Introduction: There is limited evidence on the social and emotional wellbeing (SEWB) needs of staff working at Aboriginal Community Controlled Health Services (ACCHS) in Australia. The current study employed qualitative research methods to explore ACCHS staff’s experience during the COVID-19 pandemic and its impact on their SEWB, and to identify factors that provided strength. Methods: Yarning Circles and one-on-one Yarns were employed to explore clinical and non-clinical ACCHS staff’s experiences. Participants included staff who identified as Aboriginal and/or Torres Strait Islander, or were non-Indigenous. Thirty-one staff from 5 ACCHSs participated in 7 Yarning Circles and 3 one-on-one Yarns, between December 2021 and June 2022. Staff shared their perspectives on (i) ACCHSs’ responses, (ii) community and staff reaction, and (iii) impact of service-level changes on their SEWB. Data was analysed using thematic analysis. Results: The main themes identified as impacting ACCHS staff’s SEWB were: (1) constant change and prolonged stress, (2) community as a source of strength, (3) leadership safeguarding community and staff, (4) pride in their response, and (5) opportunities to lessen psychological toll. Staff were motivated by the seamlessness of their roles. They were motivated by positive work environment, reliable infection control measures, and resourceful leadership. Major concerns included fear of contracting and transmitting infection, and long-term consequences of disrupted patient care. There was a lack of awareness among staff about formal SEWB support, and if aware they were hesitant to use services due to cultural safety and privacy concerns. A major source of support for ACCHS staff was peer support. Conclusion: During the COVID-19 pandemic ACCHS staff experienced prolonged stress exacerbated by constant changes, inconsistent information, misinformation, and lack of resources. Staff found strength in community, cultural connections, and management’s response. Informal peer support was important in upholding ACCHS staff’s SEWB, suggesting that structured peer support can provide ongoing support.

Objective: To identify factors protective of healthy weight for Aboriginal children living in urban and regional Australia. Methods: Data were collected from 1139 Aboriginal children aged 2–19 years from the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). BMI z-scores were calculated using WHO age and sex specific cut-offs. Poisson regression models were used to examine the association between BMI z-scores and child- and family-level socio-demographic, lifestyle, and environmental factors. Results: A majority of children had a healthy weight (67 %); 17 % had overweight and 16 % had obesity, with similar percentages for females and males in all three categories. Children were more likely to have a healthy weight if they were younger, had a lower waist-to-height (WHtR) ratio, a caregiver with a healthy weight and had housing affordability problems. For every extra hour of physical activity undertaken per day children were 7 % more likely to have a healthy weight. Conclusions: Healthy weight prevalence decreased with increasing age and decreasing physical activity levels in Aboriginal children and was strongly linked to caregiver BMI. Implications for public health: Implementing effective, community-led, culturally sensitive programs that support increased physical activity and promote healthy weight in childhood should be a public health priority.

This study explores the impact of the COVID-19 pandemic on the work and social and emotional well-being (SEWB) of staff at Aboriginal Community Controlled Health Services (ACCHS) in Australia. Between September and November 2021, staff from three ACCHSs in New South Wales completed an online survey to report changes to their roles, concerns about becoming infected with the COVID-19 virus, and job satisfaction in the last month. The survey measured emotional exhaustion and psychological distress by using the Maslach Burnout Inventory-Human Services Survey and Kessler-5 scale, respectively. The survey determined staff's access to SEWB support. Descriptive statistics were calculated for each variable. Among 92 staff from three ACCHSs, 36% reported a COVID-19-related change in their role and 64% were concerned about becoming infected. In spite of the pandemic, most staff (69%) were satisfied with their job. While most staff were not burnt out or psychologically distressed, 25% had high emotional exhaustion and 30% had high to very high psychological distress. Relatedly, 37% had accessed SEWB support at least once in their lifetime and 24% had accessed support in the last month. As the pandemic continues, it is important to identify factors influencing burnout or psychological distress among ACCHS staff and implement evidence-based solutions.

BACKGROUND Chronic diseases account for over 70% of health gaps between Aboriginal people and the rest of the Australian population. The 1 Deadly Step program involves community-based events that use a sporting platform and cultural ambassadors to improve chronic disease prevention and management in New South Wales (NSW). OBJECTIVE This study aimed to evaluate the feasibility and acceptability of a community-based chronic disease screening program for Aboriginal people. METHODS In 2015, the program was enhanced to include an iPad app for screening assessments, a results portal for nominated care providers, and a reporting portal for program administrators and implemented in 9 NSW community events. A mixed methods evaluation comprising survey data, analytics obtained from iPad and Web portal usage, and key informant interviews was conducted. RESULTS Overall, 1046 people were screened between April 2015 and April 2016 (mean age 40.3 years, 640 (61.19%) female, 957 (91.49%) Aboriginal or Torres Strait Islander). High chronic disease rates were observed (231 [22.08%] participants at high cardiovascular disease (CVD) risk, 173 [16.54%] with diabetes, and 181 [17.30%] with albuminuria). A minority at high risk of CVD (99/231 [42.9%]) and with diabetes (73/173 [42.2%]) were meeting guideline-recommended management goals. Overall, 297 participants completed surveys (response rate 37.4%) with 85.1% reporting satisfaction with event organization and information gained and 6.1% experiencing problems with certain screening activities. Furthermore, 21 interviews were conducted. A strong local working group and processes that harnessed community social networks were key to implementation success. Although software enhancements facilitated screening and data management, some technical difficulties (eg, time delays in processing blood test results) impeded smooth processing of information. Only 51.43% of participants had a medical review recorded postevent with wide intersite variability (10.5%-85.6%). Factors associated with successful follow-up included clinic managers with overall program responsibility and availability of medical staff for immediate discussion of results on event day. The program was considered highly resource intensive to implement and support from a central coordinating body and integration with existing operational processes was essential. CONCLUSIONS 1 Deadly Step offers an effective and acceptable strategy to engage Aboriginal communities in chronic disease screening. High rates of risk factors and management gaps were encountered, including people with no previous knowledge of these issues. Strategies to improve linkage to primary care could enhance the program’s impact on reducing chronic disease burden.

Background: Mobile health (mHealth) apps have the potential to increase smoking cessation, but little research has been conducted with Aboriginal communities in Australia. Objective: We conducted a pilot study to assess the feasibility and acceptability and explore the effectiveness of a novel mHealth app to assist Aboriginal people to quit smoking. Methods: A pilot randomized controlled trial (RCT) and process evaluation comprising usage analytics data and in-depth interviews was conducted. Current Aboriginal smokers (>16 years old), who were willing to make a quit attempt in the next month, were recruited from Aboriginal Community Controlled Health Services and a government telephone coaching service. The intervention was a multifaceted Android or iOS app comprising a personalized profile and quit plan, text and in-app motivational messages, and a challenge feature allowing users to compete with others. The comparator was usual cessation support services. Outcome data collection and analysis were conducted blinded to treatment allocation. The primary outcome was self-reported continuous smoking abstinence verified by carbon monoxide breath testing at 6 months. Secondary outcomes included point prevalence of abstinence and use of smoking cessation therapies and services. Results: A total of 49 participants were recruited. Competing service delivery priorities, the lack of resources for research, and lack of support for randomization to a control group were the major recruitment barriers. At baseline, 23/49 (47%) of participants had tried to quit in recent weeks. At 6-month follow-up, only 1 participant (intervention arm) was abstinent. The process evaluation highlighted low to moderate app usage (3-10 new users per month and 4-8 returning users per month), an average of 2.9 sessions per user per month and 6.3 min per session. Key themes from interviews with intervention participants (n=15) included the following: (1) the powerful influence of prevailing social norms around acceptability of smoking; (2) high usage of mobile devices for phone, text, and social media but very low use of other smartphone apps; (3) the role of family and social group support in supporting quit attempts; and (4) low awareness and utilization of smoking cessation support services. Despite the broad acceptability of the app, participants also recommended technical improvements to improve functionality, greater customization of text messages, integration with existing social media platforms, and gamification features. Conclusions: Smoking cessation apps need to be integrated with commonly used functions of mobile phones and draw on social networks to support their use. Although they have the potential to increase utilization of cessation support services and treatments, more research is needed to identify optimal implementation models. Robust evaluation is critical to determine their impact; however, an RCT design may not be feasible in this setting. Trial Registration: Australian and New Zealand Clinical Trials Registry ACTRN12616001550493; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371792 (Archived by WebCite at http://www.webcitation.org/76TiV7HA6).