Objective Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) people experience disproportionate mental health and alcohol and other drug (AOD) burdens and have distinct care needs, yet limited evidence on the characteristics of LGBTQ+ community-controlled organisations constrains optimal service design and delivery. This study aimed to map the landscape of LGBTQ+ community-controlled mental health and AOD organisations that provide mental health and AOD services across Australia. Methods A mixed-methods study involved 16 LGBTQ+ community-controlled organisations, using an online cross-sectional survey and semi-structured interviews. Descriptive and content analyses examined organisational characteristics and service provision. A common practice elements approach integrated both data sources to identify shared organisational and service elements. Results Organisations varied substantially in size, workforce composition, and service models. All organisations provided mental health services, and nine provided AOD services. Eight common practice elements were identified: LGBTQ+ governance and infrastructure, embedded community responsiveness, integrated holistic services, collaborative partnerships, community building, foundational knowledge, relational practice, and safety-oriented approaches. Conclusions LGBTQ+ community-controlled organisations provide essential, contextually safe mental health and AOD services and operate through distinctive yet commonly shared practices. Implications for Public Health Workforce development and integration with mainstream systems are critical to sustain LGBTQ+ community-controlled organisations and meet growing community demand for inclusive care.
Objective: The objective of the study is to describe the epidemiology of childhood acute respiratory infection (ARI) across New South Wales (NSW). Methods: Description of demographics, seasonal trends, and incidence rates (IRs) for paediatric ARI emergency departments (ED) presentations using NSW Public Health Rapid, Emergency, Disease and Syndromic Surveillance (PHREDSS) data from 2013 to 2019. Results: ARI ED presentations were numerous (n=1,099,723). Most presentations were respiratory-specific (72.4%); the leading diagnoses were non-specific ARI (34.5%), asthma/wheeze (18.4%), croup (14.1%), bronchiolitis (10.8%), and pharyngitis/tonsillitis (10.0%). Asthma/wheeze, bronchiolitis, breathing problems, and pneumonia/pneumonitis presentations were most often of high urgency (21.9–28.1%; triage categories 1 or 2) and often led to hospitalisation (38.2–54.7%). Croup was also often of high urgency (17.5%), but few required admission (8.0%). The annualised ARI IR was highest among children <1 year (3,710/10,000 population/year, standard deviation [SD] = 308.46). Bronchiolitis presentations had the highest aged-specific annualised IR at 938/10,000 <1 year (SD = 93.97). Conclusions: The burden of childhood ARI is substantial. Nearly four in every ten infants present to the ED with ARI each year, with a quarter presenting with bronchiolitis. Croup and asthma/wheeze presentations are also numerous and of high urgency. Non-specific coding is common. Implications for Public Health: More specific coding practices could further enhance syndromic surveillance systems, and current surveillance should target croup and asthma/wheeze for enhanced characterisation.
OBJECTIVE Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) can assist New Zealand (NZ) to eliminate HIV transmission by 2030. To monitor PrEP engagement, we used behavioural surveillance data and the cascade framework to construct NZ's first PrEP cascade for men who have sex with men (MSM). METHODS We created a sample of PrEP-suitable candidates from the 2022 Sex and Prevention of Transmission Study (SPOTS), the national HIV behavioural surveillance programme for MSM. Responses to three core PrEP questions (awareness, willingness, and uptake) were analysed for the overall cascade, then disaggregated by priority populations (ethnicity, age, region, and number of sexual partners). RESULTS Of PrEP-suitable participants (n=1307), most were aware and willing to use PrEP (87%). Under half the sample (48%) reported PrEP use. Disaggregating the cascade showed that MSM who were Māori, younger, and lived outside of Auckland reported less PrEP use. MSM reporting >10 sexual partners had almost two-fold higher PrEP use (75%) than those reporting ≤10 sexual partners (38%). CONCLUSIONS NZ's first PrEP cascade shows high awareness and willingness, but PrEP usage must increase. IMPLICATIONS FOR PUBLIC HEALTH Interventions that reduce inequities in PrEP uptake by ethnicity, age, and region of residence can help meet the NZ HIV Action Plan's target.
Objective To review evidence on associations between green space with mental health and physical activity in rural populations. Methods We searched PubMed, CINAHL, Scopus, Web of Science, and SPORTDiscus databases for studies published through August 2024. Eligible studies examined the relationships between green space with depression, anxiety, depression anxiety, physical activity or sedentary behaviour. Studies in care facilities or virtual green space exposure were excluded. Methodological quality was assessed using Joanna Briggs Institute Tools. Due to heterogeneity, we conducted narrative syntheses. Results Of 4,441 records identified, 25 met inclusion criteria, most (80%) of which were cross-sectional studies. Evidence on green space and mental health outcomes was mixed. However, beneficial associations were observed for private green spaces, including gardening and high-quality spaces. Associations between green space and physical activity were inconsistent, but accessibility and quality were positively associated with moderate-to-vigorous physical activity. Conclusions Private and high-quality green space may improve mental health and physical activity in rural populations, although overall evidence remains heterogeneous and limited. Implications for Public Health Public health interventions and policies should prioritise improving green space access, quality, and support backyard gardening or similar initiatives. Longitudinal and qualitative research is needed to advance understanding and guide context-specific rural health strategies.
