Australian youth perspectives on the role of social media in climate action.

OBJECTIVE: The climate crisis poses a significant public health threat to current and future generations. Limited research has examined young people's perspectives about the role of social media for climate awareness, action, and policy change. METHODS: Qualitatively led online survey of n=500 young Australians (aged 15-24). Questions focused on the effectiveness of social media platforms in communicating the need for climate action, with TikTok videos used to prompt about appeal strategies and campaigns. Data were analysed using a reflexive approach to thematic analysis. RESULTS: Participants perceived that social media platforms were a powerful and inclusive communication mechanism for climate action. Social media had the ability to reach diverse audiences and connect young people globally. Limitations included influencing key decision makers and risks associated with misinformation and disinformation. Participants supported messages that highlighted the urgent need for action, trusted celebrity and youth voices, and practical information to engage in action. CONCLUSIONS: Social media presents a powerful opportunity for engaging young people in discussions and decisions made about the climate crisis. IMPLICATIONS FOR PUBLIC HEALTH: The public health community should be guided by young people in developing a range of social media mechanisms to empower them to have a seat at the table in public health responses to climate.

The symbolic consumption processes associated with 'low-calorie' and 'low-sugar' alcohol products and Australian women.

The influence of commercial actors, practices and processes on the health and wellbeing of women is still not well understood. The alcohol industry has developed a range of products to appeal to new 'health conscious' markets, such as 'low-calorie' and 'low-sugar' products. While these products may have specific appeal for women, there has been little in-depth research that has sought to understand how women conceptualize these products and the range of symbolic meanings that women associate with these products. An online qualitatively led survey was conducted with n = 497 Australian women who had consumed alcohol in the last year. Questions related to the reasons for and influences on alcohol use, the purchasing of 'low-calorie' or 'low-sugar' products and the influence that these products might have on women's alcohol use. Data were interpreted using reflexive thematic analysis. Women consumed alcohol to relax, cope with everyday stressors and because of the alignment with social practices and social connection. Women perceived that these products provided a healthier alternative to traditional alcohol products and that they aligned with women's values relating to weight and the thin ideal. Some women were concerned that these products could increase alcohol consumption by reducing the perceptions of risk associated with alcohol. Policy consideration is needed to address how product claims and attributes may influence population groups' interpretations of the risks and benefits of these alcohol products, including the illusion that these products have protective potential and are better for overall health and wellbeing.

The lived experience of financial harm from gambling in Australia.

The financial consequences associated with harmful gambling create significant health and social stressors for individuals, their families, and communities. However, there has been limited research exploring how people impacted by gambling harm conceptualise and experience the financial impacts on their lives. To help fill this gap, this study used in-depth qualitative interviews with gamblers harmed by their own gambling and affected others harmed by someone else's gambling. Reflexive thematic analysis was used to interpret the data. The study had three key findings. First, prior to experiencing harm, gamblers and affected others did not consider the financial risks associated with gambling and only recognised the risks once the financial losses negatively impacted other areas of their lives. Second, gamblers and affected others managed the day-to-day financial impacts of gambling by adjusting their financial priorities, reducing spending in other areas, or accruing debt. Finally, the financial impacts of gambling and the associated financial management strategies led to broader and long-term problems for gamblers and affected others. This study demonstrates that financial harms from gambling are complex and contribute to the stigmatisation of people who experience harm. Current educational messages and tools simplify this complex issue and may legitimise gambling as a leisure activity which can be managed by making 'responsible' financial decisions. Public health and health promotion initiatives must recognise this complexity, developing approaches that are independent from the gambling industry and informed by lived experience.

Older adults' perceptions of the risks associated with contemporary gambling environments: Implications for public health policy and practice.

Introduction: Rapid changes in the Australian gambling environment have amplified the risks for gamblers and pose significant threats to public health. Technological advances, saturation of marketing, and the embedding of gambling in sport have all contributed to significant changes in the gambling risk environment. Older adults have witnessed the changes to the way gambling is provided and promoted in public spaces, but little is known about how these changes have shaped the way they conceptualize the risks associated with gambling. Method: Guided by critical qualitative inquiry, semi structured interviews were conducted with 40 Australian adults aged 55 years and older, who had gambled at least once in the last 12 months. Reflexive thematic analysis was used to interpret the data. Results: Participants discussed gambling environments in Australia and how they had changed through the proliferation of gambling products, environments, and opportunities; the risks posed through the embedding of gambling in community and media environments; the role of technology in gambling environments; and the role of marketing and promotions in the changing gambling environments. Participants recognized that these factors had contributed to gambling environments becoming increasingly risky over time. However, despite the perception of increased risk, many participants had engaged with new gambling technologies, products, and environments. Discussion: This research supports the adoption of public health responses that include consideration of the environmental, commercial, and political factors that may contribute to risky gambling environments.

The impact of responsible gambling framing on people with lived experience of gambling harm.

Background: The framing of health issues influences how people think about and respond to these topics. Gambling has largely been framed as an issue of personal responsibility, with the gambling industry, governments and some researchers promoting responsible gambling strategies as a way to address gambling harm. While there is evidence that the internalization of personal responsibility can negatively impact gamblers, this study aimed to explore how people who have experienced gambling harm interpret and apply personal responsibility frames and 'gamble responsibly' messages in their lives. Methods: In-depth semi-structured interviews were conducted via Zoom and telephone with 15 gamblers who had been harmed by their own gambling and six affected others who had been harmed by someone else's gambling. This study was informed by public health and critical qualitative approaches to inquiry. The data were analyzed using reflexive thematic analysis. Results: Four themes were constructed from the data. First, gamblers and affected others generally conceptualized gambling and gambling harm as being the responsibility of the individual because it was perceived as the outcome of individual behavior. Second, they attempted to apply responsibility to their own experience either as gamblers who tried to stop or reduce their gambling, or affected others who felt responsible for helping the gambler in their lives. Third, gamblers and affected others were negatively impacted when it was perceived the gambler could not 'control' their gambling or had not done enough to take responsibility. Finally, gamblers and affected others recommended responsible gambling strategies be reframed to be more effective at addressing gambling harm. Conclusion: This study provides evidence further supporting research demonstrating that personal responsibility frames may have unintended or negative consequences for gamblers and affected others. It underscores the need to reframe public messages about gambling away from responsible gambling, and toward research-based messages that can complement broader legislative changes and other measures to protect individuals.

Enablers and barriers to healthy eating among hospital nurses: A systematic review.

BACKGROUND: Nurses are the largest health professional body globally. Despite the significant role they play in healthcare, nurses exhibit poor dietary habits and have high rates of chronic diseases. Understanding the factors underlying healthy eating for nurses in the workplace is important to implement effective interventions. OBJECTIVE: To identify enablers and barriers related to healthy eating among nurses employed in a hospital setting. DESIGN: A systematic literature review of qualitative, quantitative, and mixed methods research (PROSPERO ID: CRD42021290913). DATA SOURCES: A comprehensive systematic search was conducted across PubMed, CINAHL, Embase, Web of Science and ProQuest databases for papers published after January 2015. METHODS: Two authors independently screened titles and abstracts of 4139 deduplicated studies, performed critical appraisals on eligible studies using the Mixed Methods Appraisal Tool and extracted data relevant to the research question. This review includes papers that examined nurses' eating behaviours specifically, were conducted in a hospital setting and distinguished healthy eating from other behaviours. Data synthesis was conducted through descriptive summarisation of studies and enablers and barriers were classified according to the socio-ecological model. RESULTS: A total of 29 studies were identified with 8024 participants. 8 studies were qualitative, 18 quantitative, and 3 were mixed method design. At an environmental level, barriers were high accessibility and availability of unhealthy foods, high cost and low availability of healthy foods and lack of storage and preparation facilities, while an enabler was close proximity to healthy options. Novel organisational enablers were considered roster planning which allowed for established routines around meals, and structured workplace programs that encouraged improvement in health behaviours, while barriers were shift work, inconsistent rosters and high work demands. An interpersonal enabler was supportive networks while barriers were work culture, social norms of celebrations and gifts of food from patients. Finally, intrapersonal barriers were stress and fatigue, personal values, beliefs, attitudes, and individual characteristics, with the latter two also acting as enablers. CONCLUSIONS: This review identifies the complexity and interconnectedness of enablers and barriers to healthy eating across four domains of the socio-ecological model. Multi-faceted strategies which address factors across several domains are recommended for healthcare organisations to facilitate healthy eating among nurses. Further research is needed to assess these strategies and understand the extent to which eating behaviours can be improved.

Young women's engagement with gambling: A critical qualitative inquiry of risk conceptualisations and motivations to gamble.

BACKGROUND: Younger women's engagement with gambling has changed over recent decades due to a range of socio-cultural, environmental and commercial factors. However, younger women's distinct lived experiences with gambling have rarely been considered. The following critical qualitative inquiry explored factors that influenced younger women's engagement with gambling and their perceptions of gambling risks. METHODS: Semi-structured interviews were conducted with 41 Australian women aged 18-40 years. Participants were asked questions relating to their reasons for gambling, and the perceived risks associated with gambling. Reflexive thematic analysis was used to interpret the data. RESULTS: Five themes were constructed from the data. First, women reported that they gambled to escape their everyday lives, with some women reporting gambling within their own homes. Second, women reported gambling for financial reasons, particularly to change their life circumstances and outcomes. Third, gambling was used by women as a way to connect with social network members. Fourth, gambling was an incidental activity that was an extension of non-gambling leisure activities. Finally, lower risk perceptions of participants' own gambling risk contributed to their engagement and continuation of gambling. CONCLUSION: Public health and health promotion initiatives should recognise that young women's gambling practices are diverse, and address the full range of socio-cultural, environmental and commercial factors that may influence younger women's engagement with gambling.

"Aussies love a bet": Gamblers discuss the social acceptance and cultural accommodation of gambling in Australia.

OBJECTIVE: This study aimed to explore regular gamblers' perceptions of the social acceptance and cultural accommodation of gambling in Australia, which are two dimensions of the normalisation of gambling. METHODS: Qualitatively focused online survey with 363 adults in New South Wales and Victoria who gambled in a typical month. Open-text responses about the link between gambling and Australian culture were interpreted using reflexive thematic analysis to construct themes from the data. RESULTS: Gambling was perceived to be a culturally significant part of Australian life due to existing traditions, the perception that gambling was central to the Australian identity, and perceived economic benefits. Participants considered that gambling was a common and socially accepted activity that was embedded in the activities of social networks. Participants also stated that gambling products, venues and marketing were embedded in everyday environments, although some believed that the embedding of gambling in society was harmful. Conclusion and public health implications: This study demonstrated that regular gamblers largely viewed gambling as being a socially accepted and culturally accommodated activity in Australia. There is scope for governments to develop comprehensive programs to denormalise gambling, including learning from research, evidence and experience in other areas of public health.

Women's perceptions of strategies to address the normalisation of gambling and gambling-related harm.

OBJECTIVE: Research has demonstrated that gambling is becoming increasingly normalised for women. As limited research has sought to understand women's perspectives on this issue, we sought women's opinions about the factors that may contribute to the normalisation of gambling for women, and the strategies that may counter this normalisation. METHODS: Semi-structured interviews were conducted with 41 women in young and middle adulthood, aged 20-40 years. RESULTS: Participants suggested that gambling was normal for women because gambling environments had been designed to appeal to women, newer technologies had removed the stigma of attending physical venues, and the growing equality and independence of women. To de-normalise gambling, women suggested addressing the influential role of marketing, designing new public education strategies, addressing the availability and accessibility of gambling, and restricting engagement with gambling products. CONCLUSION: This study highlighted women's perceptions of strategies to address the normalisation of gambling and the importance of providing risk information paired with broader policy reform and prevention initiatives to address the range of determinants that normalise gambling for women. IMPLICATIONS FOR PUBLIC HEALTH: Involving women in advocacy and understanding their perspectives is important in developing relevant public health responses to the normalisation of gambling for women.

Gamblers' perceptions of responsibility for gambling harm: a critical qualitative inquiry.

BACKGROUND: Gambling has traditionally been conceptualised as an issue of addiction and personal responsibility. While there are now clear public health models that recognise that gambling harm is caused by a range of socio-cultural, environmental, commercial and political determinants, government and industry messages about gambling are still largely personal responsibility focused. Given the well-recognised issues associated with personal responsibility paradigms, this study sought to understand how gamblers themselves conceptualised responsibility for gambling harm. METHODS: A qualitatively led online panel survey was conducted with 363 adult gamblers in New South Wales and Victoria, Australia. Participants were asked to respond to what they thought were the causes of gambling harm, and what could be done to prevent harm. A reflexive thematic analysis was conducted. RESULTS: Six common tropes were constructed from gamblers' responses: (1) Gambling in moderation; (2) Personal responsibility for rational behaviour; (3) Character flaws; (4) Personal responsibility to seek help; (5) More education is needed; and (6) Governments are responsible for action - but motivation and efficacy are questioned. Gamblers primarily understood gambling harm as being a matter of personal responsibility, and government responsibility was generally seen as limited to providing information to facilitate informed gambling choices. CONCLUSIONS: This study demonstrates that gamblers' perceptions of gambling harm are similar to the personal responsibility framings and tropes present in industry and government messaging strategies. Refocusing public communication strategies away from 'responsible gambling' messaging, and towards evidence-based approaches, will be an important part of addressing the harms associated with gambling.

The development and implementation of electronic gambling machine policy: a qualitative study of local government policy makers.

OBJECTIVE: To understand how policies developed by Local Government Authorities (LGAs) to address electronic gambling machine (EGM) harm are developed and implemented. METHODS: Semi-structured interviews were conducted with 16 participants from 15 LGAs in metropolitan Melbourne who worked in a role associated or aligned with gambling. An inductive thematic analysis was used to interpret the data. RESULTS: Three key themes emerged. First, participants described a shift from addiction frameworks to public health policy responses to EGMs, which was driven by increasing EGM losses and the harms caused by EGMs to communities. Second, there was the role of stakeholder groups in the policy-making process, including the challenges associated with engaging the community. Finally, there were barriers and facilitators to policy development and implementation. Barriers included a lack of financial resources and legislative boundaries imposed by the State Government. Facilitators included whole-of-LGA approaches, supportive councillors and collaborative efforts. Conclusions and implications for public health: LGAs have made shifts towards public health responses to EGM harm. Initiatives to further support policy development and implementation could include imposing a levy on EGM losses to directly support public health prevention activities and implementing robust state-based regulatory frameworks that support LGA responses to EGM harm.