Horas Wong’s research while affiliated with The University of Sydney and other places

This perspective presents a discussion on digital interventions and strategies to support the mental health of first responders working in regional, rural and remote areas. First responders are often required to respond to traumatic, violent and challenging situations. Accumulative exposure to these situations can impact first responders' mental health, and symptoms of depression, anxiety, psychological distress, and post‐traumatic stress disorder (PTSD) are common. Rural first responders have similar prevalence rates of trauma to their metropolitan counterparts. However, rural first responders are likely to experience psychological difficulties exacerbated by limited access to mental health interventions due to geographical isolation and limited availability of services. Geographical location and availability of services are barriers often preventing first responders working in rural areas from accessing interventions to help them manage their mental health. Digital adaptations of mental health interventions may help to fill this gap in rural health care. Despite the popularity of first responder research developing and evaluating industry‐specific mental health interventions and strategies, there is limited research focussing specifically on the effectiveness of these for Australian rural first responders, and how other mental health interventions can be digitally adapted.

The health and wellbeing of queer Muslims, a group positioned at the intersection of multiple marginalised identities, remains underexplored in academic literature. This scoping literature review critically analyses existing research on queer Muslim health using the 4M framework (Mega, Macro, Meso, Micro) to identify structural and individual determinants impacting health outcomes. The study highlights the profound influence of intersecting factors such as race, ethnicity, gender, sexuality, geographic location, and socioeconomic status on healthcare access and health outcomes. Findings reveal that dominant epistemological assumptions about queerness and Islam perpetuate stigma, discrimination, and minority stress, leading to adverse health outcomes. Key barriers include inadequate funding, homonormative healthcare policies, and exclusionary cultural expectations within healthcare settings. Conversely, supportive familial, peer, and religious networks, along with access to digital resources, are identified as facilitators of better health outcomes. The review calls for culturally competent, strength-based models of care and emphasises the need for future research to address the diverse health experiences of queer Muslims across different regions and identities.

Background Adolescents with intellectual and developmental disability (IDD) are reported to have lower uptake of routine vaccines than their peers. Little research has explored stakeholders' perceptions and support of school‐based vaccinations for this population in NSW, Australia. Methods Focus groups and interviews were conducted with four stakeholder groups involved in the vaccination program in special education schools in New South Wales, Australia: students with IDD, parents, education staff, and health professionals. Results Stakeholders mostly supported vaccinating adolescents with IDD in school settings. Students valued the familiar environment and emotional support from teachers. Parents appreciated the convenience and accessibility of the program. Education staff regarded vaccinations as vital for student health and mostly supported school‐based delivery but faced practical and ethical challenges, such as insufficient resourcing, confusion around holding students for safety and emotional support, and concerns about losing students' trust in the school as a safe environment if vaccination was experienced as traumatic. Health staff identified a need for better prevaccination communication with families and schools to improve vaccine uptake and student preparation. Conclusion Findings highlight a need for increased support for special schools that act as key program facilitators between those who deliver and those who receive this vital health service.

Internationally, vaccination rates among adolescents with intellectual and developmental disability (IDD) are lower than those of the general population. Little research has addressed this issue. This study investigates the experiences of vaccinating adolescents with IDD in special education settings in Australia, with a focus on student engagement. Semistructured interviews and focus groups were undertaken with 50 stakeholders involved in the school vaccination program. Data was analyzed thematically using a framework approach. We identified five themes: lack of student engagement, practices discouraging engagement, practices fostering engagement, lack of vaccination protocol adjustments, and lack of disability-specific nurse training. Nurses’ limited knowledge and skills in engaging students with IDD can result in unethical practices, students feeling excluded from vaccination decisions, and students being traumatized by negative treatment experiences. Clinical protocols lack guidance and reasonable adjustments to provide inclusive vaccination services. Supported decision making could provide more inclusive school vaccinations, more positive vaccination experiences, and higher vaccination rates among adolescents with IDD.

Peer support from social networks of gay, bisexual, and other men who have sex with men (GBMSM) has been recognised as a critical driver of engagement with HIV prevention. Using data from an online cross-sectional survey of 1,032 GBMSM aged 18 or over in Australia, a latent class analysis was conducted to categorise participants based on social support, LGBTQ + community involvement, and social engagement with gay men and LGBTQ + people. Comparisons between classes were assessed using multivariable multinomial logistic regression. Participants were allocated into four classes: ‘Gay men focused’ (n = 293, 28.4%) with high levels of support from gay men, ‘High and diverse’ (n = 75, 7.3%) with high support from people with a range of gender and sexual identities, ‘Moderate overall’ (n = 177, 17.2%) who reported some support from all sources, and ‘Low overall’ (n = 487, 47.2%) who had low support. Lifetime HIV testing was lower in the ‘Low overall’ (78.0%) and ‘Moderate overall’ (81.9%) classes compared to the ‘Gay men focused’ (96.9%) and ‘High and diverse’ (93.3%) groups. Among non-HIV-positive participants (n = 971), lifetime PrEP use was lower in the ‘Low overall’ (28.9%) than the ‘Gay men focused’ group (56.2%) but similar in the ‘High and diverse’ (59.7%) and ‘Moderate overall’ (37.5%) groups. Greater levels of social engagement with gay men and LGBTQ + people were associated with higher levels of HIV testing and PrEP use. Interventions are needed to reach GBM who are less engaged with GBMSM networks or LGBTQ + communities.

The discussion paper synthesises the insights shared during a keynote panel at the 26th International Philosophy of Nursing Conference, themed “Reimagining a nursing ecosystem in an uncertain world.” It delves into the substantial impact uncertainty has on nursing, offering innovative strategies for reconceptualization. Through a critical examination of evidence‐based practice, the tendency to homogenise nursing is discussed, prompting advocacy for a Nietzschean political framework as a form of resistance and emancipation. Drawing inspiration from Donna Haraway, a transition from individualistic to relational approaches is needed, especially amidst social and economic instability. Furthermore, the integration of caritas and Indigenous epistemologies underscore the significance of cultural sensitivity in nursing. Meanwhile, Ubuntu philosophy champions empathy and collective values, while a convergence of Eastern and Western philosophical traditions promises to enrich nursing practice. Ultimately, the panellists advocate for overcoming rigid ideologies in favour of a pluralistic approaches, ontologies, epistemologies and ethics to address contemporary challenges, and signal for a philosophical reorientation to engage uncertainty and reshape nursing roles in an ever‐evolving and world.

The uptake of human papilloma virus (HPV) and other adolescent vaccinations in special schools for young people with disability is significantly lower than in mainstream settings. This study explored the factors believed to influence parental decision making regarding vaccine uptake for students with intellectual disability and/or on the autism spectrum attending special schools in New South Wales, Australia, from the perspective of all stakeholders involved in the program. Focus groups and interviews were conducted with 40 participants, including parents, school staff, and immunisation providers. The thematic analysis identified two themes: (1) appreciating diverse parental attitudes towards vaccination and (2) educating parents and managing vaccination questions and concerns. While most parents were described as pro-vaccination, others were anti-vaccination or vaccination-hesitant, articulating a marked protectiveness regarding their child’s health. Reasons for vaccine hesitancy included beliefs that vaccines cause autism, concerns that the vaccination may be traumatic for the child, vaccination fatigue following COVID-19, and assumptions that children with disability will not be sexually active. Special school staff regarded the vaccination information pack as inadequate for families, and nurses described limited educational impact resulting from minimal direct communication with parents. More effective communication strategies are needed to address vaccine hesitancy among parents with children with disability.

Background Asian-born MSM are a priority population as Australia aims to end HIV transmission, but they reported additional barriers to access PrEP and other HIV prevention methods. This study investigates factors associated with PrEP use among Asian MSM in Sydney and Melbourne, Australia, to inform strategies to improve PrEP uptake in this population. Methods This was a sub-analysis of a community-based cross-sectional survey conducted from March to June 2021. We recruited participants online in Sydney and Melbourne, Australia. Univariable and multivariable logistic regression analyses were performed to identify the factors associated with PrEP use in the last six months and lifetime. Latent class analyses were used to identify subgroups of Asian MSM sharing similar characteristics related to their risk practices for HIV. Findings Overall, 870 Asian MSM were included: 288 Oceanian-born Asian MSM and 582 Asian-born MSM. Three latent classes were identified: 1) Asian-born MSM who recently arrived in Australia with limited English, were less likely to use PrEP and at higher risk of HIV infection (e.g., had condomless anal sex with a casual sex partner in the last six months) (4.6%); 2) Asian MSM who were at lower risk of HIV infection and less likely to use PrEP (69.3%) and; 3) Asian MSM who were at substantial risk of HIV infection and more likely to use PrEP (26.1%). Compared to Oceanian-born Asian MSM, those who were born in Southeast Asia (adjusted odds ratio (aOR) = 0.5, 95% confidence interval (CI) 0.3–0.7) and South Asia (aOR = 0.4, 95% CI 0.2–0.8) were less likely to ever use PrEP. Compared to Oceanian-born Asian MSM, those who were born in Southeast Asia (aOR = 0.4, 95% CI 0.3–0.7), Northeast Asia (aOR = 0.5, 95% CI 0.3–0.8) and South Asia (aOR = 0.4, 95% CI 0.2–0.7) were less likely to use PrEP in the last six months. Interpretation To end HIV transmission in Australia, it will be necessary to develop strategies to improve PrEP access for the significant minority of Asian-born MSM who are at substantial risk of HIV infection. Funding EPFC and JJO are supported by an Australian National Health and Medical Research Council (NHMRC) Emerging Leadership Investigator Grant (EPFC: GNT1172873 and JJO: GNT1193955). CKF is supported by an Australian National Health and Medical Research Council (NHMRC) Leadership Investigator Grant (GNT1172900).