Introduction: Between 2019 and 2024, the Alcohol and Drug Foundation (ADF) partnered with Planet Youth in Iceland to pilot the Icelandic Prevention Model in Australia. This 5-year initiative was implemented through select Local Drug Action Teams (LDATs) in South Australia and New South Wales, aiming to reduce alcohol and other drug (AOD) use among young people. The initiative sought to address risk and protective factors within communities to foster healthier environments for youth.

Methods: A central component of the pilot involved conducting three surveys with Year 10 students in 2019, 2021/2, and 2023. These surveys gathered localised data on youth AOD use, which informed the prevention activities developed by LDATs. The prevention activities were tailored to the specific needs and challenges identified within each community, with the goal of reducing AOD use through targeted interventions.

Results: Over the course of the pilot, there were significant reductions in cigarette, alcohol, and cannabis use among students, although vaping use increased during the same period. The analysis of risk and protective factors yielded mixed outcomes. Positive changes were seen in parenting-related protective factors and a reduction in peer-group risks. However, there was an increase in school-based risk factors, such as feelings of unsafety and low aspirations for completing Year 12. Social media use also saw a significant rise, while video gaming, typically considered a risk factor, was found to correlate with lower AOD use.

Conclusion: Throughout the 5-year period, several key insights emerged. Notably, while reductions in some forms of AOD use are promising, the rise in vaping and the complex relationship between physical activity and substance use underscore the need for further research. Additionally, the increased school-based risks highlight areas for further attention in youth prevention strategies.

Introducing a workload model for environmental health (and others)

Public health systems face increasing challenges in managing workloads due to growing demand, constrained resources, and the complexity of health issues. Environmental health services, in particular, must balance a broad spectrum of responsibilities, ranging from regulatory enforcement to emergency response. These pressures often result in uneven workload distribution, resource misallocation, and staff burnout. To address these issues, we present a comprehensive workload model tailored to environmental health services, but with flexibility for broader application across other public health domains.

This model integrates quantitative workload indicators—such as caseload, time-on-task, and service demand—with qualitative insights drawn from staff experiences and service user feedback. By combining both metrics, the model offers a dynamic framework that allows for the identification of workload imbalances, predicts resource requirements, and aids in more informed decision-making for management and policymakers. It accounts for fluctuations in demand, the complexity of tasks, and regional variations in health service delivery, making it highly adaptable to different public health settings.

We applied the model in several environmental health units to assess its effectiveness. The results demonstrated significant improvements in workload distribution, increased efficiency in resource deployment, and enhanced staff satisfaction. These outcomes suggest that the model can contribute to mitigating staff burnout, enhancing service quality, and ensuring that health services are more resilient to fluctuations in demand.

Beyond environmental health, the model’s design allows it to be customized for other public health fields, such as infectious disease control, regulatory services, and community health programs. We propose that future research should explore its application in these areas, with an emphasis on scalability and integration with existing health management systems.

In conclusion, this paper presents a new approach to workload management in environmental health, with potential benefits for various public health domains, offering a pathway to more efficient and equitable public health service delivery.

Problem
With increasing rates of chronic disease in Australia, the need for systemic and coordinated chronic disease prevention (CDP) action is undisputed. Health care and public health systems have previously been defined and described in the literature. However, the CDP system as a whole has not. Understanding the CDP system entities, functioning and leverage points leading to improvements is essential for change.

What we did
The Partnering for Prevention project will identify opportunities to strengthen the Australian CDP system. Acknowledging CDP system complexity, we adopted a phased approach starting with primary prevention and health-focused entities interested in CDP at national and state levels. Initially, we will use a co-design approach with leaders in CDP from government and non-government health organisations to a) identify key system entities in the Australian CPD system, and b) explore how the system is functioning using an evidence-based and peer-reviewed framework of an effective CDP system.

Results
The key entities of the Australian CDP system, as described by participants during an online facilitated workshop in February 2025 will be presented. Findings developed with participants about their perceptions of parts of the Australian CDP system that are and are not optimal, and how these compare to the attributes identified in the framework of an effective, efficient and equitable system will be outlined.

Lessons
Co-designing a picture of how the CDP system in Australia is functioning will enable leaders to identify gaps and key levers for change. By collectively describing the system and critical opportunities, we will facilitate leaders to prioritise feasible and evidence-based strategies to support a coordinated and impactful approach to strengthen the system to improve chronic disease outcomes. Lessons learned will inform future phases of the research including exploring non-health sector entities and other prevention levels of the CDP system.

Introduction: Implementation of population-wide interventions to promote healthy eating habits in children is imperative to address childhood overweight and obesity challenges. Schools provide an opportunity to deliver interventions and reach priority populations to reduce inequitable outcomes. This study aimed to determine whether the uptake of, and support to adopt, an effective school-based healthy lunchbox program, SWAP IT, differs between schools across the Hunter New England Local Health District (HNELHD) area of New South Wales, Australia.
Methods: This observational study included 368 primary and combined schools serviced by HNELHD. Data about HNELHD support officer contacts with schools to support SWAP IT adoption between 2017 and May 2023, and school characteristics, were extracted from the HNELHD database and the MySchool® website. Chi-square tests and t-tests were used to examine whether adoption of SWAP IT differed by school characteristics (remoteness [major cities; inner regional; outer regional; remote], socioeconomic status [most disadvantaged; least disadvantaged], size [enrolment numbers], sector [government; non-government]) or number of contacts. Linear regression was used to examine associations between number of contacts and school characteristics.
Results: Schools adopting SWAP IT were significantly smaller (mean enrolments: 199.7, SD:189.9 vs 252.0, SD:259.9) and included a higher proportion of government schools (55% vs 30%), than those not adopting. Additionally, government schools received significantly more contacts about SWAP IT on average than non-government schools (0.72, 95% CI: 0.07-1.37). There were no other significant differences in school characteristics and program adoption, or number of contacts received about the program.
Conclusion: These findings suggest that SWAP IT is being equitably adopted in schools across socioeconomic and geographical settings within a large, diverse LHD. However, inequities relating to SWAP IT adoption and school size and sector, and LHD contact about SWAP IT between school sectors, need to be addressed before progressing to a state-wide scale-up of the program.

Background: Cardiovascular disease (CVD), the leading cause of mortality worldwide, begins in childhood. While a large amount of the burden of CVD can be attributed to modifiable behavioural risk factors, a major challenge is initiating and maintaining behavior change, which may in part be due to inadequacies in health literacy. Interventions to improve health literacy in childhood may support prevention of cardiovascular risk factors, but this has not been thoroughly explored. This study aims to identify all previous interventions that have targeted health literacy (or proxies of) and cardiovascular health (CVH) in children (aged 4-13 years).

Methods: Two reviewers searched four databases (Medline, Scopus, CINAHL and Web of Science) for studies published from inception up to October 21, 2024. We analysed studies following the Joanna Briggs Institute framework reporting on characteristics of the interventions, conceptualisation of health literacy intervention, number of CVH metrics measured according to the American Heart Association’s Life’s Essential 8 and pre- and post-intervention effects.

Results: From 5453 potential papers, we identified 46 studies to be included in the review, of which 6 were protocols. The countries where studies were conducted included the United States (n=13), Australia (n=5), Canada (n=4), Denmark (n=4), Netherlands (n=3), United Kingdom (n=2), Faroe Islands (n=2), Sweden (2) and Spain (2). The intervention length ranged from 5-weeks to 4-years. None of the included studies explicitly conceptualised health literacy according to contemporary health literacy definitions.

Conclusion: We identified 46 intervention studies, of which 38 studies reported improvements in CVH when combined with a health education program, but no studies have conceptualised health literacy using current health literacy definitions. This emphasizes health literacy as an important element in preventive health strategies. Supporting health literacy at population level, requires political commitment. Future CVH interventions should consider inclusion of health literacy approaches to optimize prevention of CVD.

Problem
Vaping presents a significant public health challenge in Australia. In May 2023 the Australian Government announced plans to introduce stronger regulation and enforcement of vaping products, accompanied by increased access to education and cessation supports.

ACT Health approached the implementation from a coordinated public health perspective to reduce vaping harms, reduce access to vaping products by young people, reduce initiation of vaping and smoking and support people to quit.

What we did
ACT Health developed a framework for mapping priorities, activities and key stakeholders for supporting the national reforms and reducing vaping harms, based on the Ottawa Charter.
The five key domains of the Ottawa Charter (Building healthy public policy; Creating supportive environments; Strengthening community actions; Developing personal skills; Re-orienting health services) were used to map strategies, actions and stakeholders under each domain, that allowed the ACT to identify gaps, priorities and stakeholder engagement opportunities to ensure a coordinated implementation approach.

Results
The Ottawa Charter framework ensured a strategic approach to:
• promoting awareness of education activities undertaken to educate about vaping products, reducing their harms and achieve support for action
• collaboration across multiple areas of ACT Government and creation of stakeholder groups for targeted work (including compliance/enforcement and clinical pathways)
• consideration of complementary regulatory mechanisms to limit non-therapeutic access to vaping products
• clarifying internal ACT Government priorities in vaping and tobacco work.

Lessons
The Ottawa Charter is a useful tool for public health policy makers to ensure future actions are considered using all possible levers across diverse areas of government and the community. In some cases, identified priorities are dependent on the buy in of external stakeholders which cannot be guaranteed.
The vaping reforms presented a changing environment, demanding flexibility. The framework must be regularly updated in response to new evidence to remain useful.

Abstract title
Learnings from the first round of the Strengthening Our Culture Community Grants Program

Abstract author(s)
Rohan Carmody, Principal Project Officer, Aboriginal Health Promotion Team, Preventive Health SA.

Camilla Trenerry, Senior Evaluation Officer, Data Analytics and Health Translation Team, Epidemiology and Research Division, Preventive Health SA

Problem
The Cultural Determinants of Health are central to Aboriginal health and wellbeing, intrinsically linked to all aspects of Aboriginal knowledge, life and being. Aboriginal voices need to be embedded into the development and implementation of policies, practices and programs, helping to breakdown barries to accessing and applying for funding opportunities.

What you did
The Preventive Health SA, Aboriginal Health Promotion team launched the Strengthening Our Culture Community Grants Program in June 2023. This grants program, available only to Aboriginal Community Controlled Organisations (ACCO) in South Australia, was designed and implemented by the South Australian Aboriginal community, in collaboration with the Aboriginal Health Promotion team. The grants program has been built on a Community of Practice approach, supporting self-determination and community projects that focus on strengthening the Cultural Determinants of Health to improve the health and wellbeing of the Aboriginal population in South Australia.

Results
Eleven projects were funded. There were five camps on country, three archival projects, two projects focused on culturally informed business/career services and one art program. The focus on strengthening culture was well received. Through a survey of grant recipients, all respondents (8/8 or 100%) agreed that the grant guidelines allowed them to design a project, that was strong in culture and suited their community needs.


Lessons
The targeting of the ACCO sector aligns with Closing the Gap Priority Reform Two and provided ACCO’s with an opportunity to access funds without having to compete against better resourced non-government organisations.
The inclusive and strengths-based approach to the design of the grants program and the supportive application process was well received by recipients.
By adopting a Community of Practice approach, the intention was to better support grant recipients to develop sustainable skills, share knowledge and best practice while designing and delivering programs that strengthen culture for their individual communities.

Preventive health measures are key to achieving a healthier Australia. Even though Australians have one of the longest life expectancies in the world, many are living with and suffering from chronic illness.

The vision of the National Preventive Health Strategy 2021-2030 (NPHS) is to improve the health and wellbeing of all Australians through prevention. It identifies 4 Aims and 7 Focus Areas under which are key measurable targets that Australia should be striving for by 2030. This includes 2 key targets within the National Obesity Strategy 2022-2032 to reverse the prevalence of obesity in adults, and reduce overweight/obesity in children and adolescents.

This project aims to monitor all key targets from both strategies by building a monitoring dashboard. It explores changes in risk factors and health outcomes in the wider Australian population, with a focus on time trends and priority populations such as First Nations people, rural and remote areas, and socioeconomic areas.

Nationally representative data from a range of sources including the Australian Bureau of Statistic’s National Health Surveys, the Australian Institute of Health and Welfare, and the Department of Health and Aged Care were analysed, collated and visualised. The latest available data was compared against the baseline data for each target. Compared to baseline: daily smoking decreased by 3.2%; Australians ≥15 years undertaking no physical activity decreased by 16%; adults living with obesity remain steady, and the proportion eating enough fruit and vegetables has decreased.

This information has been translated to an interactive dashboard providing a comprehensive visualisation and information platform for key stakeholders to review changes in the Aims and Focus Areas of the strategies.

Ongoing collection and analysis of data, as and when it becomes available, is important to ensure comprehensive and timely updates to a monitoring platform for guiding the implementation of public initiatives.

Introduction: Chronic disease risk factors such as smoking, poor nutrition, alcohol misuse and physical inactivity (SNAP) have a significant impact on population health. The delivery of preventive care during clinical consultations can reduce chronic disease risk factors, and can be done using the Assess, Advise, Help (AAH) framework. Preventive care is often overlooked during clinical consultations, with one barrier that is often reported being limited time during consultations.

To address this issue we aimed to test the adoption of an online self-assessment tool sent prior to a clinical appointment and if this was an acceptable way to deliver preventive care.

Methods: A convenience sample of adult patients with an upcoming appointment at two regional/rural Community Health Services were sent a SMS containing a link to the online self-assessment tool in REDCap. The tool assessed SNAP risk factors compared to national guidelines. ‘Advice’ and ‘help' were provided within the tool via brief information and links to support services (e.g. Get Healthy Service). Consumer feedback was sought from patients via semi-structured telephone interviews.

Results: 20 eligible patients were unable to receive the tool (e.g. due to not having a mobile phone). The tool was sent to 78 patients (62% female, mean age 52.4), and was completed by 43 (55.1%) patients. 52 patients (66.7%) completed the feedback interview, 34 of whom had completed the tool. 88.0% of interviewed patients indicated that it was acceptable to send the tool via SMS. The main reasons for tool non-completion included inconvenient time and not being good with online forms.

Conclusion: There was high acceptability of sending the tool via SMS, and fair adoption of the online tool. Further testing is required to determine equity of access and optimal tool characteristics. There is opportunity to embed preventive care within clinical care via digital modalities.

Human health stand at a crossroad with a multitude of factors hitting it hard: from climate change and chemical pollution to widespread social and economic inequities. While understanding how to manage and address ill-health is fundamental, studying the upstream system leading to negative health outcomes is key for preventing premature deaths and diseases to occur in the first place. This latter type of research can inform cross sectoral policies that could bring long lasting planetary health equity (PHE) – the equitable enjoyment of good health in a stable Earth system. Therefore, what type of research is supported or not can have important consequences for the type of policies developed, and consequently the wider society. One research founder that is generally overlooked, compared to government and market actors, is philanthropy. However, some private foundations provide more funding to research than some public funders, giving hundreds of millions of US dollars per year. While some philanthropic organizations have been criticized for their narrow focus on biomedical and short-term outcomes, there is no recent comprehensive overview on the research priorities of health philanthropy. Therefore, this research, part of a broader PhD project, investigates the type of research philanthropic organizations focus on. A document analysis of both philanthropic organizations’ strategic documents and annual reports will be conducted to understand the type of research the organizations claim to support and actually fund. The analysis conducted will provide an overview of health philanthropy’s research priorities and the level of alignment with the type of research needed to prevent ill-health and achieve PHE. Considering that philanthropic organizations have been found to be powerful actors influencing global health priorities, this research can have important implications for global governance studies and their normative applications.