020 to October 2022. Collected data included age, gender, and disease characteristics of patients, including time of diagnosis, comorbidity, and treatment.
Results
Consistent with previous reports, we found that both cirrhosis and HCC were commonly found in men. The age groups from 60 to 79 were significantly at risk of developing HCC than other age groups. Patients with coinfections of chronic viral hepatitis were significantly at risk of HCC development. Treatment with tenofovir disoproxil fumarate in patients with only hepatitis B virus significantly reduced HCC development, compared to patients with coinfections of chronic viral hepatitis. Cirrhosis patients with hepatitis C virus (HCV) showed a significantly higher association with HCC development than those without it.

Conclusion
HBV significantly contributed to cirrhosis and HCC in Vietnam, while HCV was the major concern for HCC development. These findings explain the main cause of cirrhosis and HCC burden in Vietnam and the region.
Keywords: cirrhosis, hepatocellular carcinoma, Vietnam, hepatitis B virus, hepatitis C virus, tenofovir disoproxil fumarate.