Impact on stakeholders of a cultural adaptation of a social and emotional well-being intervention in an Aboriginal community.

PURPOSE: Australian Indigenous people conceptualise health broadly as situated within a social and emotional well-being (SEWB) framework. A consultation process with an Aboriginal community revealed that the fundamental principles of the population wide, community-based Act-Belong-Commit mental health promotion Campaign were consistent with Aboriginal people's understanding of SEWB and that a cultural adaptation of the Campaign would be welcomed in the community. The purpose of this paper is to present key stakeholders' feedback on the Campaign adaptation. METHODOLOGY: Two years after implementation of the Campaign, individual in-depth interviews were conducted with a purposeful sample of n = 18 Indigenous and non-Indigenous stakeholders to identify ongoing issues in the community and assess their reactions to the Campaign implementation and perceptions of the effects of the Campaign on the community. RESULTS: The two primary factors influencing stakeholder acceptance of the Campaign in the community were (i) the nature of the consultation process that clearly acknowledged that it was for the community to decide whether or not to adopt the Campaign and (ii) the ability of the Aboriginal Project Manager to gain the trust of the community, bring stakeholders together and illustrate the Act-Belong-Commit principles in her actions in the community. Stakeholders reported observing social and emotional well-being benefits for individuals, their families and the whole community. CONCLUSION: Overall, the results suggest that the Act-Belong-Commit mental health promotion Campaign can be successfully culturally adapted as a community-based, social and emotional well-being Campaign in Aboriginal and Torres Strait communities. SO WHAT?: The Act-Belong-Commit cultural adaptation in Roebourne provides an evidence-based best practice model for the development of culturally appropriate mental health promotion campaigns in Indigenous communities around Australia.

Impact on Students of the Act-Belong-Commit Mentally Healthy Schools Framework.

Schools can have a significant role in affecting the mental health and wellbeing of both students and staff, with considerable implications for society as a whole. Hence, there is a need for school-based interventions to both assist those experiencing mental health problems and to implement activities and policies that facilitate the enhancement and maintenance of good mental health. Unlike most school mental health interventions that are focussed on, and specific to, the school setting, the Act-Belong-Commit Mentally Healthy Schools Framework is based on the principles of the Act-Belong-Commit community-wide general population mental health promotion campaign, which has been adapted to the school setting via the World Health Organisation's Health Promoting Schools Framework. The Mentally Healthy Schools Framework is a whole-school approach to enhancing both student and staff mental health. This paper reports the findings of a preliminary impact survey administered to students after the adoption of the Framework in a number of primary and secondary schools in Western Australia. Students from two schools that had only recently adopted the Framework completed a "Baseline" questionnaire, and students from three schools that had been implementing the Framework for at least 17 months completed a "Follow-up" questionnaire. The results suggest that the Mentally Healthy Schools Framework, adapted from a community-wide campaign, can have a positive impact on students in terms of increasing openness about mental health, increasing awareness of behaviours conducive to good mental health, and increasing engagement in behaviours to improve their mental health. Such positive impacts have clear implications not only for prevention of mental disorders, but for academic achievement, employment, and overall contribution to society.

Twenty-One Reasons for Implementing the Act-Belong-Commit-'ABCs of Mental Health' Campaign.

While there has been increased attention worldwide on mental health promotion over the past two decades, what is lacking in many countries around the globe is practical knowledge of what constitutes a population-wide mental health promotion campaign, and how such a campaign can be implemented. This paper provides such knowledge based on the development, implementation and evaluation of the Act-Belong-Commit campaign, the world's first comprehensive population-wide public mental health promotion campaign which was launched in 2008 in Western Australia. Given the learnings from the full-scale implementation and evaluation of the campaign in Western Australia and its expansion nationally and internationally, along with the continuing and expanding evidence base for the campaign constructs, we crystallise 21 reasons why jurisdictions who wish to achieve the goals of the WHO and adopt the recommendations of the European framework on mental health and wellbeing should consider adopting or adapting Act-Belong-Commit when considering implementing a public mental health promotion campaign.

Factors influencing the willingness of community service organisation staff to provide smoking cessation support: a qualitative study.

OBJECTIVE: This study aimed to explore factors influencing community service organisation (CSO) staff members' willingness to provide tobacco cessation support to clients experiencing disadvantage. METHODS: Face-to-face semi-structured interviews were conducted with 29 staff members from seven services in the alcohol and other drugs, homelessness, and mental health sectors in Western Australia. RESULTS: The primary barriers to providing cessation support were believing that addressing smoking was not a priority relative to other issues, being a current smoker, and the lack of a formal tobacco cessation program within the organisation. Factors that appeared to be most influential in enabling the delivery of cessation support were organisational processes requiring staff to routinely ask clients about tobacco use, confidence to provide support, and being a past smoker. CONCLUSIONS: The introduction of organisational procedures that include routine cessation care should be of high priority in CSOs to help reduce smoking rates among clients. Staff may also benefit from receiving training in the provision of cessation support and education about the importance and feasibility of addressing smoking concurrently with other issues. Implications for public health: The results may inform future efforts to increase the delivery of cessation care to groups of people experiencing disadvantage and comorbidity.

Receptiveness to smoking cessation training among community service organisation staff.

ISSUE ADDRESSED: Smoking rates among people experiencing disadvantage are significantly higher than for the general population. Community service organisations (CSOs) have been suggested as appropriate settings to address tobacco use among this subgroup. This study aimed to (a) assess CSO staff members' interest in receiving smoking cessation training, (b) explore the factors associated with interest and (c) identify preferred cessation support information formats. METHODS: An online survey was administered to CSO staff across Australia. Respondents were asked about the main groups targeted by their service, their role in the organisation and their interest in receiving smoking cessation training. Logistic regression analyses were used to identify factors associated with receptiveness to smoking cessation training. RESULTS: Of the 242 CSO staff members responding to the survey, 53% were interested in receiving training. Having more frequent contact with clients and working at an organisation supporting people with a mental illness were positively associated with being interested in undertaking training. Online resources were identified as a preferred form of information relating to cessation support provision. CONCLUSIONS: CSO staff who have frequent contact with clients may be receptive to training that would enable them to provide smoking cessation support to people experiencing disadvantage. SO WHAT?: CSOs represent an important setting for smoking cessation interventions given their existing relationship with people who have high smoking rates and the apparent receptiveness of CSO staff to participate in such initiatives.

Potential sources of cessation support for high smoking prevalence groups: a qualitative study.

Objective This study aimed to: i) explore potential sources of cessation support as nominated by disadvantaged smokers; and ii) identify factors influencing decisions to use these sources. Methods Semi-structured interviews were conducted with 84 smokers accessing community service organisations from the alcohol and other drugs, homeless, and mental health sectors. Transcripts were coded and thematically analysed. Results Doctors emerged as the most commonly recognised source of cessation support, followed by Quitline, community service organisation staff; and online resources. The main factors contributing to the possible use of these sources of support were identified as awareness, perceived usefulness and anticipated emotional support. Conclusions The results suggest that doctors are an important group to consider when developing cessation interventions for disadvantaged smokers due to their recognised ability to provide practical and emotional support. However, efforts are needed to ensure doctors are aware of the benefits of cessation for these groups. Community service organisations appear to be another potentially effective source of cessation support for disadvantaged smokers. Implications for public health The results indicate that cessation interventions among high-priority groups should endeavour to provide personalised emotional and practical support. Doctors and community service organisation staff appear to be well-placed to deliver this support.

Attitudinal and behavioural responses to increasing tobacco control regulation among high smoking prevalence groups: A qualitative study.

INTRODUCTION AND AIMS: Despite substantial reductions in smoking prevalence in many countries, rates remain high among people who are experiencing disadvantage. This study aimed to explore attitudinal and behavioural responses to population-wide tobacco control policies among Australian smokers experiencing disadvantage. DESIGN AND METHODS: Semi-structured qualitative interviews were conducted with 84 smokers attending community service organisations in the mental health, homelessness, and alcohol and other drug sectors. Interviewees discussed various tobacco control policies (tobacco taxes, smoke-free areas, plain packaging and graphic health warnings). The interview transcriptions were coded and thematically analysed. RESULTS: Responses to tobacco taxes were mixed. Some interviewees reported smoking less as a result of price increases, while others reallocated funds from other budget areas. Many perceived smoke-free area policies as effective, although some described strategies they use to circumvent this policy, thereby diminishing its effectiveness. Plain packaging and graphic warnings were perceived as being least effective. DISCUSSION AND CONCLUSIONS: While tobacco control policies can elicit intended attitudinal and behavioural responses, additional efforts are needed to enhance their effectiveness among smokers experiencing disadvantage. Future efforts to reduce smoking rates should address responses that diminish policy effectiveness among groups exhibiting high smoking prevalence. This could be achieved through strategies that address the specific needs of these groups, such as providing additional cessation support, enforcing existing smoke-free policies in ways that minimise inequitable effects, and addressing self-exempting beliefs.

Developing a culturally appropriate branding for a social and emotional wellbeing intervention in an Aboriginal community.

ISSUE ADDRESSED: An initial consultation process to implement a culturally appropriate social and emotional wellbeing campaign in an Aboriginal community indicated that the fundamental principles of the Act-Belong-Commit mental health promotion campaign were acceptable, but that a cultural adaptation of the branding should be sought. METHODS: A competition was held inviting community members to design a brand logo for the campaign in their community. Local judges selected "winners" in various categories, and six of the submissions were selected for testing in the broader community via street intercept interviews. Respondents were asked which logo they liked best, their perceived meanings of the designs and the perceived appropriateness of the designs for a social and emotional wellbeing campaign. RESULTS: A convenience sample of N = 26 local Aboriginal people who lived and/or worked in Roebourne completed the questionnaire. There was a clear majority preference for logo "D," which communicated appropriate meanings of pride and strength in standing together, and reflected the underlying strengths and capacities of Aboriginal people which this project seeks to harness and support. CONCLUSIONS: The approach of using a logo competition to develop the campaign brand was highly successful and enabled further meaningful engagement with the community and other service providers in the town. The success of the competition process resulted from an emphasis on relationship building, listening to the local community and involving the community in decision-making. So what? By conforming to established, but not always adhered to, recommendations for community consultation, successful and more enduring outcomes are likely.

Act-Belong-Commit: Lifestyle Medicine for Keeping Mentally Healthy.

Lifestyle medicine has generally focused on behaviors related to improving physical health and preventing physical illnesses, with little attention to behaviors related to mental health. This reflects the far greater concern in health systems around the globe for physical health over mental health. The Act-Belong-Commit campaign is the first major attempt to provide a lifestyle framework for promoting mental health that can be applied at a population level, within specific settings, and in the clinic. This article describes the campaign and offers clinicians a guide to implementing the campaign in their practice.

Impact on community organisations that partnered with the Act-Belong-Commit mental health promotion campaign.

ISSUE ADDRESSED: A primary aim of the pilot phase of the Act-Belong-Commit mental health promotion campaign was to form partnerships with community organisations. As a component of the broader campaign strategy, collaborating organisations promoted their activities under the Act-Belong-Commit banner in exchange for resources, promotional opportunities and capacity building in event management and funding. METHODS: The impact of the Act-Belong-Commit campaign on the capacity and activities of collaborating organisations during the pilot phase was evaluated using self-completed mail surveys in 2006 and 2008. RESULTS: Collaboration with the campaign had a positive impact on community organisations' capacity, including staff expertise, media publicity and funding applications. Collaborating organisations had strong positive perceptions of Act-Belong-Commit officers and all expressed a willingness to collaborate in future events and activities. CONCLUSIONS: The partnership model used during the pilot phase of the Act-Belong-Commit campaign was successful in creating mutually beneficial exchanges with collaborating organisations. So what? Community partnerships are necessary for the effective delivery of mental health promotion campaigns at a local level. Successful partnerships involve the provision of real and valuable benefits to collaborating organisations in return for their cooperation in promoting health messages.