Context and Aim: This Australian implementation study aims to uncover the factors that influence the sustainability of school-based physical activity and nutrition programs. The presentation will discuss findings of a distributed survey based on the Integrated Sustainability Framework. The goal is to support the longevity of school-based health programs to garner the most from their respective benefits.

Methods and research findings: A cross sectional study was undertaken with 201 Australian primary schools currently implementing physical activity and nutrition programs. Factors perceived to be influential to program sustainment were assessed using a 28-item measure of sustainability determinants developed by the research team. This reflected five domains of the Integrated Sustainability Framework. A 5-point Likert scale was used, and domain scores were calculated for each school by averaging item responses. Determinants were ranked according to their perceived influence on program sustainment. Linear mixed regressions were conducted to evaluate associations between measure domains and length of program delivery, and ordinal analysis was conducted to compare program type to categories of sustainment. Preliminary findings indicate an average program sustainability of 7.4 years, with differences observed between physical activity and nutrition programs. The domain 'outer contextual factors' was the only domain which was significantly associated with greater sustainment. Top determinants influencing program sustainment varied between physical activity and nutrition programs, highlighting contextual specificity.
Translational outcomes: The study provides critical insights into sustaining school-based health programs, emphasising the need for tailored strategies to address program-specific challenges. Understanding distinct determinants enables targeted strategies to support program sustainment and maximise health outcomes.

Future actions: Future efforts should prioritise developing sustainability strategies tailored to the unique challenges faced by physical activity and nutrition programs in school settings, with emphasis on outer contextual factors such as leadership support and funding availability.
Learnings: The study underscores the importance of considering context-specific determinants in sustaining health program delivery, offering valuable lessons for policymakers and practitioners involved in school-based health initiatives. Addressing identified determinants can enhance the effectiveness and longevity of school-based physical activity and nutrition programs, contributing to improved population health outcomes.

Problem:
In Queensland, the Quitline service sits within the Health Contact Centre (HCC) in the Department of Health. Quitline offers accessible, client-centred, and culturally sensitive telephone counselling and support for smoking and vaping cessation. Select priority populations can also access intensive quit support (IQS), which combines multiple behavioural counselling calls and up to 12 weeks of Nicotine Replacement Therapy (NRT). It is recommended that anyone having surgery quit smoking and vaping at least eight weeks prior, as both are risk factors for poorer outcomes and recovery.

Intervention and Delivery:
Recognising surgery as a powerful motivator for patients to quit smoking and vaping, Quitline took a proactive approach. After obtaining the necessary approvals, Quitline began contacting clients on surgery waiting lists, offering them cessation support. A weekly automatic SMS process contacts all category 2 and 3 patients over 18 added to thoracic, respiratory, cardiology, and ENT surgery waiting lists. Patients who identify as Aboriginal and/or Torres Strait Islander receive extra information about the option to speak with an Identified counsellor. Relatedly, a process was also created to offer participation in a smoking and vaping cessation program to patients on public waiting lists for hospital appointments. Within the HCC is a team that contacts clients on behalf of Hospital and Health Services to confirm they still require an appointment. This team were provided training about Quitline, and the team began offering IQS-eligible patients a referral.

Results:
In the past year, 849 people have participated in a Quitline program after being proactively offered cessation support via SMS or phone. Comprehensive smoking and vaping cessation data will be available in 2025.

Lessons:
Offering cessation support to public health patients via SMS and when confirming appointments is an effective strategy to increase Quitline engagement.

Problem: Equipping families with skills, resources and capabilities to optimise child health and development outcomes is a key focus for Australian governments. Dedicated Child Health Services (CHS) are best placed to support preventative health and development checks in the early years, but data indicates service engagement declines significantly over time. mHealth presents a substantial opportunity to supplement usual care and revolutionise the delivery of preventative health care at a population level. Despite this, there are limited mHealth (text-message) interventions targeting child health and development across the first 2000 days.
What we did: Using the COM-B model of behaviour change and existing research evidence, a multidisciplinary team co-designed a text-message service aligned to age-and-stage milestones, which aimed to address key health and development outcomes, including breastfeeding, nutrition, physical activity, child development, maternal wellbeing, and immunisation/health check reminders. Commencing as a pilot, the text-message program was offered as part of usual care in five CHS, across metro, regional and rural communities within NSW. Ongoing service monitoring and evaluation activities measuring engagement, acceptability and behavioural outcomes were embedded to rapidly test program adaptations.
Results: Across 33 months 6477 families were offered the program and of those 96.09% (N=6224) enrolled. Semi-structured interviews (clinicians) and cross-sectional phone surveys (parents/carers) identified that the program was acceptable. This was supported by high engagement with content links and low unsubscribe rates. Preliminary data indicated a positive effect on any breastfeeding and delayed introduction to solids at 6-months, whilst higher fruit and vegetable intake and better maternal wellbeing was observed in the pilot sites at 12-months.
Lessons: Co-designing text-message programs that can be embedded into usual care and establishing data streams that inform continuous quality improvement may be an effective way to establish a learning health system that delivers and sustains preventative health care for Australian families.

State-wide commitment to settings-based health promotion has resulted in 12 years of successful implementation of Victoria’s Achievement Program. The program supports Victorian early childhood services and schools to adopt a whole-of-organisation approach to improve the health and wellbeing of their students, children, employees and wider community. Members use a framework based on the World Health Organization’s health promoting school’s model as well as resources, and support from Victoria’s health promotion workforce to address key health priority areas. Cancer Council Victoria’s Achievement Program is supported by the Victorian Government.

The Achievement program has supported over 800 education settings to become recognised by the Victorian government as a health promoting organisation for one or more health priority areas, including Healthy Eating and Oral Health, Physical Activity, Mental Health and Wellbeing, Smoking, Vaping, Alcohol and Other Drugs, Sun Protection and Sexual Health and Wellbeing. Over time the framework has adapted to respond to emerging or increasing health and wellbeing priorities – including vaping and climate change.  

Key lessons from settings who have successfully implemented the initiative include, the importance of champions and leadership commitment within an organisation; the benefit of external support to overcome capacity limitations; and the need for a sustained approach to creating healthy environments. As the preventative health landscape continues to evolve, the Achievement Program is undergoing a series of updates to remain strategically aligned to key stakeholders and continue to deliver value for Victorian schools and early childhood services.

We all recognise that no single professional has the knowledge, competencies or remit to deliver all the public health interventions necessary in the planning, preparation, delivery, and remediation phases of Preventative Public Health.

This presentation will highlight the capabilities that environmental health professional (with examples from around the world) can bring to the table. You will be presented the range of core skills EH practitioners possess, evidence of success, transdisciplinary skills, interoperability, and the ability to deliver effective public health solutions in the most challenging times.

The authors goal, is to present a paper that offers a unique insight into the skills, knowledge and competence of the environmental health practitioner both in Australia and beyond.

The presentation will introduce concepts from
- the United Nations Office for Disaster Risk Reduction (UNDRR) which coordinates activities to create more resilient communities.
- the Sendai Framework for DRR 2015-2030, which is the roadmap for the UN programme.

This paper draws on the expertise of international experts engaged in implementing the framework from an EH perspective.

The paper offers practical initiatives from a worldwide perspective, to support safer communities. Increasing climate change impacts on communities can be mitigated and be integrated into policy at all levels.

The final part of the paper offers delegates an insight into why EH needs to be part of current and future development of an Australian CDC, the resources needed to integrate environmental health aspects of DRR into CDC and cascade these within communities.

While the Ottawa Charter for Health Promotion(1986)provides a macro framework for improving public health, the Universal Wellbeing Model (UWM) emerged from a sixteen year mixed-method program of wellbeing research designed to increase the value and impact of professional Prevention Wellbeing Practitioners. The research conducted has built a robust philosophical, theoretical, research, and practice base capable of measurably preventing poor wellbeing, and progressing equity. The innovative new UWM (Stevenson et.al, 2023) that emerged is providing a new and highly effective framework for professionals working in the field of Prevention Wellbeing. Since the UWM emerged it has underpinned a comprehensive and holistic Universal Wellbeing Evaluation Tool (UWET). This Tool is capable of, evaluating Universal Wellbeing strengths and areas of harm, differentiating environmental impacts, and identifying an individual’s wellbeing risk level. The evidence-based UWM framework, and UWET are now forming a new Prevention Wellbeing Science Framework capable of supporting organizations to co-designed bespoke wellbeing literacy and support approaches and solutions to their work and study place wellbeing challenges. This new Prevention Wellbeing Science Framework is proving highly effective in the diverse settings in which it has been implemented to date. The new Framework disrupts conventional public health model approaches by focusing on, transformative Universal Wellbeing Literacy, and Support experiences related to the Determinants of Universal Wellbeing. A key characteristic of these Determinants is that they can be enhanced by an individual, or organization. The new UWM Prevention Wellbeing Science Framework and associated methods and approaches provide prevention wellbeing professional practitioners, and policy makers with powerful means through which they can prevent poor wellbeing. Approaches and methods include defining, measurement, literacy, supports, and the positive influencing of universal wellbeing status. Implementation in higher education and business sector organizations will be outlined.

Extending the healthspan of individuals is an increasingly important public health priority, with physical activity being a key factor in maintaining vitality across the lifespan. Traditional approaches to encouraging physical activity have often relied on socio-cognitive models, which emphasize logical reasoning and knowledge as primary drivers of behavior change. However, recent insights from “dual process models” suggest that affective associations—how people feel about physical activity—may play a more influential role than previously recognized. This talk will introduce an innovative Affective Change Technique that seeks to build positive emotional connections with physical activity, moving beyond cognitive strategies alone. The approach integrates exercise science with guided autobiographical reflection and coaching psychology, aiming to deepen individuals’ emotional engagement with active living. Presenting recent proof-of-concept and feasibility study data, a case will be made for the applied potential of this cross-disciplinary approach to make physical activity more meaningful and sustainable in everyday life. It will also outline how AI can be used to create scalable, cost effective interventions that improve equity, by making them available to less well-serviced societal groups. Whilst primarily focused on the contribution of physical activity to healthspan extension, the talk will also acknowledge the difference and diversity that exists in ageing. Specifically, it will give attention to less active or "passive" forms of leisure (e.g., socialising, playing cards) that are known to contribute greatly to cognitive and social functioning but are often overshadowed by the ubiquitous promotion of physical activity as a strategy for successful ageing. Nonetheless, affective change techniques offer a way of engaging individuals and groups in all forms of health-enhancing leisure, with the potential to become part of more accessible, equitable and enduring preventative health delivery models.

Place-based approaches (PBAs) are becoming increasingly popular across government, public health research and practice as a way to improve health and wellbeing in areas of poor health and disadvantage. As a relatively new approach, the literature on best-practice for PBAs is emergent, and delivery methods are often diverse with little evaluation of success. We explored what key principles and considerations were essential for ‘best-practice’, with the aim of developing a guiding framework for PBAs. Using Grounded Theory methodology, we conducted 23 interviews with participants from Australia, United Kingdom, Canada and New Zealand. Purposive sampling was used to recruit community members, government, program funders, researchers, Aboriginal leaders and facilitators of PBAs. The data was analysed thematically. We identified three key principles of PBAs: Preparation, Participation and Impact (PPI) which are critical at all stages of a place-based initiative to reach the key outcomes of: 1. Understanding People and Place; 2. Connecting with Community; and 3. Shifting the System. At all times, the need to ensure that power is balanced is critical to foster an inclusive engagement process. The PPI framework informs practical strategies to enable meaningful and authentic community engagement and gives importance to building trusted relationships with community members through deep listening, spending time in community and shared decision-making. It provides mechanisms to create systems change through advocacy, enabling community voices and creating the environment for sustainable change. The framework highlights the importance of fostering genuine partnerships with community members, enabling shared decision-making and inclusive co-design as ways to address power imbalances in PBAs. By following the principles outlined in this evidence-based framework, communities and funders can work together to address complex problems in a way that values the lived experience of community members and optimises the chances of achieving long-term health improvement.

A critical part of an effective preventative health system is people who are equipped with the food literacy, practical skills, appreciation of seasonal produce, and a positive, confident and healthy relationship with food. The adults of the future are the children and young people of today, and they need the knowledge, skills and experience to live healthy lives in sustainable and healthy communities.
The need for our Kitchen Garden Program has never been higher: Almost 95% of children aged 2-18 years do not meet the daily recommended intake of vegetables, and fruit consumption is also significantly below recommended levels. Ultra-processed foods account for 42% of Australian diets.
The evidence for our Kitchen Garden Program has never been stronger: Extensive independent research and evaluation over two decades confirms our program as the most impactful, benefitting children and transferring benefits to the home and broader community.
The demand for our Kitchen Garden Program has never been greater: Over 1,000 schools and early childhood settings across Australia are already part of our Kitchen Garden Program, and we have significant unmet demand from more than 1,000 additional settings.
And yet, like many preventative health programs with strong evidence/impact base, establishing sustainable funding models is elusive.
New systemic solutions for sustainability/longevity of kitchen garden programs that are vegetable and behaviour change focused across early childhood and school settings are needed. This presentation outlines some of these possibilities.