Beau Cubillo

Issue Addressed: This study aimed to quantify Aboriginal adults' exposure to digital marketing of unhealthy food and beverages, alcohol, gambling, tobacco and e‐cigarettes; analyse demographic differences in marketing exposure; and describe the nature of digital marketing reaching Aboriginal audiences, including brands, platforms and marketing tactics. Methods: Thirty‐one Aboriginal adults were asked to record their screens, capturing approximately one‐third of their usual daily screen time (maximum 60 min). Recordings were analysed using SCANNER, an automated system trained to detect unhealthy commodity marketing. Demographic data and usual online behaviours were collected via an online survey. Descriptive statistics, a post hoc Mann–Whitney U test and a Fisher–Freeman–Halton extension of Fisher's Exact test were used to analyse differences in marketing detections. Results: Most participants ( n = 29/31, 94%) were exposed to unhealthy digital marketing. Of the 587 marketing instances detected, unhealthy food brands were most common (47%), followed by gambling (28%), alcohol (15%), sweetened beverages (9%) and tobacco (1%). No e‐cigarette marketing was detected. Estimated daily exposure to unhealthy digital marketing was 40.4 (IQR: 11–92) instances per day. Male participants, aged 30 years and under, recorded significantly more marketing detections overall and for unhealthy food, alcohol and gambling brands. Conclusion: Findings highlight the pervasiveness of unhealthy food and beverage, gambling and alcohol marketing in the everyday digital lives of Aboriginal participants. So What?: Comprehensive regulation of unhealthy digital marketing is urgently required to advance Aboriginal health.

Aboriginal and Torres Strait Islander peoples experience a disproportionate burden of gambling-related harms, yet there is limited evidence on the determinants, impacts and solutions. While gambling has both cultural and social dimensions within many communities, commercial gambling products pose significant risks, particularly within the broader context of colonisation, socioeconomic inequities, and targeted industry practices. This scoping review systematically mapped and synthesised, informed by Aboriginal perspectives, the literature on the determinants and impacts of gambling harm among Aboriginal and Torres Strait Islander peoples in Australia, alongside proposed actions to reduce harm and evidence gaps. A systematic search of peer-reviewed and grey literature published after 2001 was conducted across Medline, CINAHL, PsycINFO, Informit Indigenous collection and Scopus, alongside grey literature from Australian Aboriginal and Torres Strait Islander health organisations, government agencies, and web-based sources. Articles were included if they focussed on Aboriginal and/or Torres Strait Islander peoples in Australia and examined gambling determinants, impacts or solutions. Forty-two articles (29 peer-reviewed, 13 grey literature) were identified. Socio-cultural determinants were most frequently examined (79%), followed by individual determinants (60%), with less attention to environmental (33%), social (31%), commercial (19%) and political (7%) determinants. Commercial gambling, particularly electronic gaming machines and online sports betting, was linked to financial distress, family violence and erosion of kinship networks. Responses were predominantly individual or community-based (63%), with fewer addressing structural drivers (25%). Future research should adopt a commercial determinants of health lens, particularly to examine online gambling and marketing practices on Aboriginal and Torres Strait Islander peoples.

Introduction: The commercial determinants of health (CDoH) are a rapidly growing field of research and global health priority. Despite being disproportionately affected, Indigenous Peoples’ voices and perspectives are conspicuously absent from CDoH research and policy. This article outlines the protocol for Addressing Commercial Health determinants: Indigenous Empowerment and Voices for Equity (ACHIEVE), an Aboriginal and Torres Strait Islander-led project in Australia. Methods and analysis: ACHIEVE integrates four research streams, using a novel combination of methods. The first three streams will (i) conceptualise the CDoH using Indigenous yarning methodology, (ii) evaluate the effectiveness and cost-effectiveness of policies to reduce exposure to harmful marketing and (iii) assess the impacts of specific commercial entities on Aboriginal and Torres Strait Islander health using case studies. The final stream will consolidate findings from streams 1–3 and work with Aboriginal Community Controlled Health Organisations (ACCHOs) to co-create strategies for addressing the commercial determinants of Aboriginal and Torres Strait Islander health. Ethics and dissemination: Ethical approval for streams 1–3 has been granted by Deakin University Human Research Ethics Committee. ACHIEVE is guided by a governance model that prioritises Indigenous data sovereignty, community and ACCHO partnerships, capacity building and knowledge translation. Findings will be shared with participants, ACCHOs and policymakers to maximise research impact.

Aboriginal Peoples in the Northern Territory (NT) of Australia have customary connections to seafood for cultural practices, nourishment, livelihoods, and social connections which have been linked to health and wellbeing outcomes. Global and national entities have called for health and self-determination principles to be considered across all public policies to continue to improve health and wellbeing outcomes. Specifically, there is a growing acknowledgement that the fisheries sector plays a crucial role in enhancing and supporting Indigenous health and wellbeing. However, there is limited understanding of how this can be achieved. This study applies a content analysis of ten NT fisheries policy documents to investigate: (1) the representation of Indigenous values; (2) Indigenous health and wellbeing outcomes and (3) the positioning of self-determination within NT coastal, marine and fishery policies. Findings reveal that policy focus is primarily concerned with the conservation and management of environments and resources, fisheries, management and sustainability, and fisheries-based economic development. The consideration of health and wellbeing outcomes are not explicitly represented, including fisheries as a source of food production. This is concerning considering the contribution of seafood to Indigenous Peoples diets and food security. Despite these limitations, self-determination principles were represented within the policies by recognising Aboriginal aspirations through, for example social, cultural, and environmental outcomes.

Due to the lack of resources in remote Aboriginal communities within the Northern Territory of Australia, Aboriginal people requiring chronic maintenance hemodialysis often must relocate from their home communities to Darwin city permanently to receive ongoing care. This phenomenon can cause distressing isolation from important traditional food, land, and family. The aim was to identify the relation to traditional food from an Aboriginal perspective and the enablers and barriers to accessing traditional food post-relocation from remote regions of the Northern Territory, Australia, to the urban city of Darwin. This was a qualitative study design with a total of 12 Aboriginal participants (4 males, 8 females) receiving ongoing hemodialysis at the Nightcliff Renal Unit. Participants had all relocated from a remote region to Darwin. Interviews were conducted between July and September 2018 in Darwin, Australia. Data interpretation was conducted by an Aboriginal researcher and co-authors with a combined 30 y of experience conducting research with Aboriginal people in a health context. Data analysis comprised an inductive thematic analysis approach with an indigenist knowledge interpretation lens to construct, reaffirm, and protect Indigenous views. Traditional food was an important part of participants' identity and strongly connected to social, emotional, spiritual and physical health, and well-being. Access to traditional food post-relocation is associated with enablers and barriers including mobility, local knowledge, social support networks, commercial access, and economics. Dialysis patients who are dislocated from remote Aboriginal communities to Darwin experience clear disruption to traditional food access, consumption, availability, and knowledge dissemination to the younger generations.

Mobile and tablet apps, ubiquitous and pervasive computing, wearable computing and domotics for health.

BACKGROUND The disproportionate burden of noncommunicable disease among Indigenous Australians living in remote Indigenous communities (RICs) is a complex and persistent problem. Smartphones are increasingly being used by young Indigenous adults and therefore represent a promising method to engage them in programs seeking to improve nutritional intake. OBJECTIVE This study aimed to consult RIC members to inform the content of a smartphone app that can be used to monitor and reduce sugar-sweetened beverage intake in RICs. METHODS The study was conducted in two phases. The formative phase involved a simulated grocery selection activity with think aloud (“think aloud shop”), a semistructured interview, a questionnaire outlining current smartphone and app use, and a paper prototyping activity. A preliminary end-user testing phase involved a think aloud prototype test and a semistructured interview regarding user satisfaction. Convenience sampling was used to recruit 20 18- to 35-year-old smartphone users for each phase from two RICs in the Northern Territory, Australia. Thematic analysis of transcribed audio recordings was used to identify determinants of food choice from the think aloud shop; themes related to the Theory of Planned Behavior (TPB) from the eating behaviors interview; and usability, comprehension, and satisfaction with the app from the preliminary end-user testing. RESULTS Smartphone use in RICs is currently different to that found in urban environments; in particular, extremely low use of Facebook, restricted variety of phone types, and limited Internet access. Findings regarding promoting app engagement indicate that utilizing an opt-in approach to social features such as leader boards and team challenges is essential. The inclusion of games was also shown to be important for satisfaction, as were the use of audio features, contextually embedded dissemination, and streamlined app design for comprehension in this target group. CONCLUSIONS This research provides critical insights and concrete recommendations for the development of lifestyle improvement apps targeted toward disadvantaged young adults in nonurban settings, specifically RICs. It serves as a framework for future app development projects using a consultative user-centered design approach, supporting calls for the increased use of this strategy in app development.