Mrs Angela Booth

Objective: This evaluation considered the potential of We-Yarn, a suicide prevention gatekeeper training workshop, to contribute to Aboriginal suicide prevention in rural New South Wales. Design: A mixed methods approach included surveys, in-depth interviews and workshop observations. Setting: Aboriginal suicide prevention training in rural New South Wales, Australia. Participants: Attendees at We-Yarn training. Intervention: We-Yarn provided culturally safe suicide prevention skills training for Aboriginal people and for those who work with Aboriginal communities and persons in rural New South Wales. Training workshops were delivered across multiple locations for 6 hours in one day. Workshops were facilitated by two facilitators with lived and professional experience; one Aboriginal and one non-Aboriginal facilitator. We-Yarn content was developed by staff from the Centre for Rural and Remote Mental Health, and in consultation with Aboriginal Elders and representatives of Aboriginal Medical Services to ensure relevance and cultural appropriateness. Main outcome measures: Pre and post-workshop surveys captured capacity and participants¿ confidence in identifying and responding to a person at risk of suicide. Interviews explored participants' experiences of workshops, implementation of learning, and attitudes regarding social and emotional wellbeing and suicide. Observations detailed the workshop environment, participants' engagement, and participants' responses to facilitators and content. Results: We-Yarn was considered culturally appropriate. Participants responded to facilitators' lived experiences. Participants reported significant improvements in understanding the links between cultural strengths, social and emotional wellbeing and suicide prevention. However, health professionals with existing knowledge wanted a stronger focus on clinical training. Conclusion: We-Yarn promoted discussion of suicide prevention within a holistic health framework, building on participants' pre-existing knowledge about social and emotional wellbeing. Importantly, skilful facilitators with lived experience were vital to the success of the workshops. Consideration should be given to attracting people with low suicide prevention knowledge to the workshops, developing tailored workshops for health professionals and ensuring prolonged engagement with communities. Multifaceted and long term responses in addition to this type of training are important.

In 2013, the Blue Mountains region of NSW experienced devastating bushfires. In response, the Step By Step Blue Mountains Bushfire Support Service was established by the Ministry of Police and Emergency Services and a local Blue Mountains service, Gateway Family Support. The service was to support bushfire-affected community members through a strengthsbased and solution-focused approach. This approach has been used in other support services but limited evidence exists on the effectiveness of its use in disaster recovery. The integration of research in the early stages of disaster recovery service design may prove a valuable way to support the work of governments and service delivery organisations and is an important aspect of disaster preparedness and community wellbeing. This paper highlights the vulnerability of the Blue Mountains region to bushfire and examines the 2013 response by the Ministry for Police and Emergency Services Disaster Welfare Service (DWS) in association with Gateway Family Services. The DWS and Gateway Family Services collaborated to implement the service. This paper concludes that support services should be flexible in their response to dealing with those recovering from traumatic experiences such as bushfires. It demonstrates that evaluation of existing disaster support programs could better inform future disaster responses and services to assist communities to better cope and rebuild their lives.

Background: Growing evidence points to the benefits of addressing multiple health behaviors rather than single behaviors. Purpose: This review evaluates the relative effectiveness of simultaneous and sequentially delivered multiple health behavior change (MHBC) interventions. Secondary aims were to identify: a) the most effective spacing of sequentially delivered components; b) differences in efficacy of MHBC interventions for adoption/cessation behaviors and lifestyle/addictive behaviors, and c) differences in trial retention between simultaneously and sequentially delivered interventions. Methods: MHBC intervention trials published up to October 2015 were identified through a systematic search. Eligible trials were randomised controlled trials that directly compared simultaneous and sequential delivery of a MHBC intervention. A narrative synthesis was undertaken. Results: Six trials met the inclusion criteria and across these trials the behaviors targeted were smoking, diet, physical activity, and alcohol consumption. Three trials reported a difference in intervention effect between a sequential and simultaneous approach in at least one behavioral outcome. Of these, two trials favoured a sequential approach on smoking. One trial favoured a simultaneous approach on fat intake. There was no difference in retention between sequential and simultaneous approaches. Conclusions: There is limited evidence regarding the relative effectiveness of sequential and simultaneous approaches. Given only three of the six trials observed a difference in intervention effectiveness for one health behavior outcome, and the relatively consistent finding that the sequential and simultaneous approaches were more effective than a usual/minimal care control condition, it appears that both approaches should be considered equally efficacious. PROSPERO registration number: CRD42015027876.