Perceptions of social media harms and potential management strategies: vaping case study.

BACKGROUND: The social media landscape is now ubiquitous in people's everyday lives. It is a space where culture, politics, economics and sociological and public health discourses occur. There is mounting evidence that e-cigarette products are being promoted and advertised on social media, a media platform particularly popular with young people. Our research aimed to understand industry professionals' perceptions of social media harms and potential management strategies using vaping as a case study. METHODS: A critical realist perspective guided reflexive thematic analysis of the qualitative in depth, semi structured interviews. Data collection occurred in January and February 2023 with 13 participants working in the areas of public health, digital media, law, governance, tobacco control and advocacy. RESULTS: Two superordinate themes emerged from the data: (1) Fathoming a complex system (social media) that contained the subordinate themes of Traversing Boundaries (crossing borders, crossing sectors) and Ungovernable (global and local landscapes, vested interests, self-regulation and opacity). (2) Addressing complexity (social media)- that contained the subordinate themes of Strengthening Institutions (global to local, policy and legislation, individuals and organisations); Defanging Industry (responsibility and transparency, moderation and algorithms, complaints); and Engaging Citizens (raising awareness, framing messaging). CONCLUSIONS: There was consensus among participants that e-cigarette related social media content can be harmful and government action is urgently needed. There was an identified need for the development of government led national-level regulatory frameworks, with government led appropriate legislation; identification of an organisation or organisations with suitable levels of regulatory power and resources to monitor, enforce and penalise noncompliant social media companies; accompanied by increased community awareness raising of harmful social media content and improved digital literacy.

Parents' attitudes towards the No Jab No Play legislation in Western Australia: a mixed methods study.

BACKGROUND: Mandates provide a relatively cost-effective strategy to increase vaccinate rates. Since 2014, five Australian states have implemented No Jab No Play (NJPlay) policies that require children to be fully immunised to attend early childhood education and childcare services. In Western Australia, where this study was conducted, NJNPlay legislation was enacted in 2019. While most Australian families support vaccine mandates, there are a range of complexities and unintended consequences for some families. This research explores the impact on families of the NJNPlay legislation in Western Australia (WA). METHODS: This mixed-methods study used an online parent/carer survey (n = 261) representing 427 children and in-depth interviews (n = 18) to investigate: (1) the influence of the NJNPlay legislation on decision to vaccinate; and (2) the financial and emotional impacts of NJNPlay legislation. Descriptive and bivariate tests were used to analyse the survey data and open-ended questions and interviews were analysed using reflexive thematic analysis to capture the experience and the reality of participants. RESULTS: Approximately 60% of parents intended to vaccinate their child. Parents who had decided not to vaccinate their child/ren were significantly more likely to experience financial [p < 0.001] and emotional impacts [p < 0.001], compared to those who chose to vaccinate because of the mandate. Qualitative data were divided with around half of participants supporting childhood immunisation and NJNPlay with others discussing concerns. The themes (a) belief in the importance of vaccination and ease of access, (b) individual and community protection, and (c) vaccine effectiveness, safety and alternatives help understand how parents' beliefs and access may influence vaccination uptake. Unintended impacts of NJNPlay included: (a) lack of choice, pressure and coercion to vaccinate; (b) policy and community level stigma and discrimination; (c) financial and career impacts; and (d) loss of education opportunities. CONCLUSIONS: Parents appreciation of funded immunisation programs and mandates which enhance individual and community protection was evident. However for others unintended consequences of the mandate resulted in significant social, emotional, financial and educational impacts. Long-term evidence highlights the positive impact of immunisation programs. Opinions of impacted families should be considered to alleviate mental health stressors.

The operationalisation of recovery colleges: A scoping review.

BACKGROUND: Recovery Colleges (RCs) represent an approach to enhancing mental wellbeing through education, lived experience and co-production. Despite their increasing presence, scant literature explores the operationalisation of RCs and their embodiment of co-production principles. The aim of this scoping review was to investigate the operationalisation of RCs and their application of co-production in RCs located in high-income countries over the past decade. METHODS: Employing an established scoping review methodology, searches were conducted across seven academic databases. Ten primary studies met the inclusion criteria. In addition, stakeholders were consulted to validate themes and uncover knowledge gaps. RESULTS: Findings suggest that RCs are inherently idiosyncratic, adapted to suit local contexts. Discussions persist regarding their optimal institutional contexts and positioning and the interpretation of key terms such as 'recovery' and 'co-production', influencing daily operations and stakeholder involvement. Challenges surrounding measuring success against fidelity criteria underscore the need for a broader understanding of RC value and sustainability. CONCLUSION: This review offers a synopsis of the existing literature offering insights concerning the operationalisation of RCs. Through a synthesis of diverse primary studies, it systematically identifies and describes the operational nuances within the RC landscape and the fundamental elements underpinning RC operations, while shedding light on critical knowledge gaps in both research and practice. SO WHAT?: This review underscores the importance of a broader understanding of RC value and sustainability, offering insights for both research and practice in the field of mental health and wellbeing. This review highlights the significance of further exploration and refinement of RC operationalisation to enhance their effectiveness and impact in supporting mental wellbeing.

Effectiveness of a food literacy and positive feeding practices program for parents of 0 to 5 years olds in Western Australia.

ISSUE ADDRESSED: Lifelong eating behaviours are established in childhood. Improving parents' food literacy skills is essential, as parents play a fundamental role in establishing their children's healthy eating behaviours and preferences for nutritious food. This paper describes the development and evaluation of an innovative program that combines food literacy with positive parent feeding practices, targeting parents in disadvantaged areas of Western Australia. METHODS: The Food Sensations® for Parents five-week program was delivered to participants from community-based parenting organisations during 2020 and 2021. Formative research and a pre-post evaluation design were adopted. RESULTS: Pre- and post-evaluation data were collected from 224 participants (96% female). There was a statistically significant improvement in the mean score for 13 food literacy behaviours, 10 positive parenting feeding practices and a mean increase in parents' daily vegetable intake of 1/3 serve. Participants reported significantly greater net improvements in food literacy behaviours than feeding practices, the largest being the Use a nutrition information panel to make food choices (33.1%). Multivariate logistic regression analyses found English as a first language, being older than 35, and from a higher Socio-Economic Index for Areas resulted in a higher likelihood of positive changes in behaviours and practices. CONCLUSIONS: The findings indicate that the program is effective in improving the frequency of use of food literacy behaviours, positive parenting feeding practices and increasing vegetable consumption. SO WHAT?: Analysing improvements in food literacy behaviours and feeding practices provides clarity on what change can be expected with a five-week parent program.

Tobacco companies, corporate social responsibility and the use of third-party awards: a framing analysis.

OBJECTIVE: Corporate social responsibility activities, such as third-party awards, provide an opportunity for tobacco companies (TCs) to promote themselves as socially, economically and environmentally responsible organisations. This study aimed to determine how TCs are using third-party awards to frame themselves and their core activities via company-controlled communication channels. METHODS: TC-owned media coverage promoting third-party awards was identified from company-owned media channels, including websites, reports, press releases and Twitter. Using framing theory and thematic analysis, frames and broader themes were identified using a process of inductive coding. RESULTS: TC-produced media content promoting third-party awards framed the companies as socially and environmentally responsible organisations, which excel at business and are innovative and transformative. Dominant frames identified included excellent workplace culture, championing diversity and inclusion and action on the environment. CONCLUSION: TCs are capitalising on the perceived credibility and objectivity of third-party awards using these 'honours' as a promotional strategy to justify their continuing role in society and enhance their perceived legitimacy in relation to claims of ethical and responsible behaviour. The results of this study have implications for tobacco control advocacy, as continuing to allow the promotion of these awards appears to contravene or conflict with the WHO Framework Convention on Tobacco Control.

Understanding Prevention Networks in a Local Government Area: Insights From a Social Network Analysis Among Western Australian Nutrition, Physical Activity, and Obesity Prevention Programs.

This study aimed to use systems thinking tools to understand network relationships to inform discussions, policy, and practice to improve nutrition, physical activity, and overweight/obesity prevention activities in a Western Australian local government area. An audit of nutrition, physical activity, and obesity prevention activities was conducted, and identified organizations were invited to participate in an organizational network survey. Social network analysis (SNA) determined the extent to which organizations shared information, knowledge, and resources; engaged in joint program planning; applied for and shared funding; and identified operational barriers and contributors. SNA data were mapped and analyzed using UCINET 6 and Netdraw software. Five organizations within the network were identified as core; the remainder were periphery. The strongest networks were sharing information, and the weakest was funding. The connections were centralized to one organization, enabling them to readily influence other organizations and network operations. Remaining organizations indicated limited partnership across the networks. Strengthened collaborations and partnerships are essential to health promotion, as they extend reach and organizational capabilities. This study provides a process for undertaking network analysis, identifying leverage points to facilitate communication and information sharing, and reorienting of collaborations and partnerships to consolidate scarce resources and act strategically within a bounded area. There is a need for stronger relationships between organizations and a reorientation of partnerships to facilitate resource sharing within the local government area, to improve nutrition, physical activity, and obesity prevention practices. SNA can assist in understanding organizational prevention networks within a bounded area to support future planning of practices and policy.

The emergence of e-cigarette retail shops in a regulated tobacco control environment.

ISSUE ADDRESSED: E-cigarettes are of growing concern. We aimed to determine the location and characteristics of retail shops selling e-cigarette products in Perth, Western Australia. METHODS: Two phase study: (i) identifying all e-cigarette retailers in the Greater Capital City Statistical Area of Perth; (ii) audit at the point-of-sale to assess products, promotions and shop characteristics (n = 41). RESULTS: Ninety-eight retailers selling e-cigarette products were identified: 43 tobacconists (44%), 21 vape shops (21% - up from one shop in 2017), 14 supermarkets (14%), 12 service stations (12%) and 8 smoke shops (8%). The most common e-cigarette product was non-nicotine e-liquid, available at 38 (93%) stores audited. Most stores sold parts of e-cigarette devices (n = 25, 61%). Front counter displays were the most frequent form of promotion (n = 40, 98%). Vape shops differed from other retailers, having bar-style layouts (n = 15, 71%), lounge areas (n = 7, 33%) and free e-liquid samples (n = 17, 89%). CONCLUSION: The availability of e-cigarette products from retail shops and particularly vape shops is increasing. E-cigarette retailers are using traditional promotional techniques including point-of-sale displays to market their products, while vape shops are extending their appeal through bar style, lounge layouts and free trials. IMPLICATIONS FOR PUBLIC HEALTH: Understanding the e-cigarette retail store environment is essential for identifying emergent trends, potential regulations and future research. SO WHAT?: The e-cigarette retail market in the Perth is growing, shops using traditional and new promotional techniques to market e-cigarette products. Our findings identify a need for public health surveillance, regulations and legislation.

Build and they will come: A follow-up evaluation of outdoor exercise equipment in Western Australia.

ISSUE ADDRESSED: In Australia, the role of local governments authorities (LGAs) are diverse, ranging from waste collection to the provision of recreational facilities, such as parks. One strategy to improve parks is outdoor exercise equipment (OEE), and provide free, community-based physical activity opportunities. We undertook an observational study to capture a profile and behaviour of park visitors and OEE users in 2012 and 2019. METHODS: We compared observational data at two parks using the System for Observing Play and Recreation in Communities (SOPARC) in March and June 2012 and 2019. Data were collected 6:30-7:30 AM and 5:30-6:30 PM weekdays; 8:30-9:30 AM and 3:30 to 4:30 PM weekends. Two trained staff collected data concurrently. RESULTS: Total n = 1654 visitors were observed, most at Park One (68.0%; n = 1117), half were male (50.9%; n = 841). There were significant differences in the gender of visitors across the two parks (P < 0.001). Most visitors observed were young adults (42.6%; n = 705; P < 0.001). In 2012, 3.9% (n = 65) of all observed park visitors used the OEE, in 2019, this increased to 4.8 % (n = 78). CONCLUSIONS: The adage 'Build it, and they will come' did not resonate with the two parks' local community. The key challenge is attracting people to local parks making OEE use attractive and easy. SO WHAT?: There is a demand for the provision of active environments that are accessible and inexpensive. LGAs may hold the key to delivering this infrastructure supported by diverse strategies to engage and promote the benefits of being physically active for all ages.

More than memory: A qualitative analysis of carer-reported psychosocial benefits of Memory Cafés.

ISSUE ADDRESSED: Memory Cafés are a psychosocial intervention that aims to provide socialisation and interpersonal support for those living with dementia and their carers. This study explores the Memory Café model and determines the impact of the peer-to-peer Memory Café model on the psychosocial well-being of those living with dementia and their carers. METHODS: Participants were informal carers of those living with dementia, recruited from four Memory Café's located in metropolitan Perth, Western Australia. Demographic information was collected from participants. Eleven semi-structured interviews were conducted. The data were transcribed and analysed thematically. RESULTS: The benefits of participation are described under four themes; sharing experiences and reduction of stigma, a place to feel joy and be yourself, a time to socialise and build friendships and improvements in life outside the Memory Café. The positive attributes of the Memory Cafés that contributed to the benefits were also identified. Concerns about Memory Cafés were limited to it becoming a carers-only group. CONCLUSIONS: Memory Cafés contribute significantly to the psychosocial well-being of carers of those living with dementia and provide a positive outlet for carers to build social networks and become active in their community. The effect on the psychosocial well-being of those living with dementia may be more limited but is still described positively. SO WHAT?: Dementia is a condition with significant impacts on carers and families. Successful peer-based social interventions such as Memory Cafés can lead to further development of dementia-friendly communities aimed at providing joy as well as support.

Initiatives and partnerships in an Australian metropolitan obesity prevention system: a social network analysis.

BACKGROUND: Limited resources make prevention of complex population-level issues such as obesity increasingly challenging. Collaboration and partnerships between organisations operating in the same system can assist, however, there is a paucity of research into how relationships function at a local level. The aim of this study was to audit initiatives, explore networks, and identify potential opportunities for improving the obesity prevention system in a Health Service area of Western Australia (WA). METHODS: A mixed-methods study was undertaken in a metropolitan Health Service in Perth, WA in 2019-20. Structured face-to-face interviews (n = 51) were conducted with organisations engaged in obesity prevention, to identify prevention initiatives and their characteristics using a Systems Inventory tool. The Research Team identified the 30 most active organisations during the Systems Inventory, and an online Organisational Network Survey was administered to explore: relationships across six domains; partnership duration; frequency of interaction with other organisations; barriers to implementation; and key contributions to obesity prevention. Descriptive statistics were used to summarise barriers, contributions and Systems Inventory data. Organisational Network Survey data were analysed using social network analysis through UCINET 6 for Windows and Netdraw software. Whole network and cohesion scores were calculated: average degree; density; diameter; and degree centralization. Core-periphery analysis was conducted to identify densely connected core and sparsely connected periphery organisations. RESULTS: The Systems Inventory identified 189 unique prevention initiatives, mostly focusing on individual-level behaviour change. Fifty four percent (n = 15) of the Organisational Network Survey respondent organisations and most core organisations (67%, n = 8) were government. The information and knowledge sharing network had a density of 45% indicating a high level of information and knowledge exchange between organisations. The lowest densities were found within the receiving (3.3%), providing (5.5%) and sharing (5.6%) funding networks, suggesting that these formal relationships were the least established. CONCLUSION: Applying a systems thinking lens to local obesity prevention revealed that initiatives conducted focused on individual-level behaviour change and that collaboration and communication between organisations focused on information sharing. Capturing the extent and nature of initiatives and the way partnerships operate to improve obesity prevention can help to identify opportunities to strengthen the networks.

Reducing car idling at primary schools: An intervention study of parent behaviour change in Perth, Western Australia.

ISSUED ADDRESSED: There is increasing evidence that exposure to traffic-related air pollution is related to childhood respiratory symptoms. This study demonstrated the effectiveness of an anti-idling behavioural intervention targeting parents at primary schools. METHODS: Based on two focus group discussions with parents, a low-intensity 4-week anti-idling intervention was developed, comprising onsite signage, four newsletters, and two fact sheets. Exposure to selected air pollutants was assessed during pick-up and drop-off times pre- and postintervention at 12 randomly selected independent schools (10 intervention and 2 control) across the Perth metropolitan area. RESULTS: The study results showed that a low-intensity behavioural intervention can be an effective strategy to affect parents' attitude towards vehicle idling. This was demonstrated by the reduced number of idling vehicles observed in 8 of the 10 intervention schools and decreased overall particulate matter concentration after the anti-idling intervention. CONCLUSION: Anti-idling education can be effective in promoting clean travel behaviours and has potential health benefits for school children. SO WHAT?: This intervention study provides insights on the significant effect of anti-idling education on parents' behaviour towards air quality and children's health. These promising findings warrant further rigorous actions on anti-idling education and enforcement.

University Student Health and Wellbeing Study: A test-retest reliability study of a web-based survey investigating undergraduate student health and wellbeing.

ISSUE ADDRESSED: Understanding the health behaviours of Australian university students and their impact on wellbeing and academic success is important; however, there are limited reliable, population level survey tools to measure student health across a range of domains. The purpose of the research was to determine the reliability of the web-based University Student Health and Wellbeing Study (USHWS) survey via a test-retest reliability study within a large Australian university student population. METHODS: A test-retest of the measurement instrument was completed by a sample of university students (n = 195) over a two-week period. The instrument assessed alcohol and tobacco use, mental health, sexual health, physical activity, nutrition and sun protective behaviours. Test-retest reliability was analysed using two-way random effects model of intraclass correlations (ICC) and AC1 coefficient for individual measurements with 95% confidence intervals (95% CI). RESULTS: Questions on demographics, general health, nutrition, sun protection, alcohol and tobacco use, mental health and sexual health had fair to high reliability (ICCs range from 0.32 to 1.00). Reliability of some physical activity items were poor with large variability (ICC = 0.15, 95% CI 0.01-0.28 to 0.86, 95% CI 0.82-0.89). CONCLUSIONS: A majority of the USHWS survey items represented a moderate to high test-retest reliability. Variability and poor reliability of physical activity questions may be due to survey implementation time and usual behaviour changes. SO WHAT?: The USHWS survey is reliable instrument to assess Australian university student health at a population level with the aim of informing effective programming, policy and initiatives. SUMMARY: The University Student Health and Wellbeing Study (USHWS) survey is a foundational tool to understand university student's health in Australia. The USHWS reported fair to high reliability with few physical activity items showing lower reliability. Greater variability may be due to usual day-to-day fluctuations in behaviour.

Alcohol consumption and associated harms among university students in Australia: Findings from a cross-sectional study.

ISSUE ADDRESSED: University students regularly report alcohol consumption in excess of Australian guidelines for harm. However, previous studies have overlooked the experiences of mature-aged students. This study assessed alcohol consumption and alcohol-related harms among university students aged 18-50 years old in Australia. METHODS: A cross-sectional online survey with convenience sample of university students was used in this study. Unadjusted ordinal logistic regressions were performed to explore associations between student characteristics and frequency of alcohol consumption as well as number of standard drinks consumed. Logistic regressions adjusted for student characteristics were performed to assess associations between alcohol consumptions and alcohol-related harm. RESULTS: Of the respondents (n = 486), 82% consumed alcohol, of which 50% consumed more than two standard drinks on any day. Age was significantly associated with amount consumed and blackout. Students aged 31-50 years were less likely to consume more than two standard drinks on any day (odds ratio, OR: 0.62, 95% confidence interval (95% CI): 0.40, 0.97); and less likely to experience blackout (OR: 0.45; 95% CI: 0.25, 0.83) than those aged 18-20 years. Interestingly, reducing consumption to no more than once a month, when compared to more than twice a month, reduced risk of blackout only for those aged less than 31-50 years old (adjusted OR: 0.22; 95% CI: 0.04, 1.13). CONCLUSIONS: Older university students are less likely to drink more than two standard drinks on any day than their younger counterparts. SO WHAT?: It is recommended that interventions target younger students; however, older students may assist in understanding factors that influence low risk alcohol consumption.

Measuring health promotion research impact - What researchers think?

ISSUES ADDRESSED: The significant investment in health research has resulted in an increased focus to determine suitable approaches to measure health promotion research impact. This research was undertaken at the request of a nationally competitive research organisation that funds health promotion research, to explore how Chief Investigators (CIs) on their funded projects understood research impact, its measurement and associated challenges. METHODS: Participants were required to be or have been a CI on an Australian competitive research (exploratory or intervention) grant focussed on health promotion. The qualitative study used thematic analysis from one-on-one interviews. Themes were created and descriptive quotes were selected to illustrate the main findings. RESULTS: The majority of participants were female (n = 13) working at a university (n = 13). Three themes emerged: a) defining health research impact; b) complexity and simplicity of measuring health research impact; c) challenges of measuring health research impact: i) differing language; ii) differing assessment; iii) attribution and timing; and iv) resourcing and skills. CONCLUSION: Researchers recognised that there are significant challenges in measuring the impact of health promotion research. The most significant factors identified by participants were the disciplinary background of the researchers undertaking the measurement, their skills and experience and the resources (including time) available to assess impact. SO WHAT?: Research impact assessment is complex, time consuming and requires specific skills to facilitate measurement of impact provision of funding for this activity in research grants and research impact training is required.

Motivations for use, identity and the vaper subculture: a qualitative study of the experiences of Western Australian vapers.

BACKGROUND: Vaping is a relatively new practice, and therefore its symbolic meanings and social practices are yet to be fully understood, especially within Australia where the practice is strictly regulated. This study aimed to examine vapers motivations for use, reinforcing influences, and association with the vaper subculture. METHODS: Working from a constructivist epistemology and a symbolic interaction framework, in-depth interviews were conducted with a purposive sample of 37 current (89%) and former (11%) adult vapers, 70% male, mean age of 32.5. Data was analysed via thematic analysis. RESULTS: Vapers largely started vaping to quit smoking and underwent common experiences during their initiation phase. Subsequently, vapers tended to adopt one of two dominant identities, that of the 'cloud chaser' or the 'substitute', which some users moved between during different stages of their vaping career. The social and symbolic meaning of e-cigarettes and vaping varied and involved concepts of harm reduction, addiction, pleasure, stigma and community, and for some, connection to the vaper subculture. CONCLUSIONS: Understanding the complexities of vaping, and the nuanced differences of 'cloud chasers' and 'substitute' vapers may have important implications for health communication, research and policy. E-cigarette users within this sample were not a homogeneous group and differed in their motivations for use, association with the vaper subculture and relationship with the vape community. These findings provide new insights into the socialisation process and subsequent identity adoption of vapers within the unique regulatory environment of Western Australia.

Influences of club connectedness among young adults in Western Australian community-based sports clubs.

BACKGROUND: Along with physical benefits, community-based sport provides opportunities to enhance connectedness, an important protective factor of social and emotional health. However, young Australians participating in sport have been found to drink alcohol at higher levels than their non-sporting peers, and many clubs serve unhealthy food and beverages. This study explored the association between the dependent variable, level of alcohol consumption (AUDIT-C) and connectedness to club and other health behaviours among young people aged 18-30 years who play club sport in Western Australia. METHODS: An online cross sectional survey measured levels of alcohol consumption (AUDIT-C), alcohol-related harm, connectedness (including volunteering and team cohesion), mental wellbeing, healthy food options and club sponsorship among young adults aged 18-30 years involved in sports clubs in Western Australia (n = 242). Relationships and association between the dependent variable (AUDIT-C) and independent variables were assessed. RESULTS: Male sportspeople were more likely to drink alcohol at high-risk levels than females (p < .001), and respondents belonging to a club that received alcohol-related sponsorship were more likely to drink at high-risk levels (p = .019). Females were significantly more likely to want healthy food and beverage options provided at their clubs (p = 0.011). When all factors were considered team cohesion (p = 0.02), alcohol expectations (p = < .001), occurrences of experienced alcohol-related harm (p = <.001) and length of club membership (p = 0.18) were significant predictors of high-risk AUDIT-C (R2 = .34, adjusted R2 = .33, F (4, 156) = 20.43, p = <.001). High-risk AUDIT-C and club connectedness predicted strong team cohesion (R2 = .39, adjusted R2 = .39, F (2, 166) = 53.74, p = <.001). CONCLUSIONS: Findings from this study may inform policy and practice to enhance healthy behaviours among young adults participating in community sports clubs in Australia and other countries.

"A content analysis of news media coverage of drowning events in Western Australia over two summers, 2014-2016".

ISSUE ADDRESSED: Drowning is a leading cause of death globally. Opportunities to promote drowning prevention in news media may be overlooked for attention-grabbing headlines, imagery and narrative. This study examines news media coverage of fatal drowning events in Western Australia (WA). METHODS: Coronial fatal drowning data in WA were extracted for two summer time periods (2014-2016) by date, age, gender, location and description. Corresponding print and online news articles were captured using: (i) Media Alert; (ii) Google News; (iii) Factiva. A content and frame analysis protocol was developed. A qualitative approach was taken to analyse the news angle. A subgroup analysis was undertaken for drowning focused articles. RESULTS: The final sample (n = 50) news articles matched 17 individual drowning events (T1, n = 9; T2, n = 8). Drowning stories rarely appeared on page 1 (n = 2), but were located in the first 2-10 pages (n = 20) (66.6%). In the subanalysis, one-fifth (22%) of the articles employed a news angle relating to community spirit and celebration of life. There were 32 mentions of "who was responsible for the drowning event." Environmental factors were most cited for "what was responsible" (20.4%). Experts were cited in 66.7% of articles and drowning prevention strategies were mentioned in nine of the 50 articles. CONCLUSION: Drowning was considered newsworthy; however, not the front page news. Reporting infrequently prioritised drowning prevention or discussed prevention strategies. SO WHAT?: Working closely with news outlets to embed drowning prevention messages in news stories during high-risk periods such as summer is an imperative.

The injury workforce in Western Australia: Findings from a cross-sectional survey.

ISSUE ADDRESSED: Since 1986, injury prevention and control has been classified as a National Health Priority. However, no reviews into the injury prevention workforce have been conducted in Australia since 2011 and to date; none has focused specifically on the injury prevention and safety promotion sector in Western Australia (WA). This research sought to review the scope of the injury prevention and safety promotion workforce in WA to gain a greater understanding of sector characteristics, work and needs. METHODS: An online, cross-sectional survey was conducted between mid-January and mid-March 2018. Participants were required to be: (a) based in WA or have a program running within WA; and (b) working in injury prevention and safety promotion relating to programs, policy or legislation development, implementation and/or evaluation within intentional (eg interpersonal violence, suicide and self-harm) or unintentional injuries (eg transport, poisoning, falls, drowning, burns) or farm, child and community, occupational health and safety, sport and recreation and trauma. RESULTS: The research found that participants were predominantly female (82%), aged 40 years or older (66.1%) and were employed full time (55.6%). The majority of participants worked in falls prevention (38.5%), alcohol and other drugs (38.0%), injury in general (31.8%) and community safety (30.7%). CONCLUSIONS: Findings demonstrate significant heterogeneity with a core workforce supported by a range of non-core and indirect actors. Identifying characteristics and needs of the workforce supports coordinated capacity building to implement effective injury prevention and safety promotion initiatives. With this being the first review of the workforce in WA, this article highlights the need to more regularly audit the sector to determine its breadth and composition. SO WHAT?: In the light of the recent announcement by the Commonwealth for a new national Injury Prevention Strategy, this study provides timely insights into the injury prevention and safety promotion sector in WA.

The Messages Presented in Electronic Cigarette-Related Social Media Promotions and Discussion: Scoping Review.

BACKGROUND: There has been a rapid rise in the popularity of electronic cigarettes (e-cigarettes) over the last decade, with growth predicted to continue. The uptake of these devices has escalated despite inconclusive evidence of their efficacy as a smoking cessation device and unknown long-term health consequences. As smoking rates continue to drop or plateau in many well-developed countries, transnational tobacco companies have transitioned into the vaping industry and are now using social media to promote their products. Evidence indicates e-cigarettes are being marketed on social media as a harm reduction alternative, with retailers and manufacturers utilizing marketing techniques historically used by the tobacco industry. OBJECTIVE: This study aimed to identify and describe the messages presented in e-cigarette-related social media (Twitter, YouTube, Instagram, and Pinterest) promotions and discussions and identify future directions for research, surveillance, and regulation. METHODS: Data sources included MEDLINE, Scopus, ProQuest, Informit, the Journal of Medical Internet Research, and Google Scholar. Included studies were published in English between 2007 and 2017, analyzed content captured from e-cigarette-related social media promotions or discussions, and reported results for e-cigarettes separately from other forms of tobacco and nicotine delivery. Database search ceased in October 2017. Initial searches identified 536 studies. Two reviewers screened studies by title and abstract. One reviewer examined 71 full-text articles to determine eligibility and identified 25 studies for inclusion. This process was undertaken with the assistance of the Web-based screening and data extraction tool-Covidence. The review was registered with the Joanna Briggs Institute (JBI) Systematic Reviews database and followed the methodology for JBI Scoping Reviews. RESULTS: Several key messages are being used to promote e-cigarettes including as a safer alternative to cigarettes, efficacy as a smoking cessation aid, and for use where smoking is prohibited. Other major marketing efforts aimed at capturing a larger market involve promotion of innovative flavoring and highlighting the public performance of vaping. Discussion and promotion of these devices appear to be predominantly occurring among the general public and those with vested interests such as retailers and manufacturers. There is a noticeable silence from the public health and government sector in these discussions on social media. CONCLUSIONS: The social media landscape is dominated by pro-vaping messages disseminated by the vaping industry and vaping proponents. The uncertainty surrounding e-cigarette regulation expressed within the public health field appears not to be reflected in ongoing social media dialogues and highlights the need for public health professionals to interact with the public to actively influence social media conversations and create a more balanced discussion. With the vaping industry changing so rapidly, real-time monitoring and surveillance of how these devices are discussed, promoted, and used on social media is necessary in conjunction with evidence published in academic journals.

Metabolic syndrome in rural Australia: An opportunity for primary health care.

OBJECTIVE: To measure the impact of a 6-month home-based behaviour change intervention on reducing the risk of chronic disease as determined by metabolic syndrome status and cardiovascular risk score, and discuss implications for primary care in rural areas. DESIGN: A two-arm randomised controlled trial of rural adults. SETTING: The rural town of Albany in the Great Southern region of Western Australia. PARTICIPANTS: Participants (n = 401) aged 50-69 years who were classified with or at risk of metabolic syndrome and randomly assigned to intervention (n = 201) or waitlisted control (n = 200) group. INTERVENTIONS: A 6-month intervention program incorporating goal setting, self-monitoring and feedback, with motivational interviewing was conducted. MAIN OUTCOME MEASURES: Change in metabolic syndrome status and cardiovascular risk. RESULTS: Significant improvements in metabolic syndrome status and cardiovascular disease risk score (-0.82) were observed for the intervention group relative to control group from baseline to post-test. CONCLUSION: This home-based physical activity and nutrition intervention reduced participants' risk of experiencing a cardiovascular event in the next 5 years by 1%. Incorporating such prevention orientated approaches in primary care might assist in reducing the burden of long-term chronic diseases. However, for realistic application in this setting, hurdles such as current national health billing system and availability of resources will need to be considered.