'You can't really separate these risks, our environment, our animals and us': Australian children's perceptions of the risks of the climate crisis.

Perceptions of the risks associated with the climate crisis are shaped by a range of social and political contexts and information sources. While some have expressed concerns about the impact of the spread of climate misinformation through social media platforms on young people, others have shown that the youth climate movement has played a key role in countering misinformation. Despite this, there has been very limited research with children about how they conceptualize the risks associated with the climate crisis, how they receive climate information, and how they understand and apply this to their own and others' lives. The following qualitative study used photo-elicitation techniques and in-depth interviews with Australian children to address this gap. A total of n = 28 children (12-16 years) participated, with four themes constructed from the data using a reflexive approach to thematic analysis. Children were concerned about how the climate crisis would continue to harm their futures and the health of planet and people. They recognized that some groups and countries would experience more risks associated with the climate crisis as compared to others. While they received information from a range of different sources (school, family, social media), they mostly used social media to seek out climate information. They recognized that social media sites could be a source of climate misinformation, and argued that a range of strategies were needed to identify and counter false information about the climate crisis. Children's perspectives must be harnessed to improve information about climate risks and action.

Young people's views about the use of celebrities and social media influencers in gambling marketing.

Young people's exposure to gambling marketing has had a clear impact on their gambling attitudes, risk perceptions and consumption intentions. Celebrities and social media influencers (SMIs) are increasingly used by the gambling industry in a wide range of promotions. While there is evidence that these types of promotions are influential in shaping young people's attitudes towards other harmful products, there is limited evidence in relation to gambling. Qualitative focus groups (n = 22) with n = 64, 12-17 year olds were conducted in Australia. These investigated young people's exposure to celebrity and SMI marketing for gambling and the influence they perceived this marketing had on young people's gambling attitudes. Reflexive thematic analysis was used to construct four themes from the data. First, young people perceived that celebrities and SMIs created additional appeal and recall of gambling advertisements because they were attention grabbing and familiar. Second, young people thought that celebrities and SMIs increased the trust, legitimacy and social acceptance of gambling. Third, the use of celebrities and SMIs lowered the perceptions of risk associated with gambling. Lastly, there were suggestions to reduce the impact of celebrity and SMI gambling promotions on young people, such as bans and restrictions. This study highlights the importance of a comprehensive approach to preventing young people's exposure to gambling marketing, that not only considers imposing stronger regulations to restrict the way the gambling industry is allowed to promote its products, but also aims to counter the novel ways the gambling industry attempts to appeal to children and young people.

Children, young people and the Commercial Determinants of Health.

The commercial determinants of health (CDoH) have a significant impact on the health and well-being of children and young people (subsequently referred to as young people). While most research has focused on the influence of harmful industry marketing on young people, more recent CDoH frameworks have emphasized that a range of commercial systems and practices may influence health and well-being. Focusing on the impact of traditional and digital media, contemporary marketing strategies and corporate production and consumption processes, the following article outlines the impact of the CDoH on the health and wellbeing of young people. The article also provides evidence about how young people conceptualize the impact of corporate actors on health, and their involvement in advocacy strategies to respond. The article recommends that when collaborating with young people to understand the impacts of and responses to the CDoH, we should seek to diversify investigations towards the impact of a range of corporate tactics, systems and structures, rather than simply focusing on the impacts of advertising. This should include considering areas and priorities that young people identify as areas for action and understanding why some young people are more vulnerable to commercial tactics than others. Youth are powerful allies in responding to the CDoH. Public health and health promotion stakeholders could do more to champion the voices of young people and allow them to be active participants in the decisions that are made about harmful commercial practices and health.

Adolescent sexual and reproductive health and rights for ethnic minority girls in Vietnam.

There has been significant progress in improved adolescent sexual and reproductive health and rights (ASRHR) for girls across low- to- middle-income countries (LMICs). However, progress has been uneven, and disparities persistent across and within countries. For example, Vietnam is one of only nine countries to have achieved the 2015 maternal mortality rate (MMR) target of the Millennium Development Goals (MDGs) as a nation, but for some sub-populations, progress has been much slower, and MMR is more than twice that the national average. Ensuring equity is a current focus of the Sustainable Development Goals (SDGs) agenda that seeks to Leave No One Behind. This paper explores some of these inequities and potential drivers for ethnic minority adolescent girls in Vietnam, with a specific focus on the Tay community, the largest ethnic minority group in Vietnam. This paper highlights the challenges to progress, including areas where there is still limited evidence about the range of socio-cultural factors that may determine sexual and reproductive health outcomes for Tay adolescent girls. In the era of the SDGs, Vietnam's national policy platforms and current aid architecture provide a solid basis on which to build research, policy and practice investments that improve the health of adolescent ethnic minority girls in Vietnam.

Australian young people's perspectives about the political determinants of the climate crisis.

ISSUE ADDRESSED: There has been little focus on young people's views about the political determinants of the climate crisis. As young people are likely to be the group most impacted by political decisions relating to the climate crisis, it is essential to understand their views about government decision-making. METHODS: A qualitatively-led online survey of n = 500 young Australians aged 15-24 years. Open text questions sought young people's views about current government climate policies, perceptions about policy effectiveness, and how governments could improve their climate responses. Reflexive thematic analysis was used to interpret and construct themes from the data. RESULTS: Young people perceived that governments were not taking serious action on the climate crisis. They stated that climate policies were largely influenced by economic imperatives, rather than concern for the wellbeing of current and future generations. They perceived that governments had a duty of care to protect them from the climate crisis, and needed to engage young people in climate discussions and decision-making. CONCLUSIONS: Young people's perspectives about the political determinants of the climate crisis provides information about their understanding of government policies and their recommendations for action. There is a need for collaboration between young people and decision-makers to urgently develop effective climate policies. SO WHAT?: Young people understand key issues relating to the political determinants of the climate crisis. The health promotion community has a role in advocating for structural changes in policymaking processes to ensure young people have a seat at the decision-making table.

Australian youth perspectives on the role of social media in climate action.

OBJECTIVE: The climate crisis poses a significant public health threat to current and future generations. Limited research has examined young people's perspectives about the role of social media for climate awareness, action, and policy change. METHODS: Qualitatively led online survey of n=500 young Australians (aged 15-24). Questions focused on the effectiveness of social media platforms in communicating the need for climate action, with TikTok videos used to prompt about appeal strategies and campaigns. Data were analysed using a reflexive approach to thematic analysis. RESULTS: Participants perceived that social media platforms were a powerful and inclusive communication mechanism for climate action. Social media had the ability to reach diverse audiences and connect young people globally. Limitations included influencing key decision makers and risks associated with misinformation and disinformation. Participants supported messages that highlighted the urgent need for action, trusted celebrity and youth voices, and practical information to engage in action. CONCLUSIONS: Social media presents a powerful opportunity for engaging young people in discussions and decisions made about the climate crisis. IMPLICATIONS FOR PUBLIC HEALTH: The public health community should be guided by young people in developing a range of social media mechanisms to empower them to have a seat at the table in public health responses to climate.

The symbolic consumption processes associated with 'low-calorie' and 'low-sugar' alcohol products and Australian women.

The influence of commercial actors, practices and processes on the health and wellbeing of women is still not well understood. The alcohol industry has developed a range of products to appeal to new 'health conscious' markets, such as 'low-calorie' and 'low-sugar' products. While these products may have specific appeal for women, there has been little in-depth research that has sought to understand how women conceptualize these products and the range of symbolic meanings that women associate with these products. An online qualitatively led survey was conducted with n = 497 Australian women who had consumed alcohol in the last year. Questions related to the reasons for and influences on alcohol use, the purchasing of 'low-calorie' or 'low-sugar' products and the influence that these products might have on women's alcohol use. Data were interpreted using reflexive thematic analysis. Women consumed alcohol to relax, cope with everyday stressors and because of the alignment with social practices and social connection. Women perceived that these products provided a healthier alternative to traditional alcohol products and that they aligned with women's values relating to weight and the thin ideal. Some women were concerned that these products could increase alcohol consumption by reducing the perceptions of risk associated with alcohol. Policy consideration is needed to address how product claims and attributes may influence population groups' interpretations of the risks and benefits of these alcohol products, including the illusion that these products have protective potential and are better for overall health and wellbeing.

Unhealthy and health promoting sponsorship of male and female professional sporting teams in Australia.

ISSUE ADDRESSED: There are concerns that unhealthy industries may use sponsorships to align their brands with the increased popularity of professional women's sporting events. This study aimed to identify and compare the sponsors of Australian male and female professional sporting teams in relation to unhealthy industries (alcohol, gambling, discretionary food and drink, and venues) and health-promoting companies and organisations (charities, government departments, and educational institutions). METHODS: A web-based scan was conducted from July to October 2021 to identify team and uniform sponsors, with descriptive statistics used to identify and compare results. RESULTS: About one tenth of sponsors (team n = 269; 10.9%; uniform n = 62; 10.6%) were for unhealthy industries. Men's teams had a greater number of these sponsors as compared to women's teams. Just under 10% of sponsors were for health-promoting organisations (team n = 210; 8.5%; uniform n = 44; 7.5%), with women's teams more likely to have these sponsors as compared to men's teams. CONCLUSIONS: Professional sport provides an important opportunity to facilitate health-promoting rather than -harming sponsors. Health-promoting sponsors are more prominent in women's sport, but as women's professional sport continues to grow in popularity, there is a need for policy, funding, and support to prevent engagement with unhealthy industry sponsorship and create a level playing field with men's sport. SO WHAT?: Mechanisms should be developed to help sporting codes, particularly women's sport, to adopt business models that are not reliant on industries that cause harm. Establishing strong relationships with health-promoting organisations may provide alternative sponsorship opportunities for sporting teams.

The lived experience of financial harm from gambling in Australia.

The financial consequences associated with harmful gambling create significant health and social stressors for individuals, their families, and communities. However, there has been limited research exploring how people impacted by gambling harm conceptualise and experience the financial impacts on their lives. To help fill this gap, this study used in-depth qualitative interviews with gamblers harmed by their own gambling and affected others harmed by someone else's gambling. Reflexive thematic analysis was used to interpret the data. The study had three key findings. First, prior to experiencing harm, gamblers and affected others did not consider the financial risks associated with gambling and only recognised the risks once the financial losses negatively impacted other areas of their lives. Second, gamblers and affected others managed the day-to-day financial impacts of gambling by adjusting their financial priorities, reducing spending in other areas, or accruing debt. Finally, the financial impacts of gambling and the associated financial management strategies led to broader and long-term problems for gamblers and affected others. This study demonstrates that financial harms from gambling are complex and contribute to the stigmatisation of people who experience harm. Current educational messages and tools simplify this complex issue and may legitimise gambling as a leisure activity which can be managed by making 'responsible' financial decisions. Public health and health promotion initiatives must recognise this complexity, developing approaches that are independent from the gambling industry and informed by lived experience.

Australian young people's perceptions of the commercial determinants of the climate crisis.

There is increasing public health focus on how corporate practices impact population health and well-being. While the commercial determinants of the climate crisis pose serious threats to human and planetary health, governments largely seek to balance climate action with economic imperatives. Global stakeholders recognize that young people have important voices in influencing climate responses. However, few studies have investigated young people's perceptions of the commercial determinants of the climate crisis. A qualitatively led online survey of n = 500 young Australians (15-24 years) investigated their understanding of corporate responses to the climate crisis, factors that influenced these responses and strategies to respond. A reflexive approach to thematic analysis was used. Three themes were constructed from the data. First, young people perceived that corporate responses to the climate crisis focussed on soft options and lacked meaningful action. Second, they stated that these responses were largely influenced by economic imperatives rather than planetary health, with policy levers needed to implement environmentally responsible corporate practices. Third, young people perceived that systems needed change to create demand for a cleaner environment, leading to improved practices. Young people have a clear understanding of the commercial determinants of the climate crisis and associated threats to population health. They recognize that corporate practices (and consumer demand) will not change without significant policy and structural change. Public health and health promotion stakeholders should work alongside young people to influence decision-makers to address harmful corporate behaviours.

"It shows we are serious": Young people in Australia discuss climate justice protests as a mechanism for climate change advocacy and action.

OBJECTIVE: This article aims to understand young Australians' perspectives of climate justice protests as a mechanism for climate change advocacy and action. METHOD: A qualitatively led online survey was conducted with n=511 young Australians (15-24 years). Open-text questions prompted for young people's perceptions of the appeal, accessibility, and effectiveness of climate justice protests in climate change action. A reflexive thematic analysis was conducted to construct themes from the data. RESULTS: Participants perceived that protests were an important mechanism for young people to draw attention to the need for climate action. However, they also stated that the clear messages that were sent to governments via protests did not necessarily lead to government action. Young people perceived that there were some structural issues that prevented them from taking part in these types of activities, including living far away from protests, not being accessible for young people with disabilities, and limited support from family members and/or friends to participate. CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH: Climate justice activities engage young people and give them hope. The public health community has a role to play in supporting access to these activities and championing young people as genuine political actors in addressing the climate crisis.

Older adults' perceptions of the risks associated with contemporary gambling environments: Implications for public health policy and practice.

Introduction: Rapid changes in the Australian gambling environment have amplified the risks for gamblers and pose significant threats to public health. Technological advances, saturation of marketing, and the embedding of gambling in sport have all contributed to significant changes in the gambling risk environment. Older adults have witnessed the changes to the way gambling is provided and promoted in public spaces, but little is known about how these changes have shaped the way they conceptualize the risks associated with gambling. Method: Guided by critical qualitative inquiry, semi structured interviews were conducted with 40 Australian adults aged 55 years and older, who had gambled at least once in the last 12 months. Reflexive thematic analysis was used to interpret the data. Results: Participants discussed gambling environments in Australia and how they had changed through the proliferation of gambling products, environments, and opportunities; the risks posed through the embedding of gambling in community and media environments; the role of technology in gambling environments; and the role of marketing and promotions in the changing gambling environments. Participants recognized that these factors had contributed to gambling environments becoming increasingly risky over time. However, despite the perception of increased risk, many participants had engaged with new gambling technologies, products, and environments. Discussion: This research supports the adoption of public health responses that include consideration of the environmental, commercial, and political factors that may contribute to risky gambling environments.

Protecting children and young people from contemporary marketing for gambling.

Around the world, children are being exposed to intensive marketing for gambling products. This normalizes perceptions that gambling is essentially a harmless form of entertainment, despite mounting evidence of the harms it causes. Young people and their parents are supportive of strategies to protect children from being exposed to gambling marketing. Yet existing regulatory efforts are inconsistent and inadequate, and have not protected children from exposure to the many forms of marketing now being developed and exploited by the gambling industry. We outline existing knowledge about strategies used by the gambling industry to market its products, with a specific focus on the potential impact of gambling marketing on young people. We provide a definition of gambling marketing and outline the different forms of promotion that are currently used to market gambling, current regulatory responses, and the impact of marketing on children and young people. We then argue that a comprehensive public health approach to gambling is urgently required, which must include effective action to limit the influence of marketing for gambling products, while recognizing that it is never possible to insulate children entirely from their reach.

• Gambling marketing has become particularly pervasive and aligned with major cultural activities such as sport. • Evidence clearly shows the normalizing impact of marketing on children and young people's gambling attitudes and consumption intentions. • Current regulatory efforts are inadequate and have not protected children and young people from exposure to a range of different forms of marketing. • Young people and their parents support the implementation of significant restrictions on gambling marketing. • The array of marketing mechanisms used by the gambling industry should be addressed as part of a comprehensive public health policy approach to protect children from gambling harms.

The impact of responsible gambling framing on people with lived experience of gambling harm.

Background: The framing of health issues influences how people think about and respond to these topics. Gambling has largely been framed as an issue of personal responsibility, with the gambling industry, governments and some researchers promoting responsible gambling strategies as a way to address gambling harm. While there is evidence that the internalization of personal responsibility can negatively impact gamblers, this study aimed to explore how people who have experienced gambling harm interpret and apply personal responsibility frames and 'gamble responsibly' messages in their lives. Methods: In-depth semi-structured interviews were conducted via Zoom and telephone with 15 gamblers who had been harmed by their own gambling and six affected others who had been harmed by someone else's gambling. This study was informed by public health and critical qualitative approaches to inquiry. The data were analyzed using reflexive thematic analysis. Results: Four themes were constructed from the data. First, gamblers and affected others generally conceptualized gambling and gambling harm as being the responsibility of the individual because it was perceived as the outcome of individual behavior. Second, they attempted to apply responsibility to their own experience either as gamblers who tried to stop or reduce their gambling, or affected others who felt responsible for helping the gambler in their lives. Third, gamblers and affected others were negatively impacted when it was perceived the gambler could not 'control' their gambling or had not done enough to take responsibility. Finally, gamblers and affected others recommended responsible gambling strategies be reframed to be more effective at addressing gambling harm. Conclusion: This study provides evidence further supporting research demonstrating that personal responsibility frames may have unintended or negative consequences for gamblers and affected others. It underscores the need to reframe public messages about gambling away from responsible gambling, and toward research-based messages that can complement broader legislative changes and other measures to protect individuals.

A scoping review of the individual, socio-cultural, environmental and commercial determinants of gambling for older adults: implications for public health research and harm prevention.

Gambling is a global public health issue that can cause harm to individuals, families, and communities. Older adults are vulnerable to gambling harm due to life-stage experiences. This study aimed to examine current research relating to individual, socio-cultural, environmental, and commercial determinants of gambling among older adults. A scoping review was conducted (PubMed, PsycInfo, SocIndex, CINAHL Complete, Web of Science, Social Science and Sociology databases available in ProQuest, Google Scholar, citation searching), with peer reviewed studies included that were published between 1 December 1999 and 28 September 2022. Included studies were published in English in peer-reviewed journals that examined the determinants of gambling in adults aged 55 and over. Records were excluded if they were experimental studies, prevalence studies or had a population wider than the required age group. Methodological quality was assessed using JBI critical appraisal tools. Data was extracted using a determinants of health framework and common themes were identified. Forty-four were included. Most literature examined individual and socio-cultural determinants including reasons for gambling, risk management strategies, and social motivations for gambling. Few studies investigated environmental or commercial determinants, and those that did focused on accessibility of venues or promotions as pathways to gambling. Further research is needed to understand the impact of gambling environments and industry, and effective public health responses for older adults.

"They loved gambling more than me." Women's experiences of gambling-related harm as an affected other.

BACKGROUND: Gambling poses a global threat to public health due to its far-reaching impacts. Research has demonstrated a ripple effect of harmful gambling on social network members and broader communities. While researchers have documented extreme harms associated with an affected other, limited research has qualitatively investigated how women describe their concerns about the gambling of a social network member, and any subsequent negative impacts on their own lives. METHODS: An online panel survey was conducted with women aged 18 years and older, who gambled at least once in the last 12 months, and resided in the Australian states of Victoria and New South Wales. This paper focused on the open text responses of a subsection of the sample (n = 136) who reported being negatively impacted by someone else's gambling. The study utilised reflexive thematic analysis to interpret the data. RESULTS: Results indicated that women were concerned about the gambling behaviours of a broad range of social network members. Open text responses regarding the nature of these concerns mostly related to individualised paradigms of gambling behaviour - including whether the participant perceived their network member could afford to gamble, was being responsible with their gambling, or were gambling too frequently. Participants experienced a range of negative impacts including significant financial issues, relationship difficulties, poorer emotional wellbeing as a result of worrying about the gambler, and loss of trust. Some described the negative experiences associated with growing up with a parent who gambled. CONCLUSION: The research demonstrates the broad impacts of gambling on affected others. This study enhances our understanding of how women are harmed by gambling and considers the complexities of their experiences and relationships with the gambler. This extends knowledge beyond quantitative descriptors of harm among affected others and provides a critical reflection on the nuances of women's experiences with gambling and gambling harm.