Intersection between person-centred practice and Montessori for dementia and ageing in residential aged care.

BACKGROUND: Internationally, person-centred care (PCC) is embedded in the language of regulations and mandated to be practised in residential aged care (RAC). Despite this, PCC has not been fully adopted in RAC in Australia and internationally, and concerns about the quality of care persist. Over the past 2 decades, Montessori for dementia and ageing has been introduced in RAC to support and inform a cultural change towards PCC. This study aimed to examine the intersection between the goals and approaches of Montessori and PCC in RAC. METHODS: This qualitative descriptive study reports on a secondary analysis of qualitative data from focus groups (FGs) and interviews with residents, family-members, staff, and volunteers from eight RAC homes in Victoria, Australia. Sixteen FGs and 36 interviews were conducted. A qualitative deductive approach using researcher-developed Montessori for dementia and ageing framework for data analysis was applied. RESULTS: Findings provide support for the intersection between PCC and Montessori with participants' descriptions of PCC aligning with many of the goals and approaches of Montessori. Participants most commonly described Montessori approaches of engagement in daily tasks with purposeful roles and promoting cognitive abilities through multi-sensory stimulation. Least frequently-described approaches included focusing on residents' strengths/abilities, maintaining function, using familiar objects, and guided repetition. CONCLUSIONS: Findings have important implications for practice to use Montessori as a vehicle that supports and upskills the workforce to deliver care that is person-centred. Future research must examine the resources required to support the implementation and sustainability of Montessori as a vehicle for PCC.

Assessment of foods for infants and toddlers in Australia against the World Health Organization's Nutrient and Promotion Profile Model for food products for infants and young children.

OBJECTIVE: Global public health agencies have recommended stronger regulation of food marketing to protect children's diets. This study assessed commercial foods for infants and toddlers available in Australian supermarkets for compliance with the World Health Organization (WHO) Regional Office for Europe's Nutrient and Promotion Profile Model: supporting appropriate promotion of food products for infants and young children 6-36 months in the WHO European Region (NPPM). DESIGN: Dietitians assessed a sample of commercial foods for infants and toddlers against the composition, labelling and promotion requirements of the NPPM. SETTING: Australia. PARTICIPANTS: Commercial foods for infants and toddlers (n 45) available in two major Australian supermarkets, purposely sampled across product categories and brands. RESULTS: Fewer than one quarter (23 %) of the assessed products met all nutrient content requirements of the NPPM. No products met all of the labelling or promotional requirements. All products included at least one promotional marketing claim that was not permitted under the NPPM. CONCLUSIONS: The NPPM is useful to assess and monitor the nutritional composition and prevalence of marketing claims on commercial foods for infants and toddlers. Findings of noncompliance with the NPPM recommendations indicate an urgent need for stronger government regulation of the composition, labelling and marketing of commercial foods for infants and toddlers in Australia.

Uptake of health economic evaluations alongside clinical trials in Australia: an observational study.

BACKGROUND: Australia's clinical trials sector is highly productive with continued sector investment needed to enhance research impact. Generating economic evidence alongside trials has the potential to facilitate the implementation of trial results into practice. Ascertaining the use of health economic evaluations alongside clinical trials can assist in determining whether clinical trials fully realize and operationalize their potential to change policy and practice. The aims of this study were to ascertain the uptake of health economic evaluations alongside Australian-led clinical trials and explore associations between uptake and trial characteristics. METHODS: This observational study comprised a descriptive analysis of clinical trials registries, a cross-sectional survey of Australian Clinical Trials Alliance (ACTA) networks, and a subgroup analysis of completed acute care trials. Descriptive analyses of trial registrations were conducted, with logistic regressions used to identify predictors of proposing and subsequently publishing a health economic evaluation alongside acute care trials. RESULTS: Few randomized Australian-led clinical trials (11% of 9251) and ACTA network trials (43% of 227) proposed a health economic evaluation. In the subgroup analysis, 22% of the 324 acute care trials and 53% of the 38 ACTA network acute care trials proposed a health economic evaluation. Acute care trials funded by government bodies were significantly more likely to propose and publish a health economic evaluation than those funded by hospitals, universities, and other funders, after adjusting for phase, registration year, primary sponsor type, and comparator. CONCLUSIONS: Current uptake of health economic evaluations alongside Australian-led clinical trials is low, with uptake higher among the subset of ACTA network trials. This is despite economic evidence playing an increasingly prominent role in health system management, as well as rising health expenditure, limited budgets, and competing demands. There is significant opportunity to embed health economic evaluations alongside clinical trials, particularly phase 3 trials, to increase research outputs and optimize research translation. Investing in clinical trial networks that support funding for a health economist or a health economic evaluation may be an effective strategy to increase the uptake of health economic evaluations alongside trials.

Using Intervention Mapping to co-design a psychosocial service with youth experiencing mental illness.

BACKGROUND: Descriptions of service development processes in the youth mental health sector are lacking. Further, youth with lived experience of mental illness are rarely involved in service design. Intervention Mapping (IM) is a well-established framework for program development, implementation and evaluation, yet its applicability in the youth mental health sector is unknown. This paper describes the use of IM methodology to co-design and develop a psychosocial service to support youth aged 10-25 years experiencing mental illness in Tasmania, Australia. METHODS: The six steps of IM were followed: 1) needs assessment; 2) define program outcomes and objectives; 3) program design; 4) program production; 5) implementation planning; and 6) evaluation planning. RESULTS: Key outputs of each IM step are described. The service was successfully co-designed with young people at the centre of each step. The service includes wrap-around psychosocial support from lived-experience peer-support workers; outreach; and flexible frequency/intensity/duration to achieve young people's psychosocial goals. CONCLUSIONS: This is the first study to document the use of IM in co-designing a psychosocial service with youth experiencing mental illness. IM may provide a valuable roadmap for the youth mental health sector in supporting collaborative service design, implementation and evaluation planning, and systematic documentation of service development.

The Right to Rehabilitation for People With Dementia: A Codesign Approach to Barriers and Solutions.

INTRODUCTION: People with dementia of all ages have a human right to equal access to quality health care. Despite evidence regarding its effectiveness, many people living with dementia are unable to access rehabilitation for promoting function and quality of life. Conducted in Australia, this study was designed to (1) explore barriers to access to dementia rehabilitation and (2) identify solutions that improve access to rehabilitation. METHODS: People living with dementia (n = 5) and care partners (n = 8) and health professionals (n = 13) were recruited nationally. Experience-based codesign across three virtual workshops was used to understand barriers and design solutions to improve access to rehabilitation treatments. Socio-ecological analyses, using the Levesque Access to Health care framework, were applied to findings regarding barriers and to aid selection of solutions. RESULTS: There was high attendance (92.3%) across the three workshops. Barriers were identified at a user level (including lack of knowledge, transport, cost and difficulty navigating the health, aged care and disability sectors) and health service level (including health professional low dementia knowledge and negative attitudes, inequitable funding models and non-existent or fragmented services). Solutions focused on widespread dementia education and training, including ensuring that people with dementia and their care partners know about rehabilitation therapies and that health professionals, aged care and disability co-ordinators know how to refer to and deliver rehabilitation interventions. Dementia care navigators, changes to Australia's public funding models and specific dementia rehabilitation programmes were also recommended. CONCLUSIONS: Barriers to accessing rehabilitation for people with dementia exist at multiple levels and will require a whole-community and systems approach to ensure change. PATIENT OR PUBLIC CONTRIBUTION: People with living experience (preferred term by those involved) were involved at two levels within this research. A Chief Investigator living with dementia was involved in the design of the study and writing of the manuscript. People with living experience, care partners and service providers were participants in the codesign process to identify barriers and design potential solutions.

Attitudes and Behaviours Regarding COVID-19 Mitigation Strategies in Australians With an Underlying Health Condition: A Cross-Sectional Study.

BACKGROUND: Public health strategies have focused on preventing and slowing the transmission of COVID-19 by promoting the uptake of mitigation strategies. However, little is known about the uptake of these strategies in the presence of underlying health conditions. OBJECTIVES: To describe the attitudes and behaviours of a sample of Australians towards COVID-19 mitigation strategies, and determine if uptake of these strategies differed across different health conditions. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: National survey of Australian residents over 18 years. MAIN OUTCOME MEASURES: A purpose-built survey was used to collect participants' attitudes and behaviours towards COVID-19 mitigation strategies. RESULTS: Over half (53%) of the 2867 participants (99% completion rate) reported having one or more comorbidities. The most commonly self-reported health condition was cardiometabolic conditions (28%). Most participants disagreed that masks were no longer needed (74%) and wanted the 5-day isolation mandate (66%). More than one-third would like masks to be mandated for indoor spaces (38%) and 25% avoided going to hospitals. Participants with allergies (OR 1.37; 95% CI 1.14, 1.65), cardiometabolic (OR 1.49; 95% CI 1.23, 1.79), respiratory (OR 1.32; 95% CI 1.07, 1.62) and neurological (OR 1.62; 95% CI 1.12, 2.32) conditions were more likely to avoid using public transport compared to those without. In contrast, participants with underlying mental health conditions were less likely to use N95/P2 facemasks in public spaces (OR 0.46; 95% CI 0.25, 0.87) compared to those without. CONCLUSIONS: A substantial proportion of Australians continued to adopt COVID-19 mitigation measures or expressed a desire for more mitigations, including mandatory isolation for COVID-19, despite the lack of mandates. People with an underlying health condition who represent more than half of all adults appear to be more careful with mitigations to avoid COVID-19. PATIENT OR PUBLIC CONTRIBUTION: Members of the public were invited to participate in a soft launch of the survey between 4th and 5th January 2023 to test flow and functionality, and to allow the final wording of survey questions to be refined as required.

A Controlled Evaluation of a Psychosocial Outreach Support Program for Adults with Severe Mental Illness.

Objective: Serious mental illness (SMI) remains a leading cause of disability worldwide. However, there is limited Australian evidence of community-based programs to enhance the psychosocial wellbeing of adults experiencing SMI. Foundations is a long-term community-based psychosocial outreach support program delivered in Tasmania, Australia. A longitudinal non-randomised controlled trial was conducted to examine the effectiveness of the Foundations program on adults' psychosocial functioning, clinical symptomology, and hospital readmissions, in comparison to standard care only. Method: Participants were adults aged 18-64 years experiencing SMI. Control participants received standard clinical care only. Intervention participants were engaged in the Foundations program in addition to standard care. Data were collected at program commencement, midpoint, closure, and six-months post-closure. Linear mixed modelling was used to examine differences between groups. Results: Intervention participants achieved better psychosocial functioning in comparison to the control group by program closure and at six-month follow-up. No significant differences were observed for clinical mental health symptomology or hospital readmission rates. Length of readmission stay was significantly shorter for intervention participants. Conclusions: The findings highlight the additional value of community-based, recovery-oriented, psychosocial outreach support alongside clinical mental health care to enhance the psychosocial wellbeing of adults experiencing SMI.

"I Use Technologies Strategically With My Family Now": Practices That Parents Value to Promote Physical Activity in Young Children.

BACKGROUND: Although widely accessible digital technology (DT) provided multiple opportunities for young children's play, learning, and development, it also raised parents and professionals' concerns regarding its impact on children's physical activity. This study aimed to identify practices involving DT that were valued by parents in helping their young child to be physically active. METHODS: Participants were parents of ambulatory young children (less than 5 y of age) engaged with a playgroup. The study involved representatives from 3 service organizations, who compiled a list of digital resources related to using DT to promote children's physical activity that were suitable to be shared and trialed by parents and young children. During a pretrial workshop, researchers, participants, and organization representatives collaboratively developed the intervention, which involved the delivery of selected resources by weekly email, over a 12-week period. Participants provided weekly feedback about their experiences and participated in a postintervention semistructured qualitative interview. RESULTS: Thirteen families, with children aged between 15 and 36 months, completed the trial. Participants reported several valued practices to promote their children's physical activity, including those where the child was active while engaging with DT, where child engagement with DT acted as a prompt for later physical activity, where DT assisted parents in planning physical activity, where DT assisted parents in integrating movement with learning and play, and where DT was used to reinforce the child's enthusiasm for physical activity. CONCLUSIONS: Parents reported several valued practices where children were physically active, rather than sedentary, while using digital technology.

A non-randomised controlled trial of a community-based accommodation and psychosocial support programme for adults experiencing mental illness and homelessness.

BACKGROUND: The transition out of inpatient mental health is a crucial time for adults experiencing concurrent mental illness and homelessness, yet evidence regarding effective support options is mixed. Choices is an intensive 3-month psychosocial outreach and crisis accommodation support programme for adults experiencing mental illness and homelessness, delivered by Baptcare in Tasmania, Australia. This study examined the effect of Choices on adults' psychosocial functioning, clinical symptomology and psychiatric readmissions in comparison to standard care only. METHOD: Participants were adults aged 18-64 years experiencing mental illness and homelessness, recruited upon discharge from a psychiatric admission. Intervention participants (n = 124) received the Choices programme. Control participants (n = 122) received standard care, clinical assessment and treatment from hospital-based Mental Health Services. Outcomes were psychosocial functioning (primary), clinical symptomology, hospital readmission rate and readmission length of stay. Outcomes were assessed at programme commencement and closure (3 months) and 3 months post-closure (intervention group only). Analysis of covariance was used to analyse differences between groups at closure, while controlling for baseline differences. RESULTS: Intervention participants had significantly improved social functioning (encompassing living conditions, social relationships, self-esteem/confidence), overall psychosocial functioning, symptoms of depression and anxiety and shorter hospital readmission length of stay in comparison to the control group. Intervention participants experienced further improvements in social and overall psychosocial functioning 3 months post-closure. CONCLUSION: The Choices programme is effective in enhancing the psychosocial functioning of adults experiencing concurrent mental illness and homelessness. These findings support the ongoing delivery of this combined accommodation and wrap-around psychosocial model of intensive support.

Preferred lifestyle intervention characteristics and behaviour change needs of postpartum women following cardiometabolic pregnancy complications.

BACKGROUND: Women with cardiometabolic pregnancy complications are at increased risk of future diabetes and heart disease which can be reduced through lifestyle management postpartum. OBJECTIVES: This study aimed to explore preferred intervention characteristics and behaviour change needs of women with or without prior cardiometabolic pregnancy complications for engaging in postpartum lifestyle interventions. DESIGN: Quantitative cross-sectional study. METHODS: Online survey. RESULTS: Overall, 473 women were included, 207 (gestational diabetes (n = 105), gestational hypertension (n = 39), preeclampsia (n = 35), preterm birth (n = 65) and small for gestational age (n = 23)) with and 266 without prior cardiometabolic pregnancy complications. Women with and without complications had similar intervention preferences, with delivery ideally by a healthcare professional with expertise in women's health, occurring during maternal child health nurse visits or online, commencing 7 weeks to 3 months post birth, with 15- to 30-min monthly sessions, lasting 1 year and including monitoring of progress and social support. Women with prior complications preferred intervention content on women's health, mental health, exercise, mother's diet and their children's health and needed to know more about how to change behaviour, have more time to do it and feel they want to do it enough to participate. There were significant differences between groups, with more women with prior cardiometabolic pregnancy complications wanting content on women's health (87.9% vs 80.8%, p = 0.037), mother's diet (72.5% vs 60.5%, p = 0.007), preventing diabetes or heart disease (43.5% vs 27.4%, p < 0.001) and exercise after birth (78.3% vs 68.0%, p = 0.014), having someone to monitor their progress (69.6% vs 58.6%, p = 0.014), needing the necessary materials (47.3% vs 37.6%, p = 0.033), triggers to prompt them (44.0% vs 31.6%, p = 0.006) and feeling they want to do it enough (73.4%, 63.2%, p = 0.018). CONCLUSION: These unique preferences should be considered in future postpartum lifestyle interventions to enhance engagement, improve health and reduce risk of future cardiometabolic disease in these high-risk women.

The Exercise Right for Active Ageing study: A pre-post evaluation of health-related quality of life and cost-utility in older Australians following a 12-week exercise programme.

OBJECTIVES: To determine the effect of a 12-week subsidised exercise programme on health-related quality of life (HRQoL) in community-dwelling older Australians, and the cost-utility of the programme. DESIGN: Quasi-experimental, pre-post study. METHODS: Participants included community-dwelling older adults, aged ≥65 years, from every state and territory of Australia. The intervention consisted of 12 one-hour, weekly, low-to-moderate-intensity exercise classes, delivered by accredited exercise scientists or physiologists (AESs/AEPs). Health-related quality of life was measured before and after programme participation using the EQ-5D-3L and converted to a utility index using Australian value tariffs. Participant, organisational and service provider costs were reported. Multivariable linear mixed models were used to evaluate the change in HRQoL following programme completion. Cost-utility outcomes were reported as incremental cost-effectiveness ratios (ICERs), based on programme costs and the change in utility scores. RESULTS: 3511 older adults (77 % female) with a median (IQR) age of 72 (69-77) years completed follow-up testing. There was a small improvement in EQ-5D-3L utility scores after programme completion (0.04, 95 % CI: 0.04, 0.05, p < 0.001). The cost per quality-adjusted life year (QALY) gained was $12,893. CONCLUSIONS: Older Australians who participated in the Exercise Right for Active Ageing programme reported small improvements in HRQoL following programme completion, and this included older adults living in regional/rural areas. Funding subsidised exercise classes, may be a low-cost strategy for improving health outcomes in older adults and reducing geographic health disparities. CLINICAL TRIAL REGISTRATION: The study was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12623000483651).

Interventions to Expand Community Pharmacists' Scope of Practice.

BACKGROUND: The role of community pharmacists has evolved beyond the dispensing of medicines. The aim of this scoping review was to describe the interventions that expand the pharmacist's scope of practice within a community pharmacy setting and assess their effectiveness. METHODS: We performed a scoping review to identify randomised controlled trials (RCTs), published worldwide from 2013 to 2024, which focused on interventions designed to expand pharmacists' scope of practice in the community. The review was undertaken in accordance with the Joanna Briggs Institute methodology for scoping reviews. To address the aim of this scoping review, the included RCTs were mapped to themes influenced by the Professional Practice Standards 2023 as developed by the Pharmaceutical Society of Australia: medication management, collaborative care and medication adherence. RESULTS: Twelve studies demonstrated the potential to expand community pharmacists' scope of practice. Two RCTs resulted in no effect of the intervention. One RCT (conducted in Italy) led to an actual change to community pharmacists' scope of practice, with a statistically significant improvement in the proportion of patients with controlled asthma. CONCLUSIONS: On the whole, this scoping review synthesised the findings of peer-reviewed RCT studies that revealed expanding community pharmacists' scope of practice may result in improved patient outcomes, a reduced burden for the healthcare system, and greater productivity.

Characterising Parent-Appeal Marketing on Foods for Children: A Scoping Review.

PURPOSE OF REVIEW: This scoping review examines current evidence on parent-appeal marketing on the front-of-pack of food products for children and the impacts on parents' perceptions, intentions, and behaviours. RECENT FINDINGS: Thirteen relevant studies were identified. Marketing features on packages of foods for children that appealed to parents include health claims, nutrition claims, non-nutrient claims such as 'natural', healthy-looking product images, images of healthy ingredients, and celebrity endorsements. At the same time, parents were wary of front-of-pack marketing and find it confusing, deceptive, and misleading. Child-appeal marketing features such as cartoon characters and bright colours gave parents the perception that products were unhealthy. Overall, this scoping review offers important insights into the types of front-of-pack marketing that appeal to parents and offers an inventory of parent-appeal marketing features. These findings support the design and implementation of policies that aim to reduce commercial influences on children's diets through stronger regulation of marketing of foods for children.

A longitudinal qualitative exploration of victorian healthcare workers' and organisations' evolving views and experiences during COVID-19.

BACKGROUND: The COVID-19 pandemic has profoundly impacted individuals, society, and healthcare organisations worldwide. Recent international research suggests that concerns, needs, and experiences of healthcare workers (HCWs) have evolved throughout the pandemic. This longitudinal qualitative study explored the evolving views and experiences of Victorian healthcare workers (HCWs) and organisational key personnel during the coronavirus disease (COVID-19) pandemic. METHODS: We recruited participants from the Coronavirus in Victorian Health and Aged care workers (COVIC-HA) study cohort. We conducted two rounds of semi-structured interviews with HCWs and organisational key personnel from three different healthcare settings (hospital, aged care and primary care) in Victoria, Australia, in May-July 2021 and May-July 2022. Data were analysed thematically using trajectory and recurrent cross-sectional approaches, guided by a temporal change framework. RESULTS: Twelve HCWs and five key personnel from various professional roles participated in interviews at both timepoints. Expected themes derived from mid-2021 interviews (navigating uncertainty, maintaining service delivery, and addressing staff needs) evolved over time. Concerns shifted from personal health and safety to workforce pressures, contributing to HCW burnout and fatigue and ongoing mental health support needs. New themes emerged from mid-2022 interviews, including managing ongoing COVID-19 impacts and supporting the healthcare workforce into the future. Clear and consistent communication, stable guidelines and forward-looking organisational responses were considered crucial. CONCLUSIONS: Our longitudinal qualitative study highlighted the evolving impact of the COVID-19 pandemic on HCWs' perceptions, health and wellbeing and uncovered long-term sector vulnerabilities. Analysing HCW experiences and key personnel insights over time and across different pandemic phases provided crucial insights for policymakers to protect the healthcare workforce. Findings emphasise the need for proactive strategies that prioritise HCWs' wellbeing and workforce sustainability. Policy makers must invest in HCW health and wellbeing initiatives alongside healthcare system improvements to ensure resilience and capacity to meet future challenges. TRIAL REGISTRATION: This study was approved through the Victorian Streamlined Ethical Review Process (SERP: Project Number 68,086) and registered with ANZCTR (ACTRN12621000533897) on 6 May 2021.

Health System and Individual Barriers to Supporting Healthy Gestational Weight Gain and Nutrition: A Qualitative Study of the Experiences of Midwives and Obstetricians in Publicly Funded Antenatal Care in Tasmania, Australia.

Individual and health system barriers can impede clinicians from supporting weight-related behaviour change for pregnant women, particularly in publicly funded antenatal care accessed by women from diverse socioeconomic backgrounds. The aim was to understand clinicians' experiences of supporting healthy gestational weight gain for pregnant women in a publicly funded antenatal setting. The work was undertaken to guide the implementation of systems changes, resource development, and workforce capacity building related to nutrition, physical activity, and gestational weight gain in the service. The qualitative descriptive study used purposive sampling and semi-structured interviews conducted between October 2019 and February 2020. Nine midwives and five obstetricians from a publicly funded hospital antenatal service in Tasmania, Australia participated. Interview transcripts were analysed using inductive thematic analysis. The three dominant themes were prioritising immediate needs, continuity of care support weight-related conversations, and limited service capacity for weight- and nutrition-related support. The subthemes were different practices for women according to weight and the need for appropriately tailored resources. Improving access to continuity of care and clinician training, and providing resources that appropriately consider women's socioeconomic circumstances and health literacy would enhance the ability and opportunities for clinicians to better support all women.

Building CapaCITY/É for sustainable transportation: protocol for an implementation science research program in healthy cities.

INTRODUCTION: Improving sustainable transportation options will help cities tackle growing challenges related to population health, congestion, climate change and inequity. Interventions supporting active transportation face many practical and political hurdles. Implementation science aims to understand how interventions or policies arise, how they can be translated to new contexts or scales and who benefits. Sustainable transportation interventions are complex, and existing implementation science frameworks may not be suitable. To apply and adapt implementation science for healthy cities, we have launched our mixed-methods research programme, CapaCITY/É. We aim to understand how, why and for whom sustainable transportation interventions are successful and when they are not. METHODS AND ANALYSIS: Across nine Canadian municipalities and the State of Victoria (Australia), our research will focus on two types of sustainable transportation interventions: all ages and abilities bicycle networks and motor vehicle speed management interventions. We will (1) document the implementation process and outcomes of both types of sustainable transportation interventions; (2) examine equity, health and mobility impacts of these interventions; (3) advance implementation science by developing a novel sustainable transportation implementation science framework and (4) develop tools for scaling up and scaling out sustainable transportation interventions. Training activities will develop interdisciplinary scholars and practitioners able to work at the nexus of academia and sustainable cities. ETHICS AND DISSEMINATION: This study received approval from the Simon Fraser University Office of Ethics Research (H22-03469). A Knowledge Mobilization Hub will coordinate dissemination of findings via a website; presentations to academic, community organisations and practitioner audiences; and through peer-reviewed articles.

Intervention Strategies to Address Barriers and Facilitators to a Healthy Lifestyle Using the Behaviour Change Wheel: A Qualitative Analysis of the Perspectives of Postpartum Women.

Postpartum women experience unique barriers to maintaining healthy lifestyles after birth. Theory-based behaviour change techniques and intervention strategies can be integrated into postpartum lifestyle interventions to enable women to overcome barriers to change. This study aims to explore barriers and facilitators to engaging in healthy postpartum lifestyle behaviours and develop intervention strategies for integration in a postpartum lifestyle intervention using the Behaviour Change Wheel (BCW). Semi-structured interviews were conducted with women up to two years postpartum (n = 21). Interviews were thematically analysed, themes were mapped to the Capability, Opportunity, and Motivation Model of Behaviour Change and intervention strategies were developed using the BCW. Findings suggest that women face barriers and facilitators within capability (sleep deprivation, mental exhaustion, ability to plan), opportunity (support of friends, partners and extended families) and motivation (challenges with prioritising self, exercise to cope with stress). Intervention strategies included supporting behaviour regulation and sleep to enhance capability, engaging partners, strengthening peer support to create opportunities and highlighting the mental health benefits of healthy lifestyles to inspire motivation. Integrating targeted evidence-based behaviour change strategies into postpartum lifestyle interventions may support women in overcoming commonly reported barriers to a healthy lifestyle.

Supporting the next generation of prevention research leaders to conduct effective research-policy partnerships.

Successful research-policy partnerships rely on shared vision, dedicated investment, and mutual benefits. To ensure the ongoing value of chronic disease prevention research, and support research translation and impact, Australia needs funding, university, and policy systems that incentivise and support emerging leaders to drive effective partnerships.

Environmental assessments in the workplace: an analysis of workplace wellbeing facilities for people of reproductive age.

OBJECTIVE: To investigate the availability of resources at an Australian university workplace to support the health, wellbeing, and transition to parenthood of female employees working during the preconception, pregnancy, and postpartum periods. Type of program or service: Workplace health promotion for female employees of reproductive age. METHODS: A survey of female employees aged 18-45 years evaluated participant health practices, availability of work and parenting supports, and access to health and wellbeing resources in the workplace. Additionally, an environmental assessment was completed by employees with a knowledge of local healthy lifestyle supports and a minimum of 2 years' employment. The assessment documented site characteristics and availability of wellbeing facilities across 10 campuses. RESULTS: There were 241 valid survey responses. Of 221 respondents to a question about workplace support, 76% (n = 168) indicated that the workplace should play a role in supporting the transition to parenthood and in health promotion, with 64.1% of 223 participants disagreeing with the statement "my health is not the responsibility of the university". Both the survey and environmental assessment revealed that access to parenting resources to support employee health and wellbeing were suboptimal. LESSONS LEARNT: There is a misalignment between the needs of female employees working during these health-defining life stages, and the availability of resources to support those needs. Regulatory guidance may be required to navigate resource gaps within the work environment and address factors impacting the health and wellbeing of employees of reproductive age.

SWIPE: a conceptual, multi-perspective model for understanding and informing interventions for weight stigma in preconception, pregnancy, and postpartum.

Weight stigma is salient across the preconception, pregnancy, and postpartum (PPP) periods because of prevailing prescriptive norms and expectations about weight and weight gain during the reproductive period. Weight stigma is associated with negative physical and psychological health outcomes for mother and child. A clearly defined, multi-level conceptual model for interventions, research, and policy is critical to mitigating the adverse effects of weight stigma in PPP populations. Conceptual models of weight stigma towards PPP women have advanced our understanding of this issue and guided evidence accumulation but there remains a gap in informing the translation of evidence into action. Guided by evidence-based paradigms for conceptual model development, this paper has two primary objectives. First, we review and summarise theories, frameworks, and models from the PPP population and general literature to inform our understanding of the development and perpetuation of weight stigma for PPP women. Second, we propose a novel comprehensive intervention-guiding conceptual model that draws from and synthesises across multiple disciplines - the SWIPE (Stigma of Weight In the PPP Experience) model. This conceptual model will help to plan coordinated, multi-layered, and effective strategies to reduce and ultimately eliminate weight stigma for PPP women.