Introduction
High healthcare service utilisation (HSU) commonly manifests as frequent general practice consultations, emergency department presentations, hospital admissions, and/or high healthcare costs. HSU has been described as a ‘red flag’ for unmet care needs, with people experiencing HSU having difficulties accessing the types of care that they need. Towards maximising equity and the value of care, we aimed to gain an in-depth understanding of the causes, consequences, and needs of adults with HSU in Tasmania from the perspective of the people who experience it.

Methods
Third party recruitment was used to invite people who met one of the following criteria for HSU: in the top 5% of healthcare cost, ≥5 ED presentations, ≥4 hospital admissions, or ≥10 GP consultations in 12 months. A semi-structured interview guide covered participants use, access, and experience of the healthcare system, perceptions of what is important for managing their healthcare, what health outcomes are important, and how their experience of healthcare could be improved. Participants could revise their comments. Data were independently and iteratively analysed by two investigators.

Results
55 participants undertook interviews between December 2024 to September 2025. Four themes were identified: (i) what life is like for people with HSU, (ii) using many healthcare services and strategies to manage their complex care needs, (iii) receiving or not receiving the right care, at the right time, in the right place, and (iv) being a younger person with HSU.

Conclusion
The HSU experience spans multiple dimensions of a persons’ day-to-day life. The many health services and strategies used suggest that they are more likely to benefit from high-value healthcare and conversely, be adversely affected by low-value or harmful care. Incorporating lived experiences into service design and healthcare delivery could help to improve outcomes and healthcare effectiveness and efficiency.

LGBTIQ+ community-controlled organisations have a proven track record in delivering preventive health initiatives that are trusted, relevant, and effective. Their unique strength lies in being led by and accountable to the populations they serve, enabling them to reach people who often experience exclusion or discrimination in mainstream health settings. In an environment where short-term funding cycles and policy volatility undermine long-term prevention efforts, the stability and cultural legitimacy of LGBTIQ+ community-controlled organisations represent a model of sustainable prevention.

At the centre of this model is the peer workforce. Peer workers draw on shared experience of marginalisation and resilience to engage people in health promotion, early intervention, and support services. Their presence builds trust, facilitates uptake of care, and supports the development of health literacy within LGBTIQ+ populations. From mental health and suicide prevention to alcohol and other drug services, peer-led programs have been shown to reduce risk factors, strengthen protective factors, and improve overall wellbeing.

This presentation explores how investment in LGBTIQ+ community-controlled organisations and a trained, properly remunerated peer workforce contributes to the long-term sustainability of prevention. It draws on evidence from national initiatives such as QLife and MindOut, and reflects the priorities of the National Action Plan for the Health and Wellbeing of LGBTIQA+ People 2025–2035, which identifies peer-led, community-driven approaches as central to prevention.

Embedding these approaches within national health reform and funding frameworks is essential. Sustainable prevention for LGBTIQ+ populations requires systemic recognition of community-controlled organisations as equal partners in health delivery, and of the peer workforce as a skilled and essential component of multidisciplinary care. By resourcing these organisations and embedding peer roles across the continuum of care, governments can ensure that prevention is not only sustained, but strengthened - anchored in lived experience, cultural safety, and enduring community connection.

Problem
There is broad global recognition that prevention must be strengthened to improve health and reduce inequities. Yet in Aotearoa New Zealand, investment in prevention remains modest and fragmented, with funding often focused on short-term programmes rather than long-term system change. Communities most affected by inequity have limited influence over priorities and insufficient support to build lasting capability and leadership. As a result, prevention efforts struggle to shift systemic drivers of health. Understanding how community-led, place-based prevention operates in practice - and what enables it to be effective and enduring - is therefore critical.

What we did
We have been conducting a longitudinal developmental evaluation of Healthy Families NZ, a national, community-led prevention initiative operating across diverse communities for over a decade. Instead of delivering fixed programmes, the initiative invests in locally embedded teams to build capability, strengthen partnerships, and influence the conditions shaping health. Our evaluation draws on contextual case studies to examine implementation, evolution, and emerging impacts over time.

Results
Healthy Families NZ has supported communities in identifying priorities, acting collectively, building local leadership, and influencing system settings across key determinants of health. Examples of successes include strengthening local kai/food systems, advancing smoke-free and alcohol-harm prevention, improving play and physical activity environments, and embedding wellbeing in council planning and investment. Teams have developed capabilities in systems thinking, partnership-building, and culturally grounded practice, drawing on lived experience, mātauranga Māori, and population-level evidence. This has enabled new forms of community leadership, relational infrastructure, and policy influence that are not typically seen through traditional programme delivery.

Lessons
Although modest in scale compared to national investment in treatment, Healthy Families NZ demonstrates what is possible when communities are resourced and trusted to lead prevention efforts. Key lessons include the importance of long-term, flexible investment; devolved decision-making; valuing local knowledge; and resourcing time for trust-building and learning. The initiative is demonstrating that community-led, place-based prevention can build the adaptive capacity of communities, offering practical insight for health systems seeking to become more sustainable and resilient.

Introduction
Suicidal behaviours, including ideation, thoughts, and attempts, remain a major public health concern and are risk factors for suicide. Individuals exhibiting these behaviours may reside close together supporting targeted intervention. However, the translation of spatial epidemiological findings for effective prevention initiatives is underexplored. Thus, the aim of this study was to identify and characterise “at-risk” residential clusters where individuals who had attended an emergency department (ED) in Tasmania, Australia for suicidal behaviours, reside.

Methods
Data were collected from all four public EDs across statewide Tasmania between 2017 and 2023. Retrospective discrete Poisson models were employed to identify the clusters of areas of elevated risk. Sociodemographic and episode of care characteristics were compared across clusters.

Results
Of the 12,659 ED presentations, 6,025 (48%) corresponding to 3,154 individuals were concentrated in 15 “at-risk” residential clusters (relative risk 1.26–4.34; p<0.05). Individuals residing in these 15 clusters were predominantly females (58%), young (aged 0–24: 46%), resided within 10 km of the ED (65%), and were largely from socioeconomically disadvantaged areas (54% in Index of Relative Socio-Economic Advantage and Disadvantage 1 and 2). These sociodemographic and episode of care characteristics varied across the 15 residential clusters.

Conclusion
We identified 15 “at-risk” residential clusters across Tasmania among individuals who had exhibited suicidal behaviour and attended an ED. These findings provide evidence for health service planners and policymakers, to support the development of targeted, community-based prevention strategies in these high-risk areas to inform the allocation of resources for suicide prevention practices.

Introduction:
The World Health Organization’s Framework for Maternal Wellbeing (2025) highlights resilience, autonomy, and agency as vital foundations of maternal wellbeing. However, Australian maternity systems continue to prioritise screening and risk management rather than holistic wellbeing. To create lasting preventive impact, evidence must be translated into practical, equitable, and sustainable approaches that integrate across disciplines and care settings. This project sought to establish national pathways for prevention through partnerships between women, midwives, researchers, and policy stakeholders—bridging global wellbeing frameworks with local maternity practice.

Methods:
Guided by Intervention Mapping, a theory-informed, health promotion, implementation-research methodology, via multidisciplinary collaboration (n=35) across several states and territories engaged in iterative co-design processes between September 2024 and October 2025. Women’s and midwives’ lived experiences alongside perinatal professionals’ public health expertise shaped the design and development of resources designed for adaptability, scalability, and long-term integration into routine maternity care. The process emphasised inclusion, equity, and informed decision-making to strengthen both implementation and sustainability beyond the research process into clinical practice settings.

Results:
The partnership produced four educational videos, nine visual posters, a self-directed wellbeing journal for pregnant women, and a midwife discussion guide to support preventive conversations in everyday maternity care. Maintaining momentum across diverse professional and geographic boundaries required strong facilitation, transparent communication, and a shared preventive purpose. These relational and process-driven strategies became essential mechanisms for sustaining engagement and ensuring that outcomes reflected collective values and priorities.

Conclusion:
This work demonstrates how multidisciplinary partnerships can create sustainable pathways for prevention by embedding maternal wellbeing promotion into routine maternity care. The project provides a replicable model for translating global frameworks into equitable, evidence-based practice—bridging policy aspirations with meaningful, system-level action to strengthen the wellbeing of Australian mothers.