Simone Sherriff

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.

Issue Addressed: Oppression and violence associated with colonisation have contributed to intergenerational trauma and health inequities for Aboriginal and Torres Strait Islander peoples. Health promotion can help reduce inequities by strengthening connections that support social and emotional wellbeing and enable conditions for communities to lead healthy lives. While culturally responsive health promotion strategies exist, it is unknown the extent to which these account for trauma. Methods: We conducted a narrative review to examine the intersection of evidence describing social and emotional wellbeing, trauma and health promotion for Aboriginal and Torres Strait Islander peoples. Literature was identified between April 2025 and June 2025, with an update performed in July 2026, through iterative searches of Google Scholar, Medline and HealthInfoNet, supplemented by citation tracking of key publications and relevant grey literature. Sources were selected based on relevance to the review aim, with the scope iteratively broadened from trauma‐informed approaches within Indigenous health promotion internationally to include trauma‐informed approaches in health promotion more broadly and health promotion for Aboriginal and Torres Strait Islander peoples. Results: Limited guidance was identified on how to apply trauma‐aware, healing‐informed approaches within health promotion for Aboriginal and Torres Strait Islander peoples. While frameworks exist in trauma‐informed care and health promotion separately, limited evidence of the integration of these two concepts was found. Where integration occurs, the guidance found was largely conceptual and lacks detail for implementation. Conclusions: Recognising the influence that trauma can have on health behaviours and applying trauma‐aware, healing‐informed principles may strengthen the safety, relevance and effectiveness of health promotion initiatives for Aboriginal and Torres Strait Islander peoples. So What?: Continuing to apply health promotion strategies without accounting for the social, historical and cultural impacts of colonisation and trauma may risk disengagement or unintended harm. A trauma‐aware, healing‐informed approach builds on existing culturally responsive, strengths‐based and community‐controlled health promotion by making explicit how trauma shapes health behaviours, which helps create the conditions for healing. This review provides the evidence and conceptual rationale for the development of a community‐led framework to guide the design, implementation and evaluation of trauma‐aware, healing‐informed health promotion for Aboriginal and Torres Strait Islander peoples.

Introduction: Australia's National Lung Cancer Screening (LCS) Program commenced in July 2025, targeting people at high risk of lung cancer based on age and smoking history. This study aimed to co‐design evidence‐based decision support tools to facilitate shared decision‐making (SDM) for LCS in collaboration with intended end‐users. Methods: Co‐design workshops were conducted with consumers, including Aboriginal and Torres Strait Islander peoples (4 workshops; n = 54), and clinicians/experts (2 workshops; n = 7). Participants were recruited through an independent social research company, an ongoing wellbeing support group, an Aboriginal Community Controlled Health Service and purposive sampling. Sessions involved structured activities to identify key content priorities and preferred formats for decision support tools. Workshop data were analysed concerning preferences regarding the key priorities for content and design of the tools. Cognitive interviews ( n = 15) with an independent group of consumers were undertaken to test comprehensibility and refine design elements. Interviews were analysed against the key content areas that needed to be improved and the views of participants across the three tools developed. For each participant, their likes, dislikes, suggested changes, and how they compared across the three resources were documented. All resources were developed iteratively in alignment with International Patient Decision Aid Standards. Results: Key shared priorities across consumers and clinicians included information about the screening process, what happens after the scan, benefits of screening, the need to manage cancer and smoking‐related stigma and discrimination, tailoring for different language groups, and cultural safety. Consumers emphasised the need for visual representations of the screening pathway and testimonials from previous participants, while finding icon arrays confusing and overly statistical. Both groups highlighted the importance of supporting engagement with screening and reframing potential harms as ‘other considerations’ rather than deterrents. Feedback from cognitive interviews informed refinements to improve clarity and usability. The final suite of resources comprised a 16‐page A5 booklet, a 2‐page A4 leaflet, and a 3‐min animated video. Conclusion: This co‐design process produced three decision support tools to support informed choice within Australia's National LCS Program. The tools were found to be clear, acceptable, and adaptable, with potential for broader use in international LCS implementation. Patient or Public contribution: An Aboriginal Reference Group of seven members was formed at project inception and provided cultural oversight and support in the design and conduct of the research with Aboriginal and Torres Strait Islander peoples. Members of the public who might be eligible or may have a family member eligible for lung cancer screening, were included in the conduct of the research.

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.

This commentary commends Milsom et al. for their critical and rigorous application of qualitative system dynamics to unpack corporate power in food policy-making. Their use of Critical Realism, best practice qualitative methods, and feedback loops exemplifies the maturation of system dynamics applications in public health research. We reflect on how their work aligns with broader debates about power and social theory in system dynamics and how it offers a blueprint for trustworthiness and reflexivity in qualitative modelling. Drawing on our team’s work with Aboriginal communities in Australia, we highlight the value of culturally grounded, participatory modelling in amplifying the voices of communities experiencing historical and ongoing oppression. We support the authors’ call to advance toward simulation modelling and stress the importance of engaging with both system dynamics and communitybased knowledge to realise the transformative potential of systems-informed, community-led research in reshaping food policy and practice.

Introduction Aboriginal and Torres Strait Islander women have been nurturing and sustaining babies through breastfeeding for over 65 000 years. Breastfeeding is an important practice for nutrition, culture, connection and well-being, and is associated with positive short- and long-term health and well-being outcomes for the mother and baby. Developing community-led supports that empower Aboriginal and Torres Strait Islander mothers through their breastfeeding journeys is vital for supporting the health and well-being of the next generations. Methods and analysis Yalbilinya Miya is a holistic and culturally responsive breastfeeding project being designed and led by an Aboriginal Community Controlled Health Service in New South Wales (NSW). This project aims to identify, implement and evaluate the breastfeeding supports preferred by Aboriginal and Torres Strait Islander women. Phase 1 will use yarning methodology to gather the experiences of local Aboriginal and Torres Strait Islander women and their recommendations for breastfeeding support. The information gathered will inform the development of a culturally responsive breastfeeding support programme. In phase 2, Aboriginal and Torres Strait Islander women who were ≥28 weeks gestation will be invited to participate in the pilot breastfeeding support programme. Phase 3 will evaluate the appropriateness and effectiveness of the holistic breastfeeding supports provided in the pilot programme and provide key recommendations based on the findings of the evaluation. Ethics and dissemination Ethical approval was granted by the Aboriginal Health and Medical Research Council of NSW (#2132/23). The findings from this project will be disseminated through community presentations, videos, brochures, infographics, social media, reports, conference presentations and peer-reviewed journal articles.