Patricia Fagan

Knowledge, attitudes and behaviours in relation to safe sex, sexually transmitted infections (STI) and HIV/AIDS among remote living north Queensland youth.

Objective: To assess the knowledge, attitudes and behaviours of remote Aboriginal and Torres Strait Islander youth living in far north Queensland in relation to sexually transmitted infections, HIV/AIDS and safe sex.

The Young Person Check: screening for sexually transmitted infections and chronic disease risk in remote Aboriginal and Torres Strait Islander youth.

Objective : This paper describes the implementation and selected outcomes of the Young Person Check (YPC), a high‐coverage screening program in far north Queensland targeting remote youth aged 15–24 years for sexually transmissible infections (STI) and chronic disease risk. The YPC was conducted 19 times in eight discrete remote communities and one community cluster between 2009 and 2012.

Hip Hopping the Gap – Performing Arts Approaches to Sexual Health Disadvantage In Young People in Remote Settings

Objective: Closing the gap in Indigenous health and wellbeing in remote settings in the Torres Strait and Northern Peninsula Area of Far North Queensland (FNQ) includes addressing a well-documented sexual health disadvantage among young people. Community mobilization around the underlying risk factors influencing sexual health is required. Method: Performing-arts-based workshops were conducted in schools and after-school venues in four remote Aboriginal and Torres Strait islander locations in FNQ in early 2010, to initiate consciousness-raising around the real dimensions of youth sexual health risk. Specific objectives included strengthening operational partnerships at school-level and developing ongoing consultative processes in each location for sexual health reference group development. Results: Results include a significantly strengthened productive partnership with primary and high schools in each location and sixteen production-ready hip hop songs exploring a range of physical, emotional and sexual health themes authored by the students and recorded on site. Additional outcomes included the willingness of community councils and civil society organizations to support local sexual health reference group activity. Conclusions: This initiative, the Indigenous Hip Hop Project, although accompanied by opportunity costs including alternative, more core business uses of staff time and program budget, has demonstrated the power of tapping the creative energy of young people at risk and the potential for mobilizing communities to activism around sexual health disadvantage.

Should we change the focus of health promotion in sexual health clinics

In a response to the recent article by Rudiger Pitroff and Elizabeth Goodburn on changing the focus of health promotion in sexual health clinics, Crouch and Fagan draw attention to the confusion among practitioners between brief interventions in clinics (health education) and the actual nature and scope of sexual health promotion. The response refocuses attention on the Ottawa Charter for Health Promotion and on the social determinants of sexual health inequity as appropriate design drivers of a pilot initiative proposed by Pitroff and Goodburn to re-orient sexual health service provision around the real needs of its clients.

Communities and condoms – how difficult can it be?

Sexually transmitted infections are common in remote settings in Queensland Australia yet sexually active young people living remotely do not have reliable commercial or free access to condoms. Without the ready availability of condoms young people are denied the chance to choose to be safe. This editorial reflects on the history since 2006 of the public health effort to develop sustainable condom infrastructure for Aboriginal and Torres Strait Islander residents in remote North Queensland Communities. It provides a brief discussion of some of the policy issues and health service issues including failed attempts to garner Health District management support for condom supplies in clinics and innovative programs to make condoms accessible in hotels clubs and bars. Case studies have been carried out in six communities and provide condom uptake reporting. The lack of published research into all-hours condom availability and distribution reporting in remote Aboriginal and Torres Strait Islander settings in Australia is a powerful signifier of the low priority accorded to condom access by communities health service providers and policy makers alike.

Hypertension: high prevalence and a positive association with obesity among Aboriginal and Torres Strait Islander youth in far north Queensland

Objective: Hypertension and other chronic disease risks are common among Aboriginal and Torres Strait Islander adults but there is little evidence regarding the epidemiology of these risk factors during adolescence. This study examines the prevalence of pre‐hypertension, hypertension and other cardiovascular risk factors in Aboriginal and Torres Strait Islander people aged 15–24 years living in remote Indigenous communities in north Queensland. In so doing, it aims to better inform the approach to cardiovascular disease in this population.

Successes in sexual health communications development, programmatic implementation and evaluation in the Torres Strait region 2006 to 2012.

Objective: To evaluate the Indigenous sexual health promotion program in the Torres Strait 2006–2012 that culminated in an education‐entertainment radio drama, Kasa Por Yarn (KPY).

22 HYPERTENSION AND OTHER CHRONIC DISEASE RISK FACTORS AMONG INDIGENOUS YOUNG PEOPLE. AN OPPORTUNITY FOR PREVENTIVE ACTION

Background: The burden of chronic disease in Aboriginal and Torres Strait Islander populations is well documented (1, 2, 3). This study retrospectively examines the prevalence of hypertension and other chronic disease risk factors in a sample of 1883 Aboriginal and Torres Strait Islander people aged 15-24 years that attended for a Young Person Check in 15 remote communities in far north Queensland between March 2009 and April 2011. Methods: Data relating to the prevalence of pre-hypertension, stage I hypertension, stage II hypertension, obesity, increased waist circumference, non-fasting blood sugar levels, non-fasting lipid profiles, proteinuria and albuminuria were analysed. Results: Overall the prevalence of pre-hypertension was 34.0%, stage I hypertension was 17.7% and stage II hypertension was 3.3%. The prevalence of elevated waist circumference was 47.6%, overweight or obesity 45.9%, elevated triglycerides 18.3%, decreased HDL 54.8% and proteinuria 24.3%. The prevalence of hypertension (stage I or II) among Torres Strait Islander males was 34.1%, Aboriginal males 26.9%, Aboriginal females 13.0% and Torres Strait Islander females 12.6%. The difference in hypertension prevalence between the genders was statistically significant.(p = 0.000 for both Aboriginal and Torres Strait Islanders) Conclusion: The study indicates that many remote living Indigenous youth are already on the trajectory towards chronic disease. Consequently, primary preventive activity directed at addressing the causes of chronic disease including overweight and obesity should be directed at children, their families and the environment in which the population lives. Screening for hypertension and other risk factors should commence by adolescence. ReferencesAustralian Bureau of Statistics and Australian Institute of Health and Welfare), The Health and Welfare of Australias Aboriginal and Torres Strait Islander Peoples. Canberra, 2010Wang Z, Knight S, Wilson A, Rowley K G, Best J D, McDermott R, Leonard D, Shaw JE and O’Dea K. Blood pressure and hypertension for Australian Aboriginal and Torres Strait Islander people. European Journal of Cardiovascular Prevention and Rehabilitation 2006;13:438-443Miller G, McDermott R, McCulloch B, Leonard D, Arabena K, Muller R. The Well Persons Health Check: a population screening program in Indigenous communities in north Queensland. Australian Health Review 2002;25(6):136-147.

666 HOW PREVALENT ARE HYPERTENSION AND OTHER CHRONIC DISEASE RISKS AMONG REMOTE LIVING NON-INDIGENOUS YOUNG ADULTS?

Background: Health disparities between remote and urban living Australians have commonly been attributed to the relatively high proportion of the remote population that are Indigenous (1). Methods: This study retrospectively assessed service delivery data from people aged 15–24 years attending for a Young Person Check (YPC) in 7 remote communities in far north Queensland between March 2009 and April 2011. Data relating to the prevalence of hypertension, obesity, increased waist circumference, non-fasting blood sugar levels, non-fasting lipid profiles and proteinuria were analysed. Results: Among non-Indigenous YPC participants (n = 121) the prevalence of pre-hypertension was 36.7%, stage I hypertension was 15.6% and stage II hypertension was 0%. The prevalence of overweight or obesity was 46.7%, increased waist circumference was 33.1%, increased triglycerides was 14.3%, reduced HDL was 25.8%, proteinuria was 14.9%. The prevalence of hypertension (p value 0.218), probable diabetes (p value 0.395), overweight or obesity (p value 0.455) and elevated triglycerides (p value 0.273) did not differ between non-Indigenous and Indigenous participants. A lower proportion of non-indigenous participants had an elevated waist circumference (p value 0.002), reduced HDL (p value 0.000) and proteinuria (p value 0.018) than Indigenous participants. Conclusion: These remote living non-Indigenous young adults are experiencing a heavy burden of chronic disease risk. The alignment of much of this risk with that experienced by Indigenous participants highlights the importance of addressing social determinants of health in remote communities. It also supports the need to clearly identify and respond to the particular needs of remote living non-Indigenous youth. ReferencesAustralian Institute of Health and Welfare 2004. Australias health 2004. Canberra: AIHW.