Understanding the Experiences of Food Insecurity in Older Adult Households.

Food insecurity is a pressing multidimensional problem that negatively impacts the health and well-being of a significant number of the older population. Finding ways to better address nutritional issues among this vulnerable population is vital to their well-being. Using a mixed-methods approach, we conducted semi-structured phone interviews with a representative sample of 434 low-income older adult households in Tennessee. The aim of this study is to assess the prevalence of food insecurity, examine ongoing barriers, and, using qualitative data, to explore the diverse daily experiences older adults face when confronted with a food insecure lifestyle. Based on the USDA Adult 10-Item Household Screening Module, we found that 30% in our sample were designated as marginally, low or very low food secure. Many of those most vulnerable (older women, widowed or divorced, poor health and below the poverty line) constantly struggled with food insecurity. Being food insecure was attributed to limited financial resources, lack of transportation, health limitations, and a poor psychological state. Utilizing food stretching practicing, governmental agencies offering food supplements, family/friends, religious groups and personal resilience were common coping strategies. Implications and recommendations for service providers are offered.

Australian lessons for developing and testing a culturally inclusive health promotion campaign.

The purpose of the study was to develop and test culturally appropriate health promotion materials that were seen to be socially inclusive in regard to blood donation within the Australian-African community. Materials were produced in multiple languages (English, Arabic, Swahili and Kirundi) and were initially developed based on previous pilot data, with feedback from the project partner (Australian Red Cross Blood Service) and the African community. Seven formative focus groups with 62 participants were then conducted to ensure the materials would be effective, credible and culturally acceptable to the target audience, including preferred messages, taglines and images. The response confirmed that quotes and images from community members (as opposed to actors) were critical to ensure messages were engaging and believable, and had meaningful taglines that were perceived to be authentic. The refined materials were then used in a community intervention study. The evaluation included an assessment of respondents' views of the messages post-intervention. Of the 281 African migrants who saw the campaign materials during the intervention period, the majority (75.8%) strongly agreed that the materials made them feel part of the wider Australian community. These results suggest that engagement in developmental activities with targeted communities is important for creating positively viewed culturally targeted public health campaigns. A six-step process is suggested that could be used by other organizations to ensure that messages are acceptable to targeted migrant communities.

'You could get sick, disgusting': an analysis of alcohol counter-advertisements created by children.

Advertisements are persuasive texts designed to communicate ideas explicitly and implicitly through visual grammar. Counter-advertisements allow students to engage with advertising texts as creators rather than consumers and challenge media messages. Based in critical media literacy theory, this paper explores how elementary students interpret and redesign advertisements to create meaning. This study focused on the messages upper-elementary school students created about alcohol following a 10-lesson alcohol media literacy programme. Text from the counter-advertisements (n = 161) was analysed using discourse analysis. The counter-advertisements were also content analysed for message content, persuasion strategies and production components using a media literacy framework. The content of male-targeted, female-targeted and gender-neutral ads was compared using chi-square analyses. The four main themes identified in the discourse and content analysis were 'vomit', 'sick', 'danger' and 'poison', highlighting an emphasis on short-term consequences of alcohol misuse. Sensory (un)appeal was the most frequently used persuasion strategy, while objects/symbols and colour were the most frequently used production components. The use of these devices differed depending upon the advertisement's target gender. Involving elementary students in the redesign of advertisements is a powerful pedagogy that enables students to demonstrate their understanding of media literacy practices and create health promotion messages.

Are older Australians with chronic diseases online?

ISSUE ADDRESSED: Health information can be easily and cheaply provided through the Internet. However, we do not know whether older adults, those people most likely to be living with a chronic disease, are online or whether they use the Internet to find health information. METHODS: In order to establish the proportion of older Australians online, the impact of their current health status and chronic disease diagnosis on Internet usage and whether they use the Internet to search for health information, a paper-based survey was developed and mailed to 9000 older adults, resident in New South Wales, Australia (response rate = 46.8% ). RESULTS: Results showed that many older Australians are online (52.3%) and that the majority who are use the Internet to find health information (68.5%). Respondents were more likely to use the Internet if they reported good health. The presence of most chronic diseases reduced use of the Internet; however, this was not the case for those reporting asthma, anxiety or sleep apnoea. Internet use decreased as the number of reported co-morbidities increased. However, once online, self-perceived overall health and number of chronic diseases did not affect use of the Internet to find health information. CONCLUSIONS: This study is important as there is currently little information available about Internet use for health information by older Australians. Findings show that the provision of health information online has the potential to reinforce existing barriers created by the social determinants of health. SO WHAT?: There is a role for the Internet in providing preventative, health promotion information, to older adults, who are already online and younger, computer literate audiences. However, practitioners need to consider the fact that this mode of delivery reinforces existing social divides; requires people to have Internet access and be both literate and e-literate.

A systematic review of children's alcohol-related knowledge, attitudes and expectancies.

Understanding the nature of, and transitions in, young children's alcohol-related knowledge and attitudes is important to determining the age at which we should start educating children about alcohol and informing our understanding of the focus of such education. This paper aimed to explore current literature on the alcohol-related knowledge, beliefs, attitudes and expectancies of children aged 12years and under. Electronic databases were searched for papers published from January 2000-August 2016. Further papers were identified by a manual review of reference lists, and contacting corresponding authors of included papers. Papers that reported on children's knowledge or beliefs about alcohol, attitudes towards alcohol and/or expectancies regarding alcohol consumption were included. Seventeen cross-sectional, experimental or observational studies and seven longitudinal studies met the inclusion criteria. Data on key measures was tabulated. From a very young age children are aware of and able to identify alcohol, and have some knowledge of its effects; their attitudes become more positive with increasing age and these shifts appear to precede drinking initiation by some years. The small number of available studies, with different measures of knowledge, attitudes and expectancies, made assessment of bias unfeasible. Only three studies were published in the last five years. Children's knowledge of, and attitudes towards, alcohol form before they initiate alcohol use, and are likely acquired through observation. Alcohol-related education should commence before children begin drinking, and should encourage the delay of alcohol initiation, address social norms, and reduce positive expectancies.

Qualitative process evaluation of an Australian alcohol media literacy study: recommendations for designing culturally responsive school-based programs.

BACKGROUND: Alcohol media literacy programs seek to mitigate the potentially harmful effects of alcohol advertising on children's drinking intentions and behaviours through equipping them with skills to challenge media messages. In order for such programs to be effective, the teaching and learning experiences must be tailored to their specific cultural context. Media in the Spotlight is an alcohol media literacy program aimed at 9 to 12 year old Australian children. This study evaluates the process and implementation of the program, outlining the factors that facilitated and inhibited implementation. From this evaluation, a pedagogical framework has been developed for health professionals implementing culturally responsive programs in school settings. METHODS: Process measures included: semi-structured interviews with teachers before and after the program was implemented (n = 11 interviews), program evaluation questionnaires completed by children (n = 166), lesson observations completed by teachers (n = 35 observations), and reflective journal entries completed by the researcher (n = 44 entries). A thematic analysis approach was used to analyse all of the data sets using NVivo. Inductive coding was used, whereby the findings were derived from the research objectives and multiple readings and interpretations of the data. RESULTS: Five key pedagogical considerations were identified that facilitated implementation. These were: connecting to the students' life worlds to achieve cultural significance; empowering students with real-world skills to ensure relevance; ensuring programs are well structured with strong connections to the school curriculum; creating developmentally appropriate activities while providing a range of assessment opportunities; and including hands-on and interactive activities to promote student engagement. Three potential inhibitors to implementing the alcohol media literacy program in upper-elementary school classrooms were identified. These included topic sensitivities, classroom management challenges, and fitting new programs into already busy school schedules. CONCLUSION: Overall, the program content and individual lessons were well received by the teachers and students. The lessons learned from the development, implementation and evaluation of this program can provide health professionals with key pedagogical strategies for designing culturally responsive educational programs. Culturally responsive programs are critical for ensuring interventions are effective for their specific context.

Association Between Young Australian's Drinking Behaviours and Their Interactions With Alcohol Brands on Facebook: Results of an Online Survey.

AIMS: To examine the association of alcohol-brand social networking pages and Facebook users' drinking attitudes and behaviours. METHODS: Cross-sectional, self-report data were obtained from a convenience sample of 283 Australian Facebook users aged 16-24 years via an online survey. RESULTS: More than half of the respondents reported using Facebook for more than an hour daily. While only 20% had actively interacted with an alcohol brand on Facebook, we found a significant association between this active interaction and alcohol consumption, and a strong association between engagement with alcohol brands on Facebook and problematic drinking. CONCLUSIONS: The findings of this study demonstrate the need for further research into the complex interaction between social networking and alcohol consumption, and add support to calls for effective regulation of alcohol marketing on social network platforms.

Lost in translation: a focus group study of parents' and adolescents' interpretations of underage drinking and parental supply.

BACKGROUND: Reductions in underage drinking will only come about from changes in the social and cultural environment. Despite decades of messages discouraging parental supply, parents perceive social norms supportive of allowing children to consume alcohol in 'safe' environments. METHODS: Twelve focus groups conducted in a regional community in NSW, Australia; four with parents of teenagers (n = 27; 70 % female) and eight with adolescents (n = 47; 55 % female). Participants were recruited using local media. Groups explored knowledge and attitudes and around alcohol consumption by, and parental supply of alcohol to, underage teenagers; and discussed materials from previous campaigns targeting adolescents and parents. RESULTS: Parents and adolescents perceived teen drinking to be a common behaviour within the community, but applied moral judgements to these behaviours. Younger adolescents expressed more negative views of teen drinkers and parents who supply alcohol than older adolescents. Adolescents and parents perceived those who 'provide alcohol' (other families) as bad parents, and those who 'teach responsible drinking' (themselves) as good people. Both groups expressed a preference for high-fear, victim-blaming messages that targeted 'those people' whose behaviours are problematic. CONCLUSIONS: In developing and testing interventions to address underage drinking, it is essential to ensure the target audience perceive themselves to be the target audience. If we do not have a shared understanding of underage 'drinking' and parental 'provision', such messages will continue to be perceived by parents who are trying to do the 'right' thing as targeting a different behaviour and tacitly supporting their decision to provide their children with alcohol.

Factors influencing young people's use of alcohol mixed with energy drinks.

A growing evidence base demonstrates the negative health outcomes associated with the consumption of energy drinks (ED) and alcohol mixed with energy drinks (AMED), especially among young people. Work to date has focused on the physiological effects of ED and AMED use and the motivations associated with consumption, typically among college students. The present study adopted an exploratory, qualitative approach with a community sample of 18-21 year olds to identify relevant barriers, motivators, and facilitators to AMED use and to explicate the decision-making processes involved. The sensitisation method was used to collect data from a cohort of 60 young adult drinkers over a period of six months via individual interviews, focus groups, and introspections. The findings indicate that there may be a general understanding of the negative consequences of AMED use, and that these consequences can constitute barriers that serve to discourage frequent consumption among young people. This outcome suggests the potential application of positive deviance and social norms approaches in interventions designed to reduce AMED use among this population segment. The results are promising in the identification of a large number of concerns among young adults relating to AMED use. These concerns can constitute the focus of future communications with this target group. The results are likely to have relevance to other countries, such as the US and the UK, that share similar alcohol cultures and where energy drinks have achieved comparable market penetration rates.

Parental provision of alcohol: a TPB-framed review of the literature.

There is evidence that parents are a common source of alcohol provision for teenagers, and increasing evidence that this provision is associated with current and future drinking. This review examines the current literature on parental provision of alcohol to children and teenagers, through the lens of the Theory of Planned Behavior: attitudes, subjective norms and perceived behavioral control. A search of the databases ProQuest, PsycINFO, Medline, Expanded Academic, Scopus and PBSC identified 826 articles. Of these, 810 did not meet the inclusion criteria, and 16 were included in the review. In summary, the reviewed articles demonstrated positive attitudes toward parental supply of alcohol (often driven by misperceptions), strong subjective norms, but little exploration of perceived behavioral control There is a need for further research which clearly differentiates between adolescents of different ages and genders, and which explores the predictors and role of perceived behavioral control. There is also a need for further research to more fully understand this behavior and to develop appropriate interventions which address all three predictors (attitudes, subjective norms and perceived behavioral control).

Alcohol-branded merchandise: association with Australian adolescents' drinking and parent attitudes.

There is growing evidence that young people own alcohol-branded merchandise (ABM), and that ownership influences their drinking intentions and behaviours. However, there is a paucity of research on parents' knowledge or attitudes in relation to ownership of ABM. Study 1 (n = 210) identified high levels of ownership of ABM and associations between ABM and drinking attitudes and behaviours. In Study 2, focus groups with Australian parents found that they were aware of ABM-and many had items of ABM in their home-but they had generally not engaged in consideration of the potential impact on their children. They clearly perceived ABM as advertising and, on reflection, acknowledged that this form of marketing may influence children's decisions about drinking. There is a need to raise parental awareness of the effects of ABM and to endeavour to reduce children's exposure to this influential form of alcohol marketing.

Effectiveness of alcohol media literacy programmes: a systematic literature review.

Alcohol media literacy is an emerging field that aims to address the link between exposure to alcohol advertising and subsequent expectancies and behaviours for children and adolescents. The design, rigour and results of alcohol media literacy programmes vary considerably, resulting in a number of unanswered questions about effectiveness. To provide insight into some of these questions, a systematic literature review of alcohol media literacy studies was conducted. The review was guided by the following research question: What considerations are needed to develop an effective school-based alcohol media literacy programme? On the basis of a critical synthesis of 10 interventions (published in the period 1997 to May 2014), our findings provide a comprehensive understanding of the descriptive, methodological and outcome characteristics of this small body of significant research. The review provides considerations for future alcohol media literacy programmes, including the need for an interactive pedagogical approach within the naturalistic school setting, implementation fidelity and a holistic approach to programme evaluation, a means for maintaining relevance, consideration of gender differences, relevance for an international audience and use of follow-up and longitudinal data.

Exercise bra discomfort is associated with insufficient exercise levels among Australian women treated for breast cancer.

PURPOSE: Although participating in exercise is beneficial for breast cancer survivors, not being able to find a comfortable exercise bra can be a barrier to exercise. It is likely that side effects specific to breast cancer treatment exacerbate exercise bra discomfort. This study aimed to determine the relationship between patient characteristics, physical side effects, exercise bra discomfort and exercise behaviours. METHODS: Four hundred thirty-two breast cancer survivors completed an online survey related to their treatment and demographic background, current exercise levels, reported exercise bra discomfort and breast cancer treatment side effects. Patient characteristics and exercise levels were considered in a binary logistic regression against reporting bra discomfort to ascertain significant relationships (p < 0.05) and predictive value (odds ratio). Pearson's chi-square statistics was used to determine significant relationships between reporting a side effect and exercise bra discomfort. RESULTS: Eight out of nine physical side effects were significantly related to reporting exercise bra discomfort. Reporting exercise bra discomfort was significantly related to not achieving a minimal recommended level of exercise. CONCLUSIONS: This is the first study in the scientific literature that systematically links the reporting of exercise bra discomfort to not achieving recommended levels of exercise. This effect of bra discomfort on exercise was found after controlling for age, surgery type and current treatment among a large cohort of women treated for breast cancer. Furthermore, results from this study suggest that physical side effects, as a result of surgery and treatment associated with breast cancer, are linked to experiencing bra discomfort during exercise.

Australian alcohol policy 2001-2013 and implications for public health.

BACKGROUND: Despite a complex and multi-faceted alcohol policy environment in Australia, there are few comprehensive reviews of national and state alcohol policies that assess their effectiveness and research support. In mapping the Australian alcohol policy domain and evaluating policy interventions in each of the core policy areas, this article provides a useful resource for researchers. The implications for protecting public health emanating from this mapping and evaluation of alcohol policy are also discussed. METHODS: This review considered data from: published primary research; alcohol legislation, strategies and alcohol-related press releases for all levels and jurisdictions of Australian government; international publications by prominent non-governmental organisations; and relevant grey literature. These were organised and evaluated using the established framework offered by Thomas Babor and colleagues. RESULTS: Findings indicated great variability in alcohol initiatives across Australia, many of which do not reflect what is currently considered to be evidence-based best practice. CONCLUSIONS: Research showing increasing alcohol-related harms despite steady levels of consumption suggests a need to pursue alcohol policy initiatives that are supported by evidence of harm-reduction. Future initiatives should aim to increase existing alcohol controls in line with suggested best practice in order to protect public health in Australia.

Implementing a virtual community of practice for family physician training: a mixed-methods case study.

BACKGROUND: GP training in Australia can be professionally isolating, with trainees spread across large geographic areas, leading to problems with rural workforce retention. Virtual communities of practice (VCoPs) may provide a way of improving knowledge sharing and thus reducing professional isolation. OBJECTIVE: The goal of our study was to review the usefulness of a 7-step framework for implementing a VCoP for general practitioner (GP) training and then evaluated the usefulness of the resulting VCoP in facilitating knowledge sharing and reducing professional isolation. METHODS: The case was set in an Australian general practice training region involving 55 first-term trainees (GPT1s), from January to July 2012. ConnectGPR was a secure, online community site that included standard community options such as discussion forums, blogs, newsletter broadcasts, webchats, and photo sharing. A mixed-methods case study methodology was used. Results are presented and interpreted for each step of the VCoP 7-step framework and then in terms of the outcomes of knowledge sharing and overcoming isolation. RESULTS: Step 1, Facilitation: Regular, personal facilitation by a group of GP trainers with a co-ordinating facilitator was an important factor in the success of ConnectGPR. Step 2, Champion and Support: Leadership and stakeholder engagement were vital. Further benefits are possible if the site is recognized as contributing to training time. Step 3, Clear Goals: Clear goals of facilitating knowledge sharing and improving connectedness helped to keep the site discussions focused. Step 4, A Broad Church: The ConnectGPR community was too narrow, focusing only on first-term trainees (GPT1s). Ideally there should be more involvement of senior trainees, trainers, and specialists. Step 5, A Supportive Environment: Facilitators maintained community standards and encouraged participation. Step 6, Measurement Benchmarking and Feedback: Site activity was primarily driven by centrally generated newsletter feedback. Viewing comments by other participants helped users benchmark their own knowledge, particularly around applying guidelines. Step 7, Technology and Community: All the community tools were useful, but chat was limited and users suggested webinars in future. A larger user base and more training may also be helpful. Time is a common barrier. Trust can be built online, which may have benefit for trainees that cannot attend face-to-face workshops. Knowledge sharing and isolation outcomes: 28/34 (82%) of the eligible GPT1s enrolled on ConnectGPR. Trainees shared knowledge through online chat, forums, and shared photos. In terms of knowledge needs, GPT1s rated their need for cardiovascular knowledge more highly than supervisors. Isolation was a common theme among interview respondents, and ConnectGPR users felt more supported in their general practice (13/14, 92.9%). CONCLUSIONS: The 7-step framework for implementation of an online community was useful. Overcoming isolation and improving connectedness through an online knowledge sharing community shows promise in GP training. Time and technology are barriers that may be overcome by training, technology, and valuable content. In a VCoP, trust can be built online. This has implications for course delivery, particularly in regional areas. VCoPs may also have a specific role assisting overseas trained doctors to interpret their medical knowledge in a new context.

Evidence-based recommendations for building better bras for women treated for breast cancer.

Participating in exercise is beneficial for women who have been treated for breast cancer. However, not being able to find a comfortable exercise bra can be a barrier to exercise participation. This study aimed to systematically investigate what breast support women treated for breast cancer want when they exercise in order to provide evidence-based recommendations to improve exercise bra designs for these women. Based on 432 responses from a national online survey, frequency and relationship data were analysed (binary logistic regression) to understand exercise bra issues pertinent to this population. These issues included being able to control for asymmetrical cup sizes, managing heightened skin sensitivity, managing fluid (size) fluctuations, managing a prosthesis and restoring body image by restoring shape. This study provides evidence-based recommendations to inform an exercise bra design that will meet the unique needs of women treated for breast cancer. Rigorous, evidence-based evaluations of exercise bras for women treated for breast cancer may contribute to their well-being and quality of life through enhanced designs.

Trust, continuity and agency: keys to understanding older patients' attitudes to general practice trainees.

BACKGROUND: Populations are ageing and therefore non-communicable diseases are becoming leading causes of global morbidity, which need to be the focus of primary care services and training. Some older patients are uncomfortable with general practitioner (GP) trainees managing their chronic conditions, reducing clinical experience opportunities for trainees. This Australian cross-sectional study explored the factors underlying patients' attitudes to trainees in an agency theory framework. METHODS: Fifty patients aged 60 and over from each of 38 training practices were offered a questionnaire after their consultation. Principal component analysis of the results was undertaken. Factor scores were calculated. Binary logistic modelling was used to identify relationships between participant characteristics, behaviours, attitude items and factor scores. RESULTS: The response rate was 47.9% (n = 911). Three factors were identified: 'Interpersonal Trust' (IPT); 'Institution/system Trust' (ST); and 'Interpersonal Continuity' (IPC). Lower self-rated health (SRH) was associated with higher IPT factor scores (P = 0.023); higher SRH with higher ST scores (P = 0.001); and chronic illness with higher IPC scores (P = 0.005). Higher ST scores were associated with greater comfort with trainees' involvement in chronic care (P < 0.001) and frequency of trainee visits (P < 0.001), while higher IPC scores were negatively associated (P < 0.001 and P = 0.003, respectively). High IPT scores were associated with lower satisfaction with trainee visits (P = 0.001). DISCUSSION: These results indicate that better SRH, via higher institution/ST, is associated with favourable attitudes and attendance with trainees. In addition, chronic illness, via a higher need for IPC, is associated with lower comfort and attendance. These findings are consistent with agency theory, which shows potential as a framework for future interventions and research into older patient-trainee interactions.

Using Web 2.0 for health promotion and social marketing efforts: lessons learned from Web 2.0 experts.

Web 2.0 experts working in social marketing participated in qualitative in-depth interviews. The research aimed to document the current state of Web 2.0 practice. Perceived strengths (such as the viral nature of Web 2.0) and weaknesses (such as the time consuming effort it took to learn new Web 2.0 platforms) existed when using Web 2.0 platforms for campaigns. Lessons learned were identified--namely, suggestions for engaging in specific types of content creation strategies (such as plain language and transparent communication practices). Findings present originality and value to practitioners working in social marketing who want to effectively use Web 2.0.

Asthma self management in adults: a review of current literature.

Self management programs for chronic conditions, such as asthma, have an important place in healthcare delivery. When properly implemented, they can curb the impact of disease and reduce both the high personal costs for individuals and significant financial costs for health care systems. The purpose of this review was to establish an understanding of current published literature on asthma self management programs in adults and to identify any reported attributes or components which serve to either assist or obstruct the uptake of self management strategies. Electronic data sources including Scopus, Proquest 5000, CINAHL, PubMed and Web of Science were accessed and literature searches were conducted using the key terms: asthma, chronic disease, self management, morbidity, quality of life, health outcomes, patient education and best practice. Inclusion criteria for the search included journal articles relating to adults with asthma published in English in peer reviewed journals from 1995 to 2011. Exclusion criteria included research targeting children, parents of children or families; and articles examining Asthma and COPD (or any other co-morbidity). Sixty four articles were included in this review due to their relevance to the major components of asthma self management, as defined by the Australian Asthma Management Handbook. A major conclusion from this review was that the uptake of asthma self management strategies is poor despite global recommendations for over twenty years; and that a likely reason for this is that generic asthma self management advice does not engage the individual with asthma.

Exploring Environmental Barriers and Facilitators to Inclusion on a University Campus for Autistic Students.

Background: Attending university allows individuals to build independence, develop social networks, and attain valuable qualifications, contributing to enhanced outcomes in adulthood. However, autistic people have poorer participation rates and outcomes in university than those with all other disabilities or without disabilities. Most research conducted with autistic young adults in the university environment focuses on their social and communicative challenges and supports rather than on how the physical environment impacts an autistic student's university experience. Therefore, there is a need for research into how the sensory aspects of the university environment can affect the well-being and outcomes of autistic students. Methods: This qualitative study explored the experiences of seven autistic university students in the physical spaces of an Australian university. Using a semi-structured interview guide, and photo-elicitation, we collected data in one-on-one interviews with seven autistic undergraduate students. Results: We found that sensory aspects of physical spaces on university campuses are both enabling and challenging for autistic students. These aspects not only impact how students navigate and utilize aspects of the campus, but they also influence how students engage and participate at university. Autistic students need the space and resources to manage sensory overload on campus, and universities that seek to support autistic students need to consider the physical and sensory needs of this cohort. Conclusions: Inclusive university education requires attention to the physical aspects of campuses that support the mental and physical well-being of autistic students.

Why was this study done?: Autistic people are less likely to enroll in and complete further education than those with all other disabilities or without disabilities. Most research conducted with autistic young adults in the university environment focuses on their social and communication challenges, rather than the enabling and disabling aspects of the physical university environment. What was the purpose of this study?: This study aimed to capture and understand autistic students' experiences in navigating and participating in the physical spaces in an Australian university. What did the researchers do?: We interviewed seven undergraduate university students about the places and spaces on the university campus that they found challenging and enabling. Participants took photographs of these spaces before the interview and brought the photographs with them for discussion. What were the results of the study?: We found that the participants readily identified places on the campus that were both enabling and challenging. Physical aspects that were challenging included noisy spaces, crowded areas, and spaces with bright artificial lights. These spaces impacted on their ability to participate and succeed in their studies. They also impacted on their ability to interact with other students, their enjoyment of university, and their physical and emotional well-being. Comfortable spaces that allowed them to recharge were those that were quiet, less busy, had lower levels of sensory input, and allowed them to unmask. What do these findings add to what was already known?: Previous research on the university experience of autistic students has focused primarily on social and educational supports. Research on sensory-friendly education settings has typically focused on primary and secondary education. This study provides evidence of the importance of physical and sensory environments in the educational experience of autistic students in a postsecondary environment. What are potential weaknesses in the study?: The main weakness of the study is the small number of participants (n = 7) and that they were all drawn from one university. While this limits the generalizability of the findings, this was an exploratory study and an important first step in developing our understanding of barriers and facilitators to inclusion on a university campus. How will these findings help autistic adults now or in the future?: While this is a small-scale exploratory study, and there is a need for more research in this area, there are some simple takeaways that could be implemented by universities at minimal cost to support the inclusion of autistic students. For example, sensory input could be reduced by lowering the volume of piped music or reducing the number or brightness of lights. Simple supports for students experiencing sensory overload could include quiet times in cafeterias and access to sensory retreat rooms. At a minimum, our findings could serve as a starting point for discussions between university administrators and autistic students about necessary environmental adjustments to create more inclusive campuses.