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Deadly Choices: the importance of health promotion and prevention during the COVID-19 pandemic

Introduction by Croakey: When the Consumers Health Forum began planning a focus on prevention for a themed edition of its journal Health Voices, COVID-19 was not yet a thing.

However, the pandemic provides a timely context and impetus for addressing many of the issues raised in the new edition, whose authors collectively mount a strong argument for sweeping changes to ensure prevention does not remain under-funded and under-done going forward.

Yet, much can also be learnt from successful initiatives, such as Deadly Choices, writes Adrian Carson, CEO of the Institute for Urban Indigenous Health Ltd, in an article cross-published from Health Voices with permission.


Adrian Carson writes:

The COVID-19 pandemic highlights more than ever, the need for a robust, agile and culturally relevant health promotion and prevention strategy, particularly for Aboriginal and Torres Strait Islander people.

While traditional public health promotion has delivered important messaging and education to mainstream Australians, it has failed to reach and have meaning to Aboriginal and Torres Strait Islander people. This is due to a range of factors including: use of language and terminology that is foreign, lower health literacy, and stigmatisation through ‘failure’ to change lifestyle choices.

The dispersed geographic spread of our Aboriginal and Torres Strait Islander communities also presents a challenge in ensuring that key health promotion and prevention messages are delivered through a range of appropriate channels and multi-media formats.

While many Australians may believe that the majority of Aboriginal and Torres Strait Islanders live in remote and very remote regions, the majority (79%) in fact live in urban areas.

South East Queensland has recorded the largest and equal fastest growing Aboriginal and Torres Strait Islander population in the country. It is estimated that the Aboriginal and Torres Strait Islander population will grow to 133,000 by 2031.

To address the growing population and demand for health services in the region, the Institute for Urban Indigenous Health (IUIH) was established in 2009 to assist the four member Aboriginal Community Controlled Health Services (ACCHSs) with regional planning, development and delivery of comprehensive primary health care services.

Deadly Choices was established as the flagship preventative health and community engagement brand of IUIH. “Deadly” meaning good to Aboriginal and Torres Strait Islander people, Deadly Choices is a strengths-based approach that uses cultural identity to define what it means to make healthy choices and reinforces our people as leaders and health promoters.

Deadly Choices is considered one of Australia’s most recognisable Aboriginal and Torres Strait Islander brands, with over 30 Aboriginal Community Controlled Health Organisations ACCHOS and 16 NRL and AFL clubs nationally already delivering Deadly Choices licensed activities across the country.

Behind the brand is a suite of health education, behaviour change programs and social marketing that have increased the number of Aboriginal and Torres Strait Islanders taking control of their health by accessing their local health services, completing regular Health Checks, and engaging in physical activity, nutrition, quit smoking and other healthy lifestyle programs – all critical determinants of better health outcomes.

Since 2010-11, Deadly Choices has contributed to:
• 762% increase in health checks completed in SEQ
• 33,000 new patients reached
• 576% increase in GP Management Plans

In 2018-19 alone, there were 38,000 active clients in SEQ and over 23,000 health checks completed.

An external evaluation of Deadly Choices multimedia campaign found very strong campaign recognition (73%), call to action was very high (85% indicated starting some health change after seeing the campaign) and exceptional Net Promoter Score – 59 compared to best industry score of 27.

The emergence of the COVID-19 pandemic in Australia and increasing restrictions on group assembly and social distancing necessitated a rethinking of the structure and delivery of Deadly Choices programs and activities.

Building on the recognition and experience with highly engaged Aboriginal and Torres Strait Islander people on social media, Deadly Choices dramatically increased our offerings.

Important COVID-19 awareness, education and prevention messaging was developed for Aboriginal and Torres Strait Islander audiences. Social media platforms (Facebook, Instagram, Twitter, and TikTok) continued to carry these new messages along with existing physical activity, nutrition, quit smoking and competitions.

During the first week of trialing the increased online presence, Deadly Choices achieved a massive 31,683 reach and 876 reactions to our Facebook post on “We Can Control the Spread of Coronavirus – it’s up to us.” Similarly, the “Deadly Guide to social distancing” reached 16,293 with 244 reactions.

Live streaming of our DCFit physical activity program and Good Quick Tukka (GQT) cooking program commenced in week two. Current engagement of the first series sits at over 4,300 views of the DCFit session and over 5,400 views of the GQT program. In week three, the second series of DCFit sits at over 4,000 views and GQT sits at over 1,800 within one hour of live streaming.

There is appetite within our Aboriginal and Torres Strait Islander communities for health promotion, prevention and education that is a cultural fit and engages with our people in a positive way.

Deadly Choices is well positioned to ensure that our Aboriginal and Torres Strait Islander communities are informed and up to date, not just about healthy lifestyles, but also prevention and recognition of COVID-19 symptoms.

The disruption caused by the COVID-19 pandemic has presented a rapid opportunity to rethink our traditional messaging and methods of health promotion. This is something which can be shared with mainstream public health promotion. Further investment and flexibility of funding to allow such innovation by ACCHSs is needed.

This will ensure that appropriate and timely health promotion and prevention messages reach our Aboriginal and Torres Strait Islander communities.

Adrian Carson has over 28 years’ experience in the Indigenous Health sector, working within government and non-government organisations. As CEO of the Institute for Urban Indigenous Health Ltd, he leads the development and integration of health and wellbeing services to Australia’s largest and fastest growing Aboriginal and Torres Strait Islander population in South East Queensland. He has served as Chief Executive Officer of the Queensland Aboriginal and Islander Health Council and on numerous other Aboriginal health organisations.

The references cited in this article are available here.

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Population Health Congress 2015
2016 conferences
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#ANROWS2016
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2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
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Australian Palliative Care Conference
2018 conferences
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#ACEM18
#AHPA2018
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#CPHCE
#MHED18
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