Health inequity remains a persistent public health concern, particularly for women and girls from priority communities who experience systemic disadvantage. This abstract presents findings from a qualitative evaluation of Health Promoting Neighbourhood Centres, a partnership between the Queensland Women and Girls Health Promotion Program (Queensland Health), and peak body Neighbourhoods Centres Queensland. The program resourced 25 Neighbourhood Centres to co-design and deliver locally responsive health promotion projects aimed at strengthening wellbeing and connection for women and girls in their communities.

We know that health is shaped by the places within which we are born, grow, live, work, play and age. As place-based, citizen-led organisations, neighbourhood centres, are uniquely positioned to undertake health promotion initiatives, drawing on local strengths, assets and cultural contexts. Health Promoting Neighbourhood Centres involved a flexible funding model whereby neighbourhood centres across Queensland were invited to propose a locally-driven project aimed at supporting the health and wellbeing of women and girls in their communities. Our approach sought to remove traditional barriers to funding access—including rigid and complicated application processes, and prescriptive use of funds—allowing communities to define the scope, priorities, timelines, and partnerships that best suited their local context. This flexible approach fostered community capacity and allowed for diversity and creativity in the health promotion projects' design, implementation and evaluation.

This presentation will share preliminary findings from the Health Promoting Neighbourhood Centres evaluation. We will present synthesised health and wellbeing outcomes achieved for women and girls across Queensland, and discuss enablers as well as challenges of our flexible, community-led approach. We discuss key learnings about the importance of power-sharing, adaptability, and trusting relationships. This work demonstrates how community development and health promotion can work synergistically to advance health equity.

Introduction
Hypertension is a key risk factor for cardiovascular diseases, the leading cause of disease burden in Australia. Despite years of community-level health promotion initiatives, hypertension in regional and rural communities has not decreased. This research aimed to explore the understanding of hypertension risk, then co-design and pilot solutions with communities in Northwest Tasmania.
Methods
During 2023-2025, a Design Thinking Framework guided the co-design process with communities in Northwest Tasmania. Interviews, focus groups (n=81), and workshops (n=83) were conducted to explore community understanding about hypertension risk and design locally-meaningful solutions to address hypertension risk. Further workshops with community and health professionals (n=110) were conducted to plan a pilot to address hypertension risk through accurate blood pressure (BP) measurement. Qualitative data were collected through audio recordings and voting activities, with deductive and inductive analyses used to develop themes from this data. Demographic data were analysed descriptively.
Results
The community described hypertension as a silent killer, and most of their health information came from general practitioners (GPs), “Dr Google”, and pharmacies. Participants had a good understanding of hypertension risks but a limited understanding of managing hypertension beyond medication. Locally meaningful solutions included BP monitoring in GP clinics and places in the community where people gather. There was consensus that standardised measurement and advice for managing hypertension should be available wherever BP is measured. A pilot was planned to test a standardised BP monitoring protocol in GP clinics, pharmacies, and community organisations.
Conclusion.
The Northwest community involved in this study had a good understanding of hypertension risk but wanted standardised information about how to manage hypertension. Communities were key informants in the co-design process to plan a pilot aimed at reducing the risk of hypertension that is locally meaningful.

Problem: Food security is a complex issue that affects health outcomes and broader social determinants of health. Food security means access at all times, for all people, to sufficient, culturally familiar, safe and nutritious food to meet needs of an active and healthy life. For Aboriginal and Torres Strait Islander people in north metropolitan Perth, food access is the culturally appropriate and preferred term rather than food security. For this community, having access to healthy and safe food is a priority, not in isolation, but as part of a broader vision for health that considers social and emotional wellbeing, alcohol and other drug use, physical activity and cultural continuity. The community also identified a gap in programs meaningfully and sustainably co-designed with, not for, Aboriginal people.

What we did: North Metropolitan Health Service responded to this gap through the Gnalla Meriny: Our Food project using a strengths-based, culturally secure co-design approach. Place-based prevention efforts were facilitated with Aboriginal people in two areas of north metropolitan Perth with lower socio-economic status and higher health risks. Central to the project was building on the strengths of Aboriginal people, listening deeply and working alongside the community to action meaningful and sustainable solutions to improve food access.

The first stage involved reviewing existing research and engaging with local community members and organisations to better understand food security with Aboriginal people, build trust, and explore culturally appropriate ways of working. The project was guided by Aboriginal Data Governance principles, ensuring the community exercised control over how data was created, analysed and shared. Ethics approval was received from the WA Aboriginal Health Ethics Committee and WA Health Human Research Ethics Committee.

Based on findings, a series of Yarning Sessions were facilitated in the two identified areas to co-design strengths-based approaches and local solutions to food security; each concluding with a Yarning Circle to gather feedback on co-design methodology. Data was collected using voice recordings, identified by the community as the preferred culturally appropriate tool, with participants guiding how their stories and insights were used. The community maintained ownership and control of the place-based initiatives generated, ensuring they are locally relevant, culturally grounded, and sustainable. The Stakeholder Advisory Group, including Aboriginal Community Controlled Organisations, provided ongoing cultural oversight and ensured accountability.

Results: Of focus in this presentation is the project’s outcomes of several community-led solutions to improve food security for Aboriginal people, while also fostering trust, empowerment, and driving action on other health issues. The post-Yarning Session Yarning Circles were thematically analysed to shape a local road map for co-designing with Aboriginal people in north metropolitan Perth and support the uptake of quality practices that empower Aboriginal people and community-led programs. The absence of a project end date reflects long-term community commitment. Data sovereignty was upheld throughout, with Aboriginal people leading decisions about how information was used and shared. The community maintained control and ownership of the place-based initiatives, and raised awareness of culturally secure, strengths-based approaches with partner organisations and funding bodies; building capacity for broader systems change.

Lessons: Prevention is most powerful when it is community-led and built on culture, creativity, and connection. Genuine co-design is not one-size-fits-all, and must be flexible, responsive and accountable to different communities and their local priorities. Supporting communities to advocate for co-design beyond the project builds long-term capacity and influence. Upholding Aboriginal Data Governance principles ensures that data is not just collected ethically but used in ways that benefit and empower communities. Food security is one part of a broader vision for health, and this project shows that listening first and supporting community ownership are key to lasting change.

Background: Colonisation and the associated oppression of Aboriginal and Torres Strait Islander peoples has led to cycles of intergenerational trauma and systemic health inequities. Health promotion can play a role in restoring and strengthening the connections that support social and emotional wellbeing, and reducing health inequity, by creating environments that empower communities to lead healthy lives. While culturally responsive strategies have been developed, the influence of trauma on engagement with health promotion remains under-explored.

Aim: To develop a framework that supports practitioners in creating culturally responsive, trauma-aware, healing-informed health promotion programs.

Method: The Aboriginal-led project had two components. First, a narrative review examined the intersection of social and emotional wellbeing, trauma and health promotion for Aboriginal and Torres Strait Islander peoples. Literature was identified through a non-systematic snowballing search of peer-reviewed and grey sources, with prioritisation of evidence most relevant to the project’s aims. Frameworks identified were analysed for thematic commonalities and synthesised into a pilot framework. This was refined through iterative consensus-building with the project workstream and piloted by mapping it against existing health promotion programs (the Gulibaa Project, Strong Born). Second, an online co-design workshop was held with Indigenous and non-Indigenous health promotion experts to identify what healing-informed practice looks like and which principles should underpin a framework. Findings from the review and workshop were triangulated to produce the final framework.

Results: A clear consensus emerged on guiding principles: community governance and partnership; empowerment; culture; holistic wellbeing; connectedness and relational approaches; cultural and emotional safety; and transparency and accountability.

Discussion: This project provides a critical step toward a trauma-aware, healing-informed approach to health promotion. The framework acknowledges the impacts of colonisation while strengthening individual, family and community capacity. It emphasises safety, recovery and community-led healing, while avoiding re-traumatisation, rejecting pathologisation of behaviours and addressing structural barriers to behaviour change.

Project Governance
This project is Aboriginal-led and guided by a working group of Aboriginal researchers alongside invited allies. Aboriginal researchers in the team have connections to Wiradjuri and Trawlwoolway Countries. Their leadership grounds the project in cultural integrity, reinforcing a commitment to self-determination and meaningful change in health promotion practices. Non-Indigenous members contribute technical, methodological and administrative expertise. Their role is to support the project, ensuring that Aboriginal and Torres Strait Islander voices remain central to all decision-making. This governance structure protects Indigenous authority while enabling respectful collaboration that strengthens, rather than overrides, Aboriginal leadership.

The project is built on recognition of the collective ownership of knowledge, cultural expressions and stories shared by communities. Our initial conceptual framework drew on two sources: published evidence identified through a narrative literature review and the expertise of the working group. Co-design principles guided the workshop, where over half of the participants identified as Aboriginal and Torres Strait Islander people. The workshop was facilitated by an Aboriginal woman and structured to ensure safety, respect and inclusion. Participants were invited to review the emerging framework, and authorship was offered in line with the authorship guidelines from the Lowitja journal.

Responding to Leprosy and Stigma in the Torres Strait
Leprosy remains a rare but important public health issue in northern Australia, with occasional cases still detected in the Torres Strait. Despite being difficult to transmit and entirely curable, leprosy continues to carry significant stigma and fear within affected communities. This presentation outlines a nurse-led, culturally informed approach to the management of a recent leprosy case on an outer island of the Torres Strait, demonstrating how culturally safe practice and strong community partnerships are essential to effective public health response.
During the initial case interview, it became evident that the family experienced considerable fear and shame surrounding the diagnosis. There was concern that public health intervention might threaten their ability to remain within their community. Recognising this, the response prioritised early engagement, transparent communication, and culturally guided planning to address stigma and build trust.
The response was coordinated by the Public Health Unit in collaboration with local Torres Strait Islander leaders, health workers, and primary health care nurses. Guided by nursing leadership, the team held family meetings, consulted local councillors and identified health leaders, and planned all activities with cultural sensitivity. Before contact screening commenced, community education sessions were delivered to dispel myths, reduce fear, and promote understanding. This preparatory phase—driven by nurses and supported by trusted local health workers—was key to achieving community cooperation and successful follow-up.
This case highlights the pivotal role of nurse-led, culturally grounded public health practice in remote and cross-cultural contexts. The success of the Torres Strait response was founded on respectful partnerships, shared decision-making, and the integration of clinical expertise with local cultural knowledge. This model demonstrates how nursing leadership, when combined with Indigenous collaboration and cultural insight, can deliver effective and compassionate communicable disease management in complex community settings.

Background
Stigma, fear, and misinformation about HIV remain significant barriers to health equity and inclusion. Despite medical advances and public health education, people living with HIV (PLHIV) continue to face discrimination, particularly in rural areas and among marginalised communities. Embedding the lived experiences of PLHIV into public discourse has been shown to humanise the condition, correct misconceptions, and improve attitudes. A longitudinal study (n=1,280) found that hearing directly from PLHIV decreased prejudice, reinforced prevention messages, and increased perceptions of HIV as preventable - effects that were sustained over time, especially from female speakers. Further research by Broady et al. and others has demonstrated that direct or multi-session contact with PLHIV significantly improves community attitudes and reduces stigma more effectively than one-off interventions.
Project details
Living Positive Victoria’s Positive Speakers Bureau (PSB), operated by and for PLHIV in Victoria, is a community-led initiative that delivers lived experience presentations across a wide range of settings. PSB speakers undergo formal training in public speaking, adult education, HIV epidemiology, and mental health. Presentations are tailored to audience needs and often co-delivered by speakers of different genders, ages, ethnicities, and sexualities to reflect the diverse realities of living with HIV. In 2022–23, PSB delivered 45 presentations across 16 schools, 5 universities, and 23 government agencies, reaching over 2,500 people.
Progress:
Evaluations and anecdotal evidence consistently highlight the program’s effectiveness in reducing stigma, increasing empathy, and improving sexual health literacy. Speakers also benefit personally through enhanced self-esteem, peer support, and transferable skills for employment. Research indicates that personal narratives are a powerful tool for long-term attitude change, especially when delivered in repeated or multi-speaker formats.
Implications for Policy
The Positive Speakers Bureau provides a scalable, evidence-based model for meaningful involvement of PLHIV (MIPA) in public health education and stigma reduction. Policymakers and educators should consider embedding structured lived experience programs into curricula and professional training—particularly in regional and rural settings. Funding for ongoing, multi-session speaker programs, rather than brief interventions, is critical to achieving sustainable change in attitudes and health outcomes.

Problem:
While it was inevitable that Australia would transition from an emergency response to managing COVID-19 alongside other infectious diseases, the shift has been stark and had consequences for public health. Vaccination rates are extremely poor, even though COVID-19 remains the leading cause of death from acute respiratory infections in Australia. To reposition prevention as essential to Australia’s COVID-19 response, we must listen to and amplify the experiences of communities, especially those most affected.

What you did:
In May 2025, Lung Foundation Australia conducted an online survey exploring post-pandemic experiences of COVID-19, including impacts on daily life and priorities for future action. More than 1,500 individuals responded, including community members, health professionals, and people with lung disease.

Results:
Findings revealed that COVID-19 continues to disrupt lives. Nearly half of respondents who contracted COVID-19 since early 2024 reported moderate to severe impacts on their ability to work, with this figure rising to 62% among those experiencing long COVID. One in four respondents with a lung disease said their infection had a major or severe impact on their underlying disease. Health professionals described difficulties accessing clear guidance and caring for patients with long COVID in a system lacking appropriate services. Respondents called for better treatment access, more research, improved awareness, more services, and stronger support for clinicians. Over 700 qualitative responses offered powerful personal accounts of challenges and recommendations for change.

Lessons:
How we frame preventive issues influences whether people engage with them—especially for COVID-19. By understanding people’s experiences, public health challenges can be communicated to resonate with a broader audience. In today’s climate of misinformation, it can be difficult to reach and represent those most affected. Continued effort is needed to ensure these voices are heard, for stronger policy and a healthier future.