Samantha Rowbotham

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To explore how lived and care experiences of young people (aged 16-24 years) who experience chronic musculoskeletal pain (CMP) influence their choices about CMP care, and how and where a digital health solution (DHS) could support their care. A cross-sectional, exploratory qualitative study involving 20 young people (16-24 years) experiencing CMP. Eight focus groups were conducted, guided by a focus group schedule. Data were analyzed using thematic analysis. Three main themes emerged describing young people's experiences and CMP care choices. For each main theme we identified how a DHS could support their care: (1) "Experiences of living with and managing their CMP." A DHS could buffer self-care needs by providing timely support and creating a sense of community. (2) "Experiences with healthcare providers and healthcare services." An app-based DHS could potentially help to coordinate CMP care and support health services navigation. (3) "Young people's choices about their CMP care options." DHSs can support young people prioritize their CMP care options. Understanding young people's values, alongside their care needs is critical to delivering person-centred care. A tailored DHS can value-add to young people's CMP care by helping to minimize the burden of self-care, health service navigation and interactions with healthcare providers.

People with disability and carers often experience poorer social, physical and mental health than the general population. Capitalising on opportunities for physical activity to improve these outcomes, we co-designed a prototype digital health platform (ConnectUp) to help geographically proximal consumers connect with each other to engage in shared physical activities. This protocol describes the design of a multi-stage study that aims to (1) address consumer feedback from formative research by co-designing citizen science informed features to collect, curate and share physical activity opportunities, then (2) evaluate the expanded ConnectUp platform when implemented at scale in a single-arm geographically staged implementation study. Our project incorporates co-design and citizen science principles and will include two sequential stages: (1) iterative intervention design and user testing and (2) implementation and evaluation. The reach, effectiveness, adoption, implementation and maintenance (RE-AIM) evaluation framework will guide project evaluation. Stakeholders (people with disability, carers, partner organisations) will co-design project stage two outcome measures to ensure meaningful impact for the target communities and promote pragmatic impact and knowledge translation. Using a consumer and community-driven digital health approach, the ConnectUp project aims to reduce social, physical and mental health inequities among people with disability and carers and empower these communities to create, curate and share knowledge to support advocacy for inclusive practices and policies.Study registration: Not applicable as this project will not include a controlled experimental trial.

Background: People living in ‘walkable’ areas are more active, but common approaches to assessing walkability using audit tools and geospatial data have limitations in rural areas. This project explored the feasibility, acceptability and benefits of using a citizen science approach to audit walkability in rural communities.Methods: Using a citizen science approach, community members in rural towns completed audit tools and photographs to capture walkability. Researchers collated data and facilitated workshops with community members to identify priorities for action. The feasibility of applying a citizen science approach was evaluated through surveys and interviews with citizen scientists and project team members.Results: Three rural Australian towns (population 300; 850; 2890) were included, with a total of 10 community members (1–6 per town) completing audits and 13 (4–9 per town) attending workshops. It was feasible for citizen scientists to complete audits to identify environmental and physical attributes and impediments to walking. It was less feasible for citizen scientists to audit local policies and programs. Workshops enabled a broader and deeper understanding of the data, and represent a crucial aspect of the citizen science process. Citizen scientists were motivated by a desire to improve their community. Lack of diversity among citizen scientists, safety and recruitment were limitations.Conclusion/Discussion: Citizen science was a feasible and acceptable approach for auditing rural walkability, generating a rich and deep understanding of how the built environment impacts walking. Citizen science allows researchers, policy makers and community members to work together to generate data and establish priorities.So What?: Citizen science has the potential to support the involvement of members of the public in research and decision‐making in health promotion. Researchers need to adopt strategies to ensure diversity among citizen scientists as well as consider the support needs of citizen scientists when adopting this approach.

Chronic musculoskeletal pain (CMP) and coexisting mental health conditions impact young people; however, little is known about their lived and care experiences. In a prospectively registered systematic review with qualitative evidence synthesis (PROSPERO: CRD42022369914), we explored the following: (1) lived physical, psychological, and social experiences; and (2) care experiences/preferences of young people living with CMP and mental health conditions. Inclusion criteria: studies using qualitative methods; participants aged 16 to 24 years with CMP and coexisting mental health condition(s); phenomenon explored included lived and/or care experiences. Seven databases were searched (inception to 19-May-2024), study quality was assessed, data were extracted and analysed thematically, and GRADE-CERQual was used to assess confidence in findings. Twenty-two studies (23 reports) were included (>239 participants, 82% women). Lived experiences yielded 4 themes (9 findings): 2-way relationship between CMP and mental health (2 findings, low to moderate confidence); psychosocial implications of CMP (3 findings, very low-moderate confidence); uncertainty about future (2 findings, low-moderate confidence); coping with CMP and mental health conditions (2 findings, low-moderate confidence). Care experiences/preferences yielded 3 themes (8 findings): navigating healthcare systems (2 findings, moderate confidence); receiving appropriate care (3 findings, very low-moderate confidence); point-of-care experiences and care preferences (3 findings, very low-moderate confidence). Chronic musculoskeletal pain and mental health conditions are interconnected, significantly impacting young people's lives, identities, and socialisation, yet services for CMP and mental health are often inadequate and poorly integrated. The mechanisms and interplay of CMP and mental health require deeper exploration, including how young people may be better supported with personalised, holistic, developmentally and/or life-stage-appropriate integrated care.

Issue Addressed: Despite increasing interest in citizen science as an approach to engage members of the public in research and decision making about health and wellbeing, there is a lack of practical evidence to guide policy and practice organisations to utilise these approaches. In this study we investigated how and why citizen science came to be incorporated into the work of two policy organisations.Methods: We offer two in‐depth case studies of Australian government organisations which have utilised citizen science in environmental and healthy ageing policy. Interviews with organisational informants and relevant documents were analysed inductively to explore how citizen science came to be adopted, legitimised and supported.Results: Citizen science was utilised to address multiple organisational objectives, including increasing community participation in science; enhancing individuals' wellbeing, learning, and skills, and generating data to support research and policy in a relatively cost‐effective manner. In both cases, grant funding was a mechanism to support citizen science, with project delivery facilitated through academic‐policy partnerships and led by external academic or community partners.Conclusion: Although citizen science is relatively new in policy and practice settings, this study underscores the value of these approaches in realising co‐benefits for organisations, academics, and community members. The support and advocacy of senior managers as ‘champions’, and a willingness to invest in trialling new approaches to address policy problems are necessary ingredients to foster acceptance and legitimacy of citizen science.So What?: Citizen science initiatives can be strategically utilised by health promotion organisations to enact priorities related to genuine community involvement, support research and innovation and facilitate collaboration and partnerships between academic, policy and community stakeholders.

Issue Addressed: Local governments are well‐placed to respond to communities' health and wellbeing needs. However, in the Australian state of Tasmania, the sector's roles in that respect are unclear.Methods: We interviewed 10 municipal personnel in Tasmania to understand their views on local governments' community health and wellbeing functions.Results: Participants had an integrative understanding of community health and wellbeing and recognised that collective effort from all tiers of government, community members, and other place‐based stakeholders would improve outcomes. They identified several roles local governments have to support and drive such improvements, including in relation to diverse place‐specific determinants of health and wellbeing. Capacity and capability to fulfil what is needed varied, with rural and remote councils generally less able than urban counterparts to respond consistently or comprehensively to community members' complex needs. However, in the presence of clear expectations and parameters, and appropriate support from other tiers of government, participants were eager for their councils to do more to improve their communities' health and wellbeing, including via a mandate in legislation.Conclusion: Local governments have the potential to do more to improve health and wellbeing outcomes in Tasmania, and the greatest gains could be made by addressing spatial inequalities faced by the sector. That insight is extensible to other comparable jurisdictions.So What?: We argue the need both for a shared societal goal of equitable wellbeing supported by all tiers of government and for actions proportionate to the needs of council areas.