Prevention Education

Annual Report 2023 Prevention Education & Research Unit Research and Education Network Western Sydney Local Health District

02 Prevention Education and Research Unit (PERU) Research and Education Network, Western Sydney Local Health District Faculty of Medicine and Health, The University of Sydney PO Box 533, Westmead NSW 2145 T: +612 88906505 I E: wslhd-westmead-peru@health.nsw.gov.au This report is available at https://peru-programs.sydney.edu.au/ Team Clinical Professor Smita Shah - Director Kym Rizzo Liu - Project Manager Catriona Lockett - Research Officer Lance Leung - Administration Officer Acknowledgements We appreciate the financial support from Western Sydney Primary Health Network, and other contributions from Eastern Creek Principals Network, NSW Department of Education, NSW Ministry of Health and Daniel McAlary. We thank the Blacktown, Hills, and the Mt Druitt Medical Practitioners Associations for their support of schools. Special thanks to Professor Peter Hockey, Professor Mark McLean, Helene Abouyanni and Dalia Younan and the administrative staff of Research and Education Network for their ongoing guidance and support. Acronyms BEAT Breathe Easy All Together BMPA Blacktown Medical Practitioners Association FMH Faculty of Medicine and Health GWS Giants Greater Western Sydney Giants MDMPA Mount Druitt Medical Practitioners Association MoH Ministry of Health MRFF Medical Research Future Fund NHMRC National Health and Medical Research Council PERU Prevention Education and Research Unit REN Research and Education Network SALSA Students As LifeStyle Activists SPL SALSA Peer Leaders Triple A Adolescent Asthma Action TSANZ The Thoracic Society of Australia and New Zealand UoW University of Wollongong USyd The University of Sydney WSLHD Western Sydney Local Health District

Table of Contents Foreword ............................................................................................................................... 4 Prevention Education & Research Unit ...................................................................................5 2023 at a Glance....................................................................................................................6 The SALSA Program ...............................................................................................................8 Unpacking Vaping in Schools Project....................................................................................16 Teaching.............................................................................................................................. 27 Collaborations and Partnerships ..........................................................................................28 Conferences and Publications...............................................................................................29 Digital Channels ..................................................................................................................44

04 Foreword The best examples of health promotion and community education always focus on empowerment of individuals - to manage their own health and to facilitate others to do the same. The inspiring work of Professor Smita Shah and the PERU team is doing exactly this with the young people of Western Sydney’s school communities. The PERU programs on healthy eating and lifestyle, e-cigarettes and smoking, among others, are delivering demonstrable benefits. Importantly, their education and engagement model enable students to find their own voice and to have positive influences in their schools, families and broader communities. Most importantly, students are motivated to tackle issues that are meaningful to them and to adopt approaches that are most impactful for their peers. The scale and effectiveness of the PERU programs is growing year by year and they are becoming a model which is being adopted in many other regions. I congratulate all involved in the success of the PERU initiatives and look forward to another year of collaboration and achievement. Professor Mark McLean Executive Director of Research, WSLHD Conjoint Professor of Medicine, Western Sydney University Honorary Professor Faculty of Medicine and Health The University of Sydney Acknowledgement of Country We acknowledge the Dharug people as the traditional custodians of the land covered by Western Sydney Local Health District upon which our work was conducted, and pay respect to Elders past, present and emerging.

05 Prevention Education & Research Unit We are pleased to share with you the ongoing work, achievements and highlights from the Prevention Education and Research Unit in 2023. Established in 1995, PERU continues to be at the forefront of delivering innovative community and school-based prevention and health leadership programs. We work in partnership with schools, universities and a range of organisations, including general practitioner associations to deliver evidence-based prevention programs and interventions to improve the health and wellbeing of young people. What do we do? PERU Team, 2023 Lance Leung, Kym Rizzo Liu, Catriona Lockett and Professor Smita Shah OAM

06 2023 at a Glance

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08 The SALSA Program The Students As LifeStyle Activists (SALSA) is a peer-led leadership program designed to motivate high school students to increase physical activity and improve diet. University students are trained as SALSA Educators to deliver a one-day workshop to Year 10 students. Year 10 students are trained as SALSA Peer Leaders and deliver activities linked to the Stage 4 NSW Personal Development, Health and Physical Education curriculum. SALSA Educator’s Workshop We held two workshops for 35 university students from The University of Sydney, University of Western Sydney and Macquarie University. An additional workshop was held for 11 university students at the Department of Rural Health, University of Newcastle, Tamworth in partnership with HealthWISE. Students were from a range of faculties including allied health, education, medicine, pharmacy and public health. SALSA Educators workshop, USyd SALSA Educators workshop, USyd SALSA Regional Educators workshop, University of Newcastle .

09 Project Outcomes SALSA Educators Celebration The volunteerism of the university students was acknowledged at the annual SALSA Educators’ celebration. They were awarded a certificate of contribution in appreciation of their delivery of the SALSA Peer Leader workshop in at least one high school. The students were presented their certificate by Associate Professor Julie Mooney-Sommers, School of Public Health, The University of Sydney. “The SALSA program opened my eyes to programs that can be implemented within schools in developing leadership skills and empowering students to make healthy changes in their lives.” – SALSA Educator, Faculty of Medicine and Health, University of Sydney “It was such a great experience overall and the abilities and skills learnt throughout will be beneficial for careers in the future. The chance to go to smaller/rural towns and provide education and help those within such communities is a wonderful opportunity.” – SALSA Educator, Faculty of Nutrition and Dietetics, University of Newcastle

10 SALSA Peer Leader Workshops We held eleven peer leader workshops in 2023, with 330 Year 9/10 students trained. The SALSA Program was delivered by the peer leaders to Year 7 or 8 students. SALSA Peer Leaders, Blacktown Girls HS SALSA Peer Leaders, Model Farms HS SALSA Peer Leaders, Narrabri HS SALSA Peer Leader Debrief Sessions To ensure program acceptability, currency, and relevance we hold a debrief session in each school with the peer leaders. Students complete a post questionnaire to measure changes in behaviours, such as vegetable intake, and the skills developed from being a peer leader. During the debrief session, students also reflect on their experiences as SALSA Peer Leaders in relation to what worked well, what was challenging, what they gained, and their School Action Plans. This data helps us to reassess the program and make any necessary changes.

11 Project Outcomes SALSA Peer Leader Feedback SALSA Peer Leader Debrief Session, Colyton HS

12 SALSA Youth Voices SALSA Youth Voices is an extension of the SALSA program providing students with an opportunity to create a supportive school environment to increase physical activity and/or healthy eating. It is underpinned by the Socio-Ecological Model and the Positive Youth Development Framework. The SALSA Program Model Giants player Finn Callaghan speaks to students SALSA Youth Voices Leadership Workshop This year, the GWS Giants generously hosted the workshop at Sydney Olympic Park. SPLs eagerly volunteered for the Leadership Day, driven by their aspirations to refine their leadership abilities, develop and execute a school action plan, and embrace a healthier way of living. The workshop happened to coincide with the Giants preparing for their semi-final against Port Adelaide (which they coincidentally won). As such, the SPLs were privileged to witness an elite AFL training and recovery session. This firsthand account will surely stay with them for the rest of their lives. SPLs enjoyed fun activities like human bingo, mind-teaser challenges, an exclusive tour of the Giants facilities, practicing their AFL skills on the field, and receiving motivational talks from Giants players Wade Derksen, Ryan Angwin, and Finn Callaghan. Additionally, they engaged in small group brainstorming sessions to identify barriers and enablers to adopting a healthy lifestyle, uncovering opportunities for instigating change within their school environment, developing school action plans, and presenting these innovative ideas for feedback. These plans' impact have the potential to reach 5,135 high school students.

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14 SALSA Youth Voices Action Day The Action Day was a huge success as youth voices were integrated throughout all aspects of the program including a student MC, the Acknowledgment of Country, and shared reflections on their experiences peer leaders. Six schools shared their plans and actions to an audience of health and education professionals, including a presentation from Glen Innes and Oxley High Schools. Student plans were generously supported by Western Sydney Primary Health Network and HealthWISE. SALSA Youth Voices Action Day SALSA Youth Voices Action Day Project Outcomes In collaboration with Mt Druitt Medical Practitioner’s Association we hosted the Water Refill Stations ceremony at Mt Druitt Medical Centre, 8th August 2023. This event was key to ensuring continued partnerships between local doctors and schools. Dr Kean-Seng Lim, Principal Jennifer Boyall Erskine Park HS and Professor Smita Shah

15 Model Farms HS ran their project Smooth Steps in Term 4 2023. This initiative was a tremendous success and will continue in 2024. All other plans are projected to be implemented early in 2024.

16 Unpacking Vaping in Schools Project Continuing from work started in 2021, we maintained our commitment to work in collaboration with schools and other stakeholders to tackle the issue of adolescent e-cigarette use. This included several established activities, such as the Unpacking Vaping Prevention and Cessation Special Interest groups, and culminated in the development and testing of the Breathe Easy All Together (BEAT) peer-leadership program. Building on the learnings of our comprehensive listening phase in 2022, we shifted our focus to the next phase of ‘Actions in Prevention’ in 2023. As a result, we successfully updated the Unpacking E-cigarettes online course and developed the BEAT program, including the codesign of an animation to empower students as advocates of respiratory health. Implementing these actions was informed by the literature, stakeholder input and data from the Unpacking Vaping in Schools study. Moving Waves through community action

17 Unpacking Vaping Special Interest Groups Prevention Group We convened monthly meetings for the Unpacking Vaping Prevention Special Interest Group with health and education stakeholders to discuss the prevention of e-cigarette use in adolescents. The purpose of the prevention SIG is to: 1. Share and discuss the latest information from schools, and what is needed to prevent adolescent e-cigarette use 2. Provide a safe space for open discussion 3. Identify opportunities for collaboration Speakers and their topics in 2023 included:  Local school staff shared what was happening in schools regarding e-cigarette use  Ballarat Community Health, Central Coast, Illawarra Shoalhaven, Mid-North Coast, Murrumbidgee, Northern Sydney, Western Sydney, Multicultural Health, The Matilda Centre, Tackling Indigenous Smoking and LifeEd shared their grassroot activities to prevent e-cigarette use  Dr Arthur Chesterfield shared the successes of the BUGA-UP anti-smoking campaign  The Cancer Institute presented the NSW Health social marketing campaign  The University of Wollongong presented their study on the chemical analysis of confiscated e-cigarettes Participants in the Unpacking Vaping Prevention Special Interest Group

18 Cessation Special Interest Group We also convened monthly meetings for the Unpacking Vaping Cessation Special Interest Group for health professionals. The membership includes GPs, paediatric and adolescent specialists, academics, university students, public health and school staff. The purpose of the cessation SIG is to: 1. Share and discuss the latest information, strategies and what is needed to support ecigarette cessation in adolescents 2. Share university student-led research 3. Provide a safe space for open discussion 4. Identify opportunities for collaboration Speakers and their topics in 2023 included:  Dr Habib Bhurawala and Dr Rajiv Singh: GPs perceptions of providing e-cigarettes cessation support  Jessica Twyman: Harnessing student support officers as navigators for e-cigarette cessation in schools  Dr Krista Monkhouse and Mel Jackson: E-cigarette cessation text-messaging intervention  Tara Lawson: E-cigarette cessation training workshops for WHINs  WSLHD Youth Health: Cessation workshop in schools  Dr Moya Vandeleur: The effects of e-cigarette use on respiratory cilia  Dr Renee Bittoun: The effects of nicotine and the brain, passive e-cigarette use, and advocacy in young people  Dr Caroline Sharpe: Revised clinical guidelines for e-cigarette cessation  Minderoo Foundation: National ‘UNCLOUD’ anti-vaping campaign  The JED Foundation: How to quit vaping  Dovetail: Vape Check Tool  Student supervision projects; Aaron Lipovic, Naima Nimmi, David Le

19 Unpacking Vaping in Schools Study The end of 2022 into 2023 was productive. The data collected from seven schools as part of our Unpacking Vaping in Schools study was cleaned, categorised, analysed and reported by the Research Officer, Catriona Lockett, and Associate Professor Julie Mooney-Sommers, School of Public Health, The University of Sydney. Study Findings A manuscript was submitted to the Health Education Journal that explores the findings from the study. Below are some of the findings from the study. What participants want to know about vaping Reasons why young people vape At first glance, students, staff and parents perceived that young people might vape for some similar reasons such as the social normalisation of vaping as ‘cool’ and peer pressure. However, students gave greater emphasis to reasons such as coping with mental health issues and sensation seeking, which were scarcely or not at all touched on by staff and parents. Figure. Participant responses to ‘In your opinion, what is the main reason that adolescents vape?’

20 In small group discussions, participants provided further reasons, which included:  Students perceived that young people might vape due to a lack of confidence to refuse e-cigarettes from their peers, to ‘fit in’ with and ‘stand out’ from their peers, and to cope with mental health issues.  School staff and parents perceived that young people vape to experiment, rebel, or because it is not like smoking – although the latter was not an important touchpoint for students. Concerns about vaping In addition to being concerned about the health and wellbeing related harms of vaping,  Students were concerned about the misuse of vaping to cope with mental health issues, addictiveness, and the gateway effect of vaping. Importantly, the long-term effects of vaping were seen as a distant concern.  School staff were concerned about the impact of vaping on students’ education, learning and behaviour. Staff worried that students did not take the consequences of vaping seriously.  Parents were concerned about their capacity to engage their children in informed, open, and honest conversations about vaping. Key messages moving forward  The differences in how each group understood and experienced vaping was reflective of their relationship in the lives of students. This lends value to the development of targeted prevention strategies. There is no ‘one size fits all’ approach.  We found that how we engage with young people is just as important as the content of the messages being delivered to them. It was overwhelmingly suggested by participants that they would prefer interventions which promote student agency through peer-led initiatives and co-designed prevention messaging.  We need a whole-school and whole-community approach to support the prevention and cessation of e-cigarettes in students.  And, to make this happen, we must foster the development of a strong partnership between health and education – including schools – to ensure the delivery of effective strategies.

21 Presentation to schools Presenting the preliminary results to the study schools was key to ensuring the data was both relevant and actionable. When school staff were asked ‘what do they see as the important findings?’, they included:  The differences in perceptions around adolescent e-cigarette use between students, staff and parents; particularly in relation to students’ reported use of e-cigarettes to cope with mental health issues and understanding of addiction.  Interventions to effectively address e-cigarette use amongst students should be short, clear, and focus on the immediate impacts of e-cigarette use. When asked ‘how do you think your school will use these findings?’:  Further development of educational practices which place emphasis on building student agency and prioritising student-led initiatives to address the issue.  Implement PDHPE lessons informed by the data and what is needed.  Drive conversations about e-cigarette use amongst parents and school staff. Unpacking Vaping in Schools Study event with school staff Using input from this meeting, a report was developed for each study school and shared with them in a face-to-face meeting. See the following page for an example school report. “I think this is a starting point. This shows the information and views of the community and would be interesting to see how it can be implemented” – School Principal

22 Example of a report personalised for schools involved in the study

23 Voices from the Community on the Prevention of Youth Vaping live zoom event Flyer to promote the event This was a live zoom event attended by (n=144) participants and a wide range of presenters. The study findings from the Unpacking Vaping in Schools study were presented, in conjunction with current actions that were taking place in health and education. Click here to view the live recording.

24 Co-design projects Vaping just BEAT it In collaboration with Visionary Digital studios, and Erskine Park and Blaxland high schools an animation was created as the empowerment activity for the Breathe Easy All Together (BEAT) program. The animation follows the quit journey for Zac, supported by his good friend Jasmine, to BEAT the vape. All students played a vital role in ensuring the video’s acceptability for the BEAT program. Snippet from Vaping just BEAT it Student collaborators E-cigarette infographic Following requests from schools, we partnered with University of Wollongong and NSW Health to test confiscated vapes collected from high schools. In September 2023, results from the commissioned e-cigarette analysis study were released. To ensure the information shared with stakeholders was clear and relevant, we visited high schools to ask for their input. Using this information collected from seven schools, a two-page infographic (see Appendix 1) was developed in partnership with schools. This was then shared with high schools and stakeholders. School partners, Colyton High School

25 Breathe Easy All Together Pilot The Breathe Easy All Together (BEAT) peer-leadership program aims to empower students by providing them with the knowledge, skills and confidence to make informed decisions about ecigarette use and advocate for respiratory health. Project outcomes BEAT was piloted in four government high schools with 90 students, three Year 9 and one Year 10 class, in western Sydney. There were 41 females (46%) and 47 males (52%). 11% of students identified as Aboriginal, 4 % as Torres Strait Islander, and 2% as Aboriginal and Torres Strait Islander. The most common language spoken at home was English (66%), followed by Asian (22%), and Polynesian (11%) languages. Students participating in the BEAT pilot As part of the BEAT pilot students completed a self-paced online course, participated in a oneday workshop and developed a social marketing campaign. Overall, the program was well received by students and school staff. By participating in the BEAT workshop students reported improving their knowledge of asthma, its prevention, and management. Students also reported improving their knowledge of vaping harms, the chemical contents of e-cigarettes, and external pressures which influence young people to vape. Importantly, students improved their confidence and skills in decision-making, the management of an asthma emergency, and refusal of e-cigarettes. “Having been part of the pilot and evaluation of BEAT in 2023, I know the program not only addresses the immediate issue of e-cigarette use but also fosters student leadership skills and enriches our school community. This approach aligns with the school's Strategic Improvement Plan and our commitment to supporting the health, wellbeing and holistic development of our students” Rebecca Smith, Deputy Principal, Model Farms High School 2023

26 Inaugural Health Hackathon To further engage students in developing solutions we hosted the Health Hackathon in collaboration with Regional Industry Education Partnerships, NSW Department of Education and the NSW Ministry of Health. The Hackathon aimed to upskill students through industry connections, broaden students’ awareness of careers in health, and empower students to develop a health education campaign. The unique methodology of the two-day workshop provided (n=27) students with the opportunity to engage in concentrated and immersive group work to address their chosen health issue within a clear problem definition-to-solution structure. “It is such a worthwhile program. It was exciting to see my students really take charge, dive headfirst into their campaign and produce a researched campaign in less than 48 hours. Truly they were stars.” School Staff Member, Windsor HS

27 Teaching FMH, The University of Sydney, School of Pharmacy, Pharmacy students We facilitated 7 x 2.5hr Health Promotion workshops for The University of Sydney fourth year and Master of Pharmacy Students (n=256). We highlighted our health promotion programs, including the Adolescent Asthma Action (Triple A) program and the Breathe Easy All Together (BEAT) Pilot for this workshop. FMH, The University of Sydney, Western Clinical School, Medical students  Year 1 Introduction to Respiratory History and examination of a patient with a cough PHD, Internship and Work Placement students  Rachel Chua, Master of Public Health, USyd work placement, “Evaluation of SALSA University Educators”  Sareena Oberoi, Master of Public Health, USyd work placement, “Sustainability of the SALSA program”  Aaron Lipovic, medical student, University of Western Sydney, MD Project “Scoping review of cessation resources for Health Care Professionals”  Catriona Lockett, PhD, 2023-ongoing, co-supervisor, The University of Sydney, “Unpacking Vaping in Schools: Engaging Peer Influence to Prevent Adolescent Ecigarette Use in High School Students”  Fay Karpouzis, PhD, 2019-ongoing, co-supervisor, Deakin University, Melbourne. “Promoting food literacy, sustainable and healthy eating in children aged 10-12 years: Implementation and Evaluation of OzHarvest’s school-based FEAST (Food Education and Sustainability Training) Program”  Naima Nimmi, PhD, 2022-ongoing, co-supervisor, Federation University, Victoria, “Survey knowledge, attitudes, practices, self-efficacy and perceived barriers of GPs and paediatricians on adolescent vaping support”  David Le, PhD, 2023-ongoing, co-supervisor, The University of Sydney, “Vaping health implications and awareness amongst pharmacists”  Dr Rajiv Singh, Paediatric registrar, Nepean Hospital “Survey on knowledge, attitudes and practice of GPs regarding the use of e-cigarettes in children and adolescents (NSW)”

28 Collaborations and Partnerships Research Collaborations  Carson-Chahhoud KV, Tai A, Sandford D, Shah S, Mayer W, Segal L, Perveen S, O’Connor A, Tingey-Holyoak J, Sharrad K, Esterman A, Crutzen R, Hamari J, Cao J, Smith R, Gwilt I, Chong A, Henderson M. Clinical trial to evaluate a digital self-management and mental health intervention for young people with asthma and their families. WCH Foundation 2023 Bloom Grant Round. $1,395,044; 3-years (across 2023-2026)  MacIntyre R, Shah S et al The BREATHE Study: A randomised controlled trial of mask use in control of respiratory outcomes during bushfire season. MRFF- EPCDR Bushfire Impact Research Grant $473,135  Carson-Chahhoud KV, Shah S et al Empowering asthma self-management and therapeutic adherence through a comprehensive evidence-based behavioural support program delivered through augmented reality technology. MRFF Chronic Respiratory Conditions Grant Opportunity (unsuccessful)  Jensen M, Shah S et al Medical Nutrition Therapy targeting overweight and obesity in paediatric asthma – the EAT healthy for Asthma Telehealth (EAT) trial MRFF Chronic Respiratory Conditions (unsuccessful)

29 Conferences and Publications Presentations 1. Unpacking Vaping in Schools: a community approach, Blacktown Medical Practitioners Association, February 2023, oral presentation 2. Unpacking Vaping: voices from the school community, TSANZ Conference Christchurch New Zealand, March 2023, poster presentation (see Appendix 3) 3. Unpacking Vaping in Schools: preliminary findings, Rooty Hill High School March 2023 4. SSOs perceptions of e-cigarette use and preferred strategies to support students in cessation, April 2023 5. Voices from the Community on the Prevention of Youth Vaping, live zoom event to share study findings, 4th May 2023 6. Voices from the Community on the Prevention of Youth Vaping, E-cigarettes and young people meeting, NSW Ministry of Health, May 2023 7. Breathe Easy: GPs response to e-cigarette use in young people, Hills Doctors Association, 18 May 2023, oral presentation 8. Tackling Vaping in Schools, Westlab Webinar, 19 May 2023, oral presentation 9. Unpacking Vaping in Schools: A whole school approach Exploring National Responses to smoking and vaping in Aboriginal and Torres Strait Islander Communities June 2023, oral presentation 10. Unpacking Vaping: voices from the school community, Westmead Hospital week poster, August 2023, poster presentation 11. Views of Healthcare Providers on providing vaping cessation support to Adolescents scoping review, Australian Public Health Conference, September 2023 12. Moving Waves in E-cigarette Prevention, Child Safety Conference, Australian Independent Schools (AISNSW), 19th September 2023, oral presentation 13. Moving Waves in E-cigarette Prevention in Schools, Smoking and Vaping Professional Development Day, Lung Health Promotion Centre, 24th October 2023, oral presentation 14. Moving Waves in E-cigarette Prevention in Schools, P&C AGM, Nepean CAPA High School, 25th October 2023, oral presentation 15. Vaping Cessation Support to Adolescents by Healthcare Providers, Asia Pacific Academic Consortium for Public Health Conference, 31st October, Oral presentation 16. Moving Waves in E-cigarette Prevention in Schools, Western Sydney Deputy Principals Network, 9th November 2023, oral presentation 17. Moving Waves in E-cigarette Prevention in Schools, Eastern Creek Network Principals Meeting, 21st November 2023, oral presentation

30 Abstracts 1. Lockett C, Shah S Rizzo Liu K, Mooney Somers J. Moving Waves in E-cigarette Prevention in Schools: A Pilot Study of the Breathe Easy All Together (BEAT) Peer-Led Program. Abstract submitted for the TSANZ Conference 2024 2. Rizzo Liu K, Lockett, C and Shah, S ‘Stories from the Schoolyard: Youth Voices Solving Physical Activity Challenges ‘, and Rizzo Liu K, Lockett, C, Irani, F, Slepcev, V, Assanti, C, Shah, S ‘Tik Tok Fortnite and Graphic Novels: Students Deliver Solutions to Health Problems’. Abstracts submitted for the PHAA Preventative Health Conference 2024 Publications 1. Shah, SS, Rizzo Liu, K, Lockett, CL, Sainsbury, E (2023) “Youth Voices creating healthy eating and physically active environments in schools” Health Education Journal,vol82, no 5, pp 542-554 doi: 10.1177/00178969231173266. 2. Karpouzis, F, Lindberg, R, Walsh, A, Shah, S, Abbott, G, Ball, K (2023) “Impact and process evaluation of a primary-school Food Education and Sustainability Training (FEAST) program in 10-12-year-old children in Australia: pragmatic cluster non-randomized controlled trial" BMC Public Health, 4a525562-6948-4f58-bb91-1569cef8bd15 3. Karpouzis, F, Lindberg, R, Walsh, A, Shah, S, Abbott, G, Ball, K (2023) “Primary-school-aged children inspire their peers and families to eat more vegetables in the KiiDSAY Project: A qualitative descriptive study” BMC Paediatrics, 1a7c2c9c-4214-470a-bbfe-0e59e5f51cae 4. Seale, H, Trent, M, Marks, G.B, Shah. S, Chughtai, A.A, MacIntyre, C.R (2023) “Exploring the use of masks for protection against the effects of wildfire smoke among people with preexisting respiratory conditions” BMC Public Health https://doi.org/10.1186/s12889-023-17274-3 5. Stone E, Evison M, van Zyl-Smit RN, Andarini S, Shah S, Vandeleur M (2023) “Recreational vaping ban in Australia – policy failure or masterstroke?” Lancet, https://doi. org/10.1016/ S01406736(23)02298-5 6. Singh R, Bhurawala H, Shah S, “Exploring General Practitioners' Knowledge, Attitudes, and Practices towards E-cigarette Use/Vaping in Children and Adolescents: A Pilot Cross- sectional Study in Sydney”, European Journal of Pediatrics 3debdc64-e254-428e-8da0-a468ee8dfdf0 7. Lockett, CL, Shah, SS, Rizzo Liu, K, Towns, S, Smith, R, Mooney-Sommers, J “Unpacking Vaping in Schools: Voices from the School Community” HEJ (under review) 8. Nimmi, N, Joseph, B, Bhurawala, H, Shah, S, Munoz, A, Aziz Rahman, M “Vaping cessation support to adolescents by healthcare providers: scoping review” (manuscipt submitted to Addictive Behaviour Journal)

31 Media Articles and other 1. “Actions speak louder than words: Western Sydney Local Health District’s Professor Smita Shah receives esteemed OAM, 13 Jan 2023 (see Appendix 3) 2. “SALSA Youth Voices Actions in Western Sydney,” The NSW Doctor, NSW Australian Medical Association, January 19 2023 3. “HealthWISE collaboration brings students’ health to the forefront,” The Northern Daily Leader, 10 May 2023 4. “’Eye-opening’: Western Sydney Local Health District leads the way on new key research about vaping in schools”, The Pulse, 17 May 2023 (see Appendix 4) 5. “Western Sydney high school students say ghost it to vaping,” The Pulse, 31 May 2023 6. “Not just a young person’s habit: Western Sydney Local Health District workshop tackles e-cigarette problem,” The Pulse, 31 May 2023 7. SALSA kicks off, 7 Prime Tamworth 8. “Empowering students to build healthier futures”, WentWest, June 8 2023 (Appendix 5) 9. “Water campaign,” Hills to Hawkesbury Community News, June 22 2023 10. “Peer led health program launched in local high schools,” New England Times, 23 June 2023 11. “The Research Files Episode 84: Empowering young people to prevent e-cigarette use, ACER Podcast, July 20 2023 12. “Empowering Youth for Health and Career Success,” HealthWISE News, 19 May 2023 13. “Empowering students for health and leadership: SALSA Program launches at Glen Innes High School,” HealthWISE News, 22 June 2023 14. “Building confidence and leadership skills with SALSA at Narrabri High School,” HealthWISE News, 28 June 2023 15. “Gunnedah and Oxley High School students become lifestyle activists in SALSA workshop,” HealthWISE News, 3 July 2023 16. “Tik Tok videos and online games could boost youth health,” The Grenfell Record, 14 Nov 2023 17. “Future health innovators: Western Sydney students take centre stage at Westmead Hospital ‘Health Hackathon,’ The Pulse, 15 Nov 2023 18. “Could a video stamp out vaping? Western Sydney students share ideas at first Health Hackathon”, The Pulse, 28 Nov 2023 (see Appendix 6) 19. “Youth health message cuts through at Hackathon”, NSW Education News, 30 Nov 2023 20. “Voices of the future: Western Sydney students become health advocates at SALSA Youth Voices Leadership Day at Westmead Hospital”, The Pulse, 11 Dec 2023 (see Appendix 7)

32 Appendix 1

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34 Appendix 2

Appendix 3

Appendix 4

37 Appendix 5

38 Appendix 6

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Appendix 7

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44 Digital Channels https://peru-programs.sydney.edu.au/ or scan the QR Code below: Social Media @PERUWSLHD @peru_programs @PERUWestmead Peru Westmead PERU: Youth Voices

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