Gaawaadhi Gadudha: understanding how cultural camps impact health, well-being and resilience among Aboriginal adults in New South Wales, Australia-a collaborative study protocol.

INTRODUCTION: The health and well-being of Aboriginal Australians is inextricably linked to culture and Country. Our study challenges deficit approaches to health inequities by seeking to examine how cultural connection, practice and resilience among Aboriginal peoples through participation in 'cultural camps' held on sites of cultural significance promotes health and well-being. METHODS AND ANALYSIS: The study will be undertaken in close collaboration and under the governance of traditional cultural knowledge holders from Yuwaalaraay, Gamilaraay and Yuin nation groups in New South Wales, Australia. Three cultural camps will be facilitated, where participants (n=105) will engage in activities that foster a connection to culture and cultural landscapes. A survey assessing connection to culture, access to cultural resources, resilience, self-rated health and quality of life will be administered to participants pre-camp and post-camp participation, and to a comparative group of Aboriginal adults who do not attend the camp (n=105). Twenty participants at each camp (n=60) will be invited to participate in a yarning circle to explore cultural health, well-being and resilience. Quantitative analysis will use independent samples' t-tests or χ2 analyses to compare camp and non-camp groups, and linear regression models to determine the impact of camp attendance. Qualitative analysis will apply inductive coding to data, which will be used to identify connections between coded concepts across the whole data set, and explore phenomenological aspects. Results will be used to collaboratively develop a 'Model of Cultural Health' that will be refined through a Delphi process with experts, stakeholders and policymakers. ETHICS AND DISSEMINATION: The study has ethics approval from the Aboriginal Health and Medical Research Council (#1851/21). Findings will be disseminated through a combination of peer-reviewed articles, media communication, policy briefs, presentations and summary documents to stakeholders.

'Surrounding yourself with beauty': exploring the health promotion potential of a rural garden appreciation group.

Gardening has the potential to enhance health and well-being, through increased physical activity and social connectedness. However, while much is known about the benefits of garden activities, less is known about the potential health implications of more passive forms of engagement with gardens, for example, viewing gardens. In addition, much garden research is undertaken in urban settings, leaving little known about potential health impacts for rural populations. The present study explored these research gaps by gaining an understanding of the experiences and perspectives of members of a gardening appreciation group in rural Australia: The Colac Horticultural and Marvellous Property Appreciation Society (CHAMPAS). A phenomenological, qualitative methodology was applied, using semi-structured interviews for data collection. Eleven participants were selected using purposive and snowball sampling and the data were analysed by applying interpretive, reflexive thematic analysis. Four main themes and supporting sub-themes were generated. The four main themes were: (i) motivations for maintaining participation in CHAMPAS; (ii) social connections and friendships, formed from membership; (iii) sense of community and structure of CHAMPAS and (iv) the perceived health and well-being benefits of continued involvement in this group. This study found that members perceived health and well-being benefits stemmed from CHAMPAS facilitation of social connectedness, function as a community group and a way for members to share a love for home gardening. This study provides insights into the perceived and potential health-promoting effects of garden appreciation groups for rural populations.

There are many health and well-being benefits of gardening. However, research is predominantly focused on the active practice of gardening in urban environments, and little is known about the passive activity of garden appreciation, nor about the benefits of this activity in rural areas. This paper explores the health promotion potential of garden appreciation groups through the experiences of members of a rural group called CHAMPAS. Eleven members of CHAMPAS were asked to talk about what kept them attending, and what health and well-being benefits the group provided them. The study found that CHAMPAS benefits stemmed from its function as a social group and a way for members to share a love for home gardening. The findings suggest that garden appreciation groups potentially provide health promotion benefits for people in rural areas. A recommendation of this paper is to undertake further research to map and analyse these benefits across rural Australia.

Experiences of gardening during the early stages of the COVID-19 pandemic.

Gardening has the potential to improve health and wellbeing, especially during crises. Using an international survey of gardeners (n = 3743), this study aimed to understand everyday gardening experiences, perspectives and attitudes during early stages of the COVID-19 pandemic in 2020. Our qualitative reflexive thematic and sentiment analyses show that during the first months of the COVID-19 pandemic, gardening seemed to create a safe and positive space where people could socially connect, learn and be creative. Participants had more time to garden during the pandemic, which led to enhanced connections with family members and neighbours, and the ability to spend time in a safe outdoor environment. More time gardening allowed for innovative and new gardening practices that provided enjoyment for many participants. However, our research also highlighted barriers to gardening (e.g. lack of access to garden spaces and materials). Our results illustrate the multiple benefits of gardening apparent during COVID-19 through a lens of the social-ecological model of health.

A transformative mission for prioritising nature in Australian cities.

Australia is experiencing mounting pressures related to processes of urbanisation, biodiversity loss and climate change felt at large in cities. At the same time, it is cities that can take the leading role in pioneering approaches and solutions to respond to those coupling emergencies. In this perspective piece we respond to the following question: What are the required transformations for prioritising, valuing, maintaining and embracing nature in cities in Australia? We adopt the mission framework as an organising framework to present proposed pathways to transform Australian cities as nature-positive places of the future. We propose three interconnected pathways as starting actions to steer urban planning, policy and governance in Australian cities: First, cities need to establish evidence-based planning for nature in cities and mainstream new planning tools that safeguard and foreground urban nature. Second, collaborative planning needs to become a standard practice in cities and inclusive governance for nature in cities needs to prioritise Aboriginal knowledge systems and practices as well as look beyond what local governments can do. Third, for progressing to nature-positive cities, it is paramount to empower communities to innovate with nature across Australian cities. Whilst we focus on Australian cities, the lessons and pathways are broadly applicably globally and can inspire science-policy debates for the post COP15 biodiversity and COP26 climate change implementation processes.

Ethnic Variation and Its Association With Malaria Awareness: A Cross-sectional Study in East Nusa Tenggara Province, Indonesia.

OBJECTIVES: This study investigated associations between ethnicity and malaria awareness in East Nusa Tenggara Province (ENTP), Indonesia. METHODS: A community-based cross-sectional study was conducted upon 1503 adults recruited by multi-stage cluster random sampling. A malaria awareness questionnaire was used to collect data, according to which participants were classified as aware or unaware of malaria. Logistic regression was applied to quantify the strength of associations of factors with malaria awareness. RESULTS: The participation rate in this study was high (99.5%). The participants were distributed relatively evenly among the Manggarai, Atoni, and Sumba ethnicities (33.0, 32.3, and 30.2%, respectively). Malaria awareness was significantly different amongst these groups; it was most common in the Manggarai ethnicity (65.1%; 95% confidence interval [CI], 59.9 to 70.3) and least common in the Sumba ethnicity (35.0%; 95% CI, 27.6 to 42.4). The most prominent factor influencing the malaria awareness in the Sumba and Manggarai ethnicities was education level, whilst it was socioeconomic status (SES) in the Atoni ethnicity. The likelihood of malaria awareness was significantly higher in adults with an education level of diploma or above (adjusted odds ratio [aOR], 21.4; 95% CI, 3.59 to 127.7 for Manggarai; aOR, 6.94; 95% CI, 1.81 to 26.6 for Sumba). Malaria awareness was significantly more common amongst high-SES adults in the Atoni group (aOR, 24.48; 95% CI, 8.79 to 68.21). CONCLUSIONS: Low education levels and low SES were prominent contributors to lower levels of malaria awareness in rural ENTP. Interventions should focus on improving malaria awareness to these groups to support the Indonesian government's national commitment to achieve a malaria elimination zone by 2030.

Malaria treatment-seeking behaviour and its associated factors: A cross-sectional study in rural East Nusa Tenggara Province, Indonesia.

INTRODUCTION: The World Health Organization recommends seeking medical treatment within 24 hours after transmission of malaria to reduce the risk of severe complications and its onwards spread. However, in some parts of Indonesia, including East Nusa Tenggara Province (ENTP), this adherence is not achieved for a range of reasons including delays in visiting health centres. This study aims to determine factors related to the poor understanding of appropriate malaria treatment-seeking behaviour (AMTSB) of rural adults in ENTP. AMTSB was defined as seeking treatment at professional health facilities within 24 hours of the onset of malaria symptoms. METHODS: A cross-sectional study was conducted in the East Sumba, Belu, and East Manggarai district of ENTP between October and December 2019. A multi-stage cluster sampling procedure was applied to enrol 1503 participants aged between 18 and 89 years of age. Data were collected through face-to-face interviews. Multivariable logistic regression analyses were used to assess significant factors associated with the poor understanding of AMTSB. RESULTS: Eighty-six percent of participants were found to be familiar with the term malaria. However, poor understanding level of AMTSB in rural adults of ENTP achieved 60.4% with a 95% confidence interval (CI): 56.9-63.8. Poor understanding of AMTSB was significantly higher for adults with no education (adjusted odds ratio (AOR) 3.42, 95% CI: 1.81, 6.48) compared to those with a diploma or above education level; having low SES (AOR: 1.87, 95% CI: 1.19, 2.96) compared to those having high SES; residing at least three kilometres (km) away from the nearest health facilities (AOR: 1.73, 95% CI: 1.2, 2.5) compared to those living within one km from the nearest health service; and working as farmer (AOR: 1.63, 95% CI: 1.01-2.63) compared to those working at government or non-government sector. Whilst, other factors such as ethnicity and family size were not associated with the poor understanding of AMTSB. CONCLUSION: The proportion of rural adults having a poor understanding of AMTSB was high leading to ineffective implementation of artemisinin-based combination therapies as the method to treat malaria in ENTP. Improving awareness of AMTSB for rural adults having low level education, low SES, working as a farmer, and living at least three km from the nearest health facilities is critical to support the efficacy of malaria treatment in ENTP. This method will support the Indonesian government's objective to achieve malaria elimination by 2030.

Gardening can relieve human stress and boost nature connection during the COVID-19 pandemic.

The COVID-19 pandemic has severely disrupted social life. Gardens and yards have seemingly risen as a lifeline during the pandemic. Here, we investigated the relationship between people and gardening during the COVID-19 pandemic and what factors influenced the ability of people to garden. We examined survey responses (n = 3,743) from gardeners who reported how the pandemic had affected personal motivations to garden and their use of their gardens, alongside pandemic-related challenges, such as food access during the first wave of COVID-19 (May-Aug 2020). The results show that for the respondents, gardening was overwhelmingly important for nature connection, individual stress release, outdoor physical activity and food provision. The importance of food provision and economic security were also important for those facing greater hardships from the pandemic. While the literature on gardening has long shown the multiple benefits of gardening, we report on these benefits during a global pandemic. More research is needed to capture variations in public sentiment and practice - including those who do little gardening, have less access to land, and reside in low-income communities particularly in the global south. Nevertheless, we argue that gardening can be a public health strategy, readily accessible to boost societal resilience to disturbances.

Associations of Vigorous Gardening With Cardiometabolic Risk Markers for Middle-Aged and Older Adults.

This study investigates the associations of vigorous-intensity gardening time with cardiometabolic health risk markers. This cross-sectional study (AusDiab) analyzed 2011-2012 data of 3,664 adults (55% women, mean [range], age = 59.3 [34-94] years) in Australia. Multiple linear regression models examined associations of time spent participating in vigorous gardening (0, <150 min/week, ≥150 min/week) with a clustered cardiometabolic risk (CMR) score and its components, for the whole sample and stratified by age and gender. Of participants, 61% did no vigorous gardening, 23% reported <150 min/week, and 16% reported ≥150 min/week. In the whole sample, spending ≥150 min/week in vigorous gardening was associated with lower CMR (lower CMR score, waist circumference, diastolic blood pressure, and triglycerides) compared with no vigorous gardening. Stratified analyses suggested that these associations were almost exclusively observed for older adults and women. These findings suggest the public health potential of vigorous-intensity gardening in reducing CMR.

Barriers to Accessing Healthcare: Perspectives from Autistic Adults and Carers.

Autistic adults have higher health needs compared to most, yet they continue to experience barriers to accessing appropriate healthcare. Presently, no qualitative research exists exploring these barriers which impact overall physical and mental health. We conducted a qualitative analysis in Victoria (Australia) of the perceived experiences of healthcare access for autistic adults (n = 9) and primary caregivers of autistic adults (n = 7). Specifically, a three-staged phenomenological approach was applied involving: (i) a communicative checklist, (ii) a health status survey and (iii) face-to-face interviews. Elements such as support, responsibilities and protective factors exhibited by caregivers, may impact healthcare access for autistic adults. Results indicate the need for further research exploring interdependent factors that impact healthcare access by caregivers, so evidence-based interventions can be developed to support caregivers in the future.

Malaria awareness of adults in high, moderate and low transmission settings: A cross-sectional study in rural East Nusa Tenggara Province, Indonesia.

INTRODUCTION: The 2009 Indonesian roadmap to malaria elimination indicated that the nation had been progressing towards achieving malaria elimination by 2030. Currently, most of the districts in the western part of Indonesia have eliminated malaria; however, none of the districts in the East Nusa Tenggara Province (ENTP) have met these set targets. This study aimed to investigate the status of malaria awareness of rural adults in the ENTP. METHODS: A community-based cross-sectional study was conducted between October and December 2019 in high, moderate, and low malaria-endemic settings (MESs) in the ENTP. After obtaining informed consent, data were collected using an interviewer-administered structure questionnaire among 1503 participants recruited by a multi-stage cluster sampling method. A malaria awareness index was developed based on ten questions. A binary logistic regression method was applied to investigate the significance of any association between malaria awareness and the different MESs. RESULTS: The participation rate of the study was 99.5%. Of this number, 51.4% were female and 45.5% had completed primary education. The malaria awareness index was significantly low (48.8%, 95% confidence interval [CI]: 45.2-52.4). Malaria awareness of rural adults residing in low endemic settings was two times higher than for those living in high endemic settings (adjusted odds ratio [AOR]: 2.41, 95% CI: 1.81-3.21) and the basic malaria knowledge of participants living in low malaria-endemic settings was almost four times higher than that in high endemic settings (AOR: 3.75, 95% CI: 2.75-5.11). Of the total participants, 81.3% (95% CI: 79.1-83.5) were aware that malaria could be prevented and 75.1% (95% CI: 72.6-77.6) knew at least one prevention measure. Overall, the awareness of fever as the main symptom of malaria, mosquito bites as the transmission mode of malaria, and seeking treatment within 24 hours of suffering from malaria was poor at 37.9% (95% CI: 33.9-41.9), 59.1% (95% CI: 55.9-62.3), and 46.0% (95% CI: 42.3-49.7), respectively. The poor level of awareness was significantly different amongst the three MESs, with the lowest levels of awareness in the high endemic setting. CONCLUSION: Malaria awareness of rural adults needs to be improved to address Indonesia's national roadmap for malaria elimination. Results indicated that public health programs at a local government level should incorporate the malaria awareness index in their key strategic intervention to address malaria awareness.

Where birds felt louder: The garden as a refuge during COVID-19.

During the COVID-19 pandemic, many countries experienced something of a boom in interest in gardening. Gardens have long been considered as refuges into which we retreat to escape various struggles and challenges. In this study we examine the characteristics and functions of the garden as a refuge during the period of increased garden interest associated with the COVID-19 pandemic. Analysis of qualitative results about garden experiences from 3,743 survey respondents revealed intertwining garden and emotional geographies. Utilising non-representational and therapeutic landscape theories, we found multifarious and heightened experiences of non-material aspects of gardens; that is, the sensory and emotional aspects. People experienced, for example, a sense of joy, beauty, and reassurance, a greater attunement to the natural world and an increased sense of nature connection than they had at other times: birds felt louder. These heightened sensory and emotional experiences had therapeutic benefits, across age and geographical spectrums, during these difficult times. This research improves our understandings of the positive potential of non-material aspects of gardens in the creation of therapeutic landscapes in and beyond COVID-19.

Developing a framework identifying the outcomes, principles and enablers of 'gathering places': Perspectives from Aboriginal people in Victoria, Australia.

Aboriginal 'gathering places' have been described as cultural hubs, healing centres, and social meeting places. This article explores a gap in the literature on the health and wellbeing outcomes of gathering places from the perspectives of Aboriginal people who attend them. The aim of this study was to develop a framework to articulate the enablers, principles, and outcomes of 'successful' Aboriginal gathering places. In this study, sixty-nine (n = 69) community members participated in qualitative interviews or focus group discussions across thirteen gathering place sites in Victoria (Australia). The research found that gathering places address social health disparities through the provision of a broad range of health and wellbeing programs that benefit Aboriginal community members accessing them. Gathering places were described by participants as providing connections to place, Aboriginal culture, and healing and mainstream health services that enhanced wellbeing. These findings contribute to a better understanding of how Aboriginal gathering places function and offer strategies for creating culturally safe and welcoming settings for Aboriginal peoples, with potential for consideration in international contexts. This research informed a best-practice framework and outlines different models for developing community empowering and culturally affirming gathering places for improving Aboriginal people's access to culturally appropriate health and support services, while simultaneously reducing health and social inequalities. Key elements of this framework that contribute to a successful gathering place include the people, place (location/facilities), programs and community themselves, whilst the principles that enable these places include elements like self-determination, respect of culture, sustainability and strong governance.

Epidemiology of Malaria in East Nusa Tenggara Province in Indonesia: Protocol for a Cross-sectional Study.

BACKGROUND: Malaria is a global pandemic that results in approximately 228 million cases globally; 3.5% of these cases are in Southeast Asian countries, including Indonesia. Following the World Health Organization (WHO) initiative, Indonesia is in the process of achieving malaria-free zone status by 2030. However, the eastern part of Indonesia, including the East Nusa Tenggara Province (ENTP), still has a disproportionately high rate of malaria. OBJECTIVE: The aims of this cross-sectional study are to determine the awareness and knowledge, attitude, and practice toward various aspects of malaria among rural adults and their associated factors, including sociodemographic factors and ethnicities; assess the gap between coverage of, access to, and use of long-lasting insecticide-treated nets (LLINs) among the households; estimate the prevalence of and factors associated with malaria in rural adults; and develop a risk prediction model for malaria. METHODS: A multistage cluster sampling procedure with a systematic random sampling procedure at cluster level 4 was applied to recruit 1503 adults aged 18 years or older from the ENTP. Each participant participated in a face-to-face interview to assess their awareness and knowledge, attitude, and practice toward aspects of malaria, practices of sleeping under LLINs, and history of malaria. Information on sociodemographic, environmental, and lifestyle factors was also documented. The proportion of knowledge, attitude, and practice toward aspects of malaria and their variations across different sociodemographic and ethnic groups will be analyzed using descriptive statistics and chi-square tests. Coverage and access to LLINs will be evaluated based on the WHO recommendations. Malaria risk factors will be analyzed using logistic regression. Multilevel logistic regression will be applied to estimate the risk score for malaria. RESULTS: Of the total participants, 99.46% (1495/1503) of rural adults from 49 villages in the ENTP participated in a face-to-face interview from October to December 2019. The study results are expected to be published in peer-reviewed journals. CONCLUSIONS: The best malaria risk prediction model will be developed in this study. In this protocol, we developed a methodology to provide new evidence to guide health policy in supporting the ENTP government's expectation to achieve the malaria-free rating by 2030. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/23545.

Applying the Mandala of Health in the Anthropocene.

ISSUE ADDRESSED: The Anthropocene is a new era in which human activity has been the dominant influence on climate and the environment. The negative impact humans have on the earth's systems pose significant threats to human health. Health promotion is a discipline well placed to respond to planetary health challenges of the Anthropocene. The overarching aim of this paper is to describe the elements of 21st century socio-ecological health and apply them in a revised socio-ecological framework for health promotion. METHODS: A qualitative description study design was employed to explore the significance of ecological and cultural determinants of health and review models in contemporary health promotion to inform the development of a revised Mandala of Health. Purposeful sampling was used to recruit ten experts from across Australia including academics and practitioners working at the nexus of health promotion, environmental management and sustainability. Data were analysed thematically, using deductive and inductive methods. RESULTS: A revised Mandala of Health could address existing gaps in health promotion theory and practice. Ecological and cultural determinants of health were considered essential components of health promotion that is often lacking in socio-ecological frameworks. Indigenous Knowledge Systems were considered immensely important when addressing ecological and cultural determinants of health. CONCLUSIONS: A revised Mandala of Health could encourage development of contemporary health models, assisting health promotion to evolve with the health and environmental issues of the Anthropocene. This study highlights the need for more theoretical development and empirical research regarding ecological and cultural determinants of health in a health promotion context. SO WHAT?: In the context of the Anthropocene, this study highlights the potential gaps in health promotion theory and practice in terms of the natural environment and health and emphasises the need of a paradigm shift to embed ecological and cultural determinants with other determinants of health.

Virtually Trans: an Australian Facebook group supporting gender diverse adults' health and wellbeing.

Social networking sites are the primary means by which trans and gender diverse people meet, enabling both community contact and information exchange. This study considers the meaning of participation in a secret Facebook group for trans and gender diverse adults in Melbourne (Australia). A peer ethnographic methodology was used to study the Melbourne-based group listed under the pseudonym 'Virtually Trans'. Qualitative semi-structured interviews were conducted with 12 Virtually Trans group members. Interviews were transcribed and thematically analysed. Interview data were supplemented with field notes written throughout online participation over an 8-month period to add richness and provide context to the data. Three major themes were developed from this analysis. First, experiences outside of Virtually Trans, most notably within health care settings, were perceived to be unsafe. Second, practices of care in Virtually Trans conferred a sense of kinship and identity affirmation. Finally, Virtually Trans enabled localized information exchange between peers. Virtually Trans is not a neutral platform of self-performance but a safe(r) environment for expanding the gendered possibilities of who and how people may become. This study highlights the importance of a secret Facebook group in filling care, information and resource gaps experienced by trans and gender diverse people within a major metropolitan setting. The findings have implications for practitioners working with trans and gender diverse adults and peer health navigation.

Healthcare access for autistic adults: A systematic review.

BACKGROUND: People with autism spectrum disorder (ASD) have an increased susceptibility for many chronic health conditions compared with their peers. An increasing number of adolescents are transitioning from pediatric to adult healthcare services. Thus, being able to access appropriate healthcare services that can not only address specific needs of the person but enable them to better manage healthcare conditions and decrease the development of preventable disease is necessary. A systematic review was conducted to identify barriers and enablers of healthcare access for autistic adults. METHODS: The studies included in the review were quantitative and qualitative and were published between 2003 and 2019. The participants for the review are considered to be adults (over 18 years of age) with a primary diagnosis of ASD. RESULTS: In total, 1290 studies were initially identified and 13 studies were included based on the inclusion and exclusion criteria outlined in a previous protocol paper. The analysis of these studies identified areas of concern to access appropriate healthcare, such as clinician knowledge, the environment, and life events. CONCLUSION: Identifying the barriers to healthcare, highlights ways healthcare services can regulate scope of practice, the physical environment, and the process of managing health conditions, thus, autistic adults can strive for optimal health. This review contributes to peer-reviewed evidence for future research and up-to-date information when developing and piloting health interventions for autistic adults. ETHICS AND DISSEMINATION: There are no human participants, data, or tissue being directly studied for the purposes of the review; therefore, ethics approval and consent to participate is not applicable. REGISTRATION AND STATUS: PROSPERO 2018 CRD42018116093.

A Systematic Review Protocol to Identify the Key Benefits and Associated Program Characteristics of Community Gardening for Vulnerable Populations.

Gardening has long been a popular pastime. There is a growing evidence base for the health and well-being benefits of gardening. Community gardening brings a social aspect to gardening, thereby increasing the potential benefits to include addressing social inclusion and poor community health through sharing of values, support of others, and building networks. This systematic review protocol aims to determine the characteristics of community gardening that could lead to beneficial outcomes such as connection with the community and development of new skills. Thirteen academic databases will be searched for studies looking at the benefits of community gardening, with a focus on vulnerable populations. Data will be extracted from all studies meeting the inclusion criteria and summarized to provide an overview of the current literature. This systematic review aims to provide a comprehensive investigation into community gardening, its benefits, and how they are achieved for the target population. By gathering and synthesizing this information, the review should allow policy makers and practitioners to work more effectively to address health and social inequities, by highlighting areas of need and enabling optimization of future interventions.

Trans, gender diverse and non-binary adult experiences of social support: A systematic quantitative literature review.

Background: Trans, gender diverse and non-binary (TGDNB) adults experience significant health disparities relative to their cisgender peers. While social support is a known health-protective factor within the general population, no systematic reviews of TGDNB experiences of social support exist. Aim: To systematically review prior research of social support for TGDNB adults. We sought to assess the defining characteristics of the research, the participants and the research findings, mapping emerging trends across disciplines. Methods: Six electronic databases (PubMed, MEDLINE, CINAHL, Web of Science, LGBT Life and PsycNet) were searched for literature pertaining to TGDNB adults, social support, and health or well-being published in the past decade. Results: The findings illustrate a predominance of USA-based quantitative research that measures social support of friends, family and a singular intimate partner. The majority of participants were white, binary-identified transgender women and TGDNB people living in metropolitan settings. Social support was commonly reported as a protective factor, with TGDNB peer support the most frequently reported correlate of health and well-being for TGDNB adults. Discussion: The results suggest standardized inventories do not capture the emic nature of social support for TGDNB adults. A key opportunity lies in an inductive, hypothesis-forming approach to the study of what is socially supportive for TGDNB adults. In turn, this knowledge will enable the appropriate measurement, implementation and interpretation of social support studies.

A Systematic Review Protocol Investigating Community Gardening Impact Measures.

Existing community gardening research has tended to be exploratory and descriptive, utilising qualitative or mixed methodologies to explore and understand community garden participation. While research on community gardening attracts growing interest, the empirical rigour of measurement scales and embedded indicators has received comparatively less attention. Despite the extensive body of community gardening literature, a coherent narrative on valid, high quality approaches to the measurement of outcomes and impact across different cultural contexts is lacking and yet to be comprehensively examined. This is essential as cities are becoming hubs for cultural diversity. Systematic literature reviews that explore the multiple benefits of community gardening and other urban agriculture activities have been undertaken, however, a systematic review of the impact measures of community gardening is yet to be completed. This search protocol aims to address the following questions: (1) How are the health, wellbeing, social and environmental outcomes and impacts of community gardening measured? (2) What cultural diversity considerations have existing community garden measures taken into account? Demographic data will be collected along with clear domains/constructs of experiences, impacts and outcomes captured from previous literature to explore if evidence considers culturally heterogeneous and diverse populations. This will offer an understanding as to whether community gardening research is appropriately measuring this cross-cultural activity.