This paper utilizes the concept of "colonial master narratives" to examine how racial propaganda is mobilized in the Australian imaginary to "flatten" the stories of Blac/k people and how African Australians deploy counternarratives to reject these racialized projections. Specifically, we examine how master narratives, as a form of colonial propaganda, were challenged and subverted by participants' refusal to be spoken for and about through myths and falsehoods, presented as truisms about who black people are (or are not). In so doing, we analyse how African Australians encounter, negotiate, and actively refuse the colonial 'master' narratives that are institutionalized across Australian politics, policy settings, media representations, and everyday social hierarchies. Forty-two African Australians were recruited across Queensland, Victoria, Western Australia, South Australia, and New South Wales to share their experiences of belonging, Africanness, and racial dignity. The findings demonstrate that, despite ongoing stereotyping, profiling, and racial labelling, African Australians deploy practices of refusal through dignity-affirming counternarratives that actively seek to disrupt deficit-oriented framings of Blackness and Africanness. We argue that such counternarratives are necessary resistances to racial harm and are generative political acts that reimagine life in Australia as something that can be experienced agentically, beyond the racial myths and falsehoods instrumentalized by colonial logics. Counternarratives are, therefore, a way of "refusing indignity" and making space for stories of love, beauty, and joy.
Military veterans have high rates of mental health conditions; complex post-traumatic stress disorder may be the most functionally impaired trauma diagnosis in this patient group. Psychological resilience acts as a protective factor for mental health. Still, it is unclear how this may influence relationships between the two main symptom clusters of complex post-traumatic stress disorder and functioning impairment in veterans. Therefore, we investigated the relationships between psychological resilience, trauma symptom severity, trauma exposure and work/social functional impairment among Australian Defence Force veterans. Cross-sectional survey including 148 mental health support-seeking former-serving Australian Defence Force veterans in primary care. Relationships between variables were explored using correlations, mean difference tests and mediation analysis to examine the role of resilience in the relationship between complex post-traumatic stress disorder symptoms and functional impairment. Resilience showed significant negative correlations with functioning impairment. The number of traumas showed weak positive correlations with disturbances in self-organisation symptoms, post-traumatic stress disorder symptoms and functional impairment. The complex post-traumatic stress disorder group had significantly lower resilience and functioning than those with no diagnosis. After controlling for the number of trauma exposures, resilience partially mediated the association between post-traumatic stress disorder symptoms and functioning (indirect effect = 0.141, p < 0.05), and partially mediated the association between disturbances in self-organisation symptoms and functioning (indirect effect = 0.157, p < 0.05). Psychological resilience was associated with better functioning in veterans regardless of trauma diagnosis. Resilience also partially mediates the relationship between disturbances in self-organisation/post-traumatic stress disorder symptoms and functioning in those with International Classification of Diseases, 11th Revision, complex post-traumatic stress disorder, indicating it is an important intervention target in Australian Defence Force veterans with polytrauma.
Autistic individuals referred for medical imaging examinations may face barriers without appropriate adjustments. Strengthening the relationship between patients and the healthcare system is crucial, as positive patient experiences can improve adherence and future engagement with healthcare services. This study explored Australian radiographers' experiences and perceptions of imaging autistic patients. Terminology preferences among autistic individuals vary across countries, communities and individuals. This paper adopts identity-first language, 'autistic person' or 'autistic patient', aligned with recommendations from Australian organisations and medical imaging researchers. Semi-structured online interviews were conducted via Zoom with 10 diagnostic radiographers. Anonymised transcripts were analysed using reflexive thematic analysis to identify patterns of meaning across participants' experiences. All radiographers (n = 10) reported experience performing medical imaging procedures for autistic patients. Four themes were identified: (1) Educational resources and recommendations, (2) Organisational factors affecting radiographic practice, (3) Patient and carer factors affecting radiographic practice, and (4) Key strategies that facilitate positive patient care. Although radiographers lacked formal training specific to caring for autistic individuals, they attributed positive patient experiences to their patient-centred approach, existing knowledge, communication skills, teamwork, and personal attitudes. Radiographers expressed interest in targeted training and remain committed to high-quality patient care. Improving the accessibility of radiology departments through collaboration with autism organisations and the broader community is essential to support better imaging experiences for all patients. Future research should prioritise the perspectives of autistic individuals and their families to comprehensively understand their medical imaging experiences and identify the range of meaningful, patient-defined indicators of quality care.
Drug-related early warning systems (EWS) rapidly identify and share information on emerging risks, linked to unregulated drug markets. Such systems depend on effective interdisciplinary and interorganisational network collaboration, however, the mechanisms underpinning this collaboration and the outcomes it generates remain under-examined. This paper explores how network collaboration operates, and the outcomes it produces within Australian drug-related EWS. Twenty practitioners with experience of brokering, managing and participating in nationwide and jurisdiction specific EWS networks in Australia were interviewed. Interviews were transcribed verbatim. Drawing on realist evaluation methodologies data were analysed to derive context, mechanism and outcome (CMO) configurations, which supported the development of an initial program theory for network collaboration. Danermark's critical realist model for explanatory research guided this process. Among practitioners interviewed, network collaboration was described as generating three core outcomes: i) establishing and strengthening trust, ii) building EWS capacity, situational awareness, and preparedness, and iii) enabling rapid, reliable and resonant EWS responses. These outcomes appeared to emerge incrementally, be mutually reinforcing, and follow a cyclical pattern. However, they were contingent upon collaborators aligning on purpose, maintaining respect, preserving each other's remits and affirming diverse types of expertise. Drug-related EWS networks can foster relational trust, triggering reciprocal sharing, learning, and timely exchanges about acute concerns. The impact of collaboration may be further strengthened via formal governance mechanisms that enable close to real-time interorganisational and interjurisdictional data-sharing. Our program theory may inform practitioner efforts to broker, manage, and evaluate collaborative networks addressing drug related harms.
A thorough understanding of the challenges involved in practising in long-term care communities is essential to enhance optometric engagement with this sector. Vision impairments are common among older adults living in long-term care communities. However, significant gaps in access and utilisation of eyecare services exist in this setting. This study explored the barriers and enablers faced by optometrists to provide domiciliary eyecare services in long-term care. A qualitative descriptive approach was adopted. Twenty-seven Australian optometrists (16 with long-term care experience) participated in interviews or focus groups, guided by the theoretical domains framework. The sessions were audio recorded, transcribed, coded deductively and inductively, and analysed iteratively to form themes. Five themes emerged, highlighting several barriers at macro/ system-level (e.g. regulatory gaps, workforce shortage), meso/ organisational level (e.g. environment, poor care coordination) and micro/ practitioner-patient-family level (e.g. capabilities, competing priorities). Enablers included positive beliefs about socio-professional responsibilities, experience managing complex conditions, confidence in clinical skills and practising in non-traditional settings, knowledge of referral practices, and job satisfaction. Recommendations to overcome barriers included financial incentives, peer-support, and mentoring opportunities, an enabling environment in aged care, centralised health records, and collaborative models of care involving aged care staff, health professionals, and families. Multifaceted challenges hinder eyecare in long-term care. The findings highlight the need for advocacy and a systems-thinking approach to build capacity, enhance care coordination, and optimise funding for domiciliary optometry to improve eye and health outcomes for people in long-term care. The study recommendations align with the Integrated People-Centred Health Services framework of the World Health Organization, offering opportunities for further development.
This study examined inter-community-based variations in spirometry parameters in 243 Aboriginal patients aged >18 years from 14 individual remote communities (61% female, with a median age of 54.6 years). Mixed ventilatory impairment was the most common pattern (51.6%), followed by restrictive (32.4%) and obstructive (9.8%). Significant inter-community variability was observed, ranging for mixed (85.7% to 37.5%), restrictive (62.5% to none) and obstructive (20% to none). These findings indicate a more tailored approach is needed to address lung health in rural and remote residing adult Aboriginal Australians.
Cervical screening in Australia is currently accessed through a healthcare provider, typically a general practitioner in primary care. We aimed to assess the real-world availability of and access to cervical screening services, including self-collection. Cross-sectional study was conducted using a secret shopper methodology with a standardized telephone script that emulated real-life calls. A random sample of Australian general practices, from each State/Territory (contacted November 2024-February 2025). Of the 310 general practices, 72 (23%) could not offer a cervical screening appointment for new patients. Among practices able to provide an appointment, 217 (89%) said self-collection was available. By jurisdiction, the proportion of practices reporting availability of cervical screening ranged from 72 to 83% but did not significantly differ. The proportion of clinics that offered the choice of self-collection differed significantly by State/Territory ( χ 7 2 =15·774, P = ·013), ranging from 60 to 100%. More regional clinics (94%) offered self-collection compared to metropolitan clinics (85%)(P = ·017). Practices located in the most disadvantaged socioeconomic quintile had a significantly higher proportion offering self-collection (95%) compared to those located in the most advantaged quintile (79%)(P = ·043). Out-of-pocket or gap fees were charged by 183 (75%) clinics (average: $AU50·73, range $AU15-$94·15). Our study highlighted that access to cervical screening may be constrained by limited appointments for new patients, out-of-pocket costs, and other factors. These barriers may disproportionately affect individuals facing structural and financial disadvantage. We found significant variability in availability of self-collection by location. Exploring flexible models, including mail-out, pharmacy supported, or community-led models, may improve accessibility and reduce burden on general practices.
Influenza is a leading cause of pediatric hospitalizations, with clinical presentations and outcomes varying between types A and B. This study compared the clinical characteristics and complications of children hospitalized with influenza A and B at the Sydney Children's Hospitals Network (SCHN) in the post-COVID era. We conducted a retrospective cohort study of children < 18 years admitted to SCHN with influenza during 2022-2023. Data on patient demographics, clinical presentations, complications, and management were extracted from electronic medical records. Group comparisons used chi-square or Fisher's exact tests, and modified Poisson regression estimated adjusted risk ratios (RRs) with 95% confidence intervals (CIs) for key clinical outcomes. Among 704 influenza hospitalizations, 480 (68.2%) were due to influenza A and 224 (31.8%) to influenza B. Influenza B hospitalizations were more frequent in older children aged 5-< 18 years (67.4% vs. 57.7%) and associated with myalgia and pharyngitis, whereas influenza A hospitalizations were more common in children < 5 years (42.3% vs. 32.6%) and linked to cough, wheeze, and seizures. Although less common, influenza B hospitalizations exhibited greater clinical severity, with higher risks of noninvasive respiratory support (RR = 2.94; 95% CI 1.49-5.81) and intensive care unit (ICU) admission and/or mechanical ventilation (RR = 3.23; 95% CI 1.43-7.32). Influenza B, though less prevalent, was associated with greater severity, particularly in older children. These findings underscore the importance of continued protection against both influenza types and support consideration of expanding vaccine access to children aged 5 years and older.
Price promotions are widely used in supermarkets and are more commonly applied to less healthy foods and beverages. We aimed to examine how supermarket price promotions influence food and beverage purchasing among households with school-aged children in Australia, and how perceptions vary by income. A cross-sectional qualitative study using semi-structured interviews, analysed using thematic analysis. Australia, within the supermarket retail food environment. Twenty-two parents or caregivers of school-aged children from households with differing income levels. Participants across income groups reported using supermarket price promotions as a budgeting strategy, particularly in the context of rising food costs. Price promotions were described as encouraging unplanned purchases, most often for unhealthy foods and beverages. Compared with higher income households, lower income households reported greater awareness of supermarket pricing strategies and more frequent purchasing of price-promoted products. Participants perceived that healthy options were less frequently discounted, and suggested that increasing promotions for healthy foods and beverages would better support healthy diets. Supermarket price promotions were perceived to shape purchasing decisions, often encouraging purchases of less healthy foods and beverages. Regulatory approaches that reduce promotions on less healthy products while improving the affordability of healthier options may support healthier and more equitable food environments, particularly for households experiencing financial constraints.
Australian demand for medicinal cannabis remains high despite limited evidence of efficacy. One proposed explanation for this disconnect is the 'entourage effect', which suggests that non-cannabinoid components of whole-plant formulations, typically missing from the standardised products subject to trial, enhance therapeutic outcomes. While advocates cite observational studies and overseas usage patterns, there is no clinical or in vitro evidence supporting this hypothesis. Furthermore, Australian usage patterns do not suggest a preference for whole plant products. Until further evidence emerges from well-designed trials, the entourage effect remains speculative and claims regarding the benefits of whole-plant preparations must be interpreted as such.
Multimorbidity is rising in primary care, yet adherence to guidelines is hindered by fragmented, disease-specific recommendations. This study sought to establish consensus among general practitioners (GPs) on indicators of adherence to Australian guidelines in managing five common chronic conditions [type 2 diabetes mellitus (T2DM), obesity, hypertension, cardiovascular disease, and chronic kidney disease (CKD)], aiming to develop a unified tool for holistic care. A two-round reactive Delphi survey was conducted with 21 GPs in Western Australia, following RAND methodology. Indicators were drawn from the Royal Australian College of General Practitioners' guidelines and covered biophysical markers, lifestyle risks, and pharmacological management. Participants rated indicators for relevance and clarity on a 4-point Likert scale without a neutral option. Consensus was defined as ≥70% of GPs rating an indicator ≥3 for mean relevance. The process ended when ≥80% of indicators reached this threshold, and no new items were proposed. Feedback refined wording and, where relevant, was reported verbatim. In Round 1, 57 indicators achieved consensus on relevance, with four additional items suggested. By Round 2, consensus was reached on 61 indicators. Most were rated clear, except two addressing pharmacological management of CKD with T2DM, which require clearer guidance. Feedback emphasized the need for refined lipid management guidelines, prioritizing obesity management for prevention, and challenges in lifestyle counselling. This study represents the first integration of disease-specific indicators into a GP-informed tool for multimorbidity management. Strong consensus highlights its practicality, warranting piloting to evaluate effects on guideline adherence and patient outcomes.
Atmospheric deposition contributes to the long-range transport of per- and polyfluoroalkyl substances (PFAS). It is thus a potentially important source of these compounds to seas, lakes and other water bodies. However, measurements of PFAS in southern hemisphere rain are limited. Here we present data on PFAS in Australian rainwater. Eight of the 30 compounds tested for were detected, with substantial variation in amounts and composition. The concentration of ∑30 PFAS in rain was 18.05 ng/L in 2024 and 4.95 ng/L in 2025. Longer-chain (>C7) compounds were the predominant class during the wet autumn period, whereas shorter-chain (C4-C7) PFAS were more prevalent during the drier summer. Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) modelling indicated that air originating over the ocean had the lowest concentrations of PFAS, whereas air that passed over land had the highest concentrations. The concentrations of Perfluorooctanoic acid and Perfluorooctanesulfonic acid (PFOS) in rainwater did not exceed current Australian drinking water guidelines. Concentrations of PFOA exceeded the U.S. Environmental Protection Agency Lifetime Drinking Water Health Advisory limits in 2024 and 2025; PFOS concentrations exceeded the guidelines in 2025. Preliminary calculations based on Melbourne rainfall and the surface area of Port Philip Bay indicated that rainwater could contribute ∼10.6 kg of PFAS to the bay each year.
Congenital hypogonadotropic hypogonadism (CHH) is a rare group of disorders of gonadotropin deficiency, either isolated or as a part of multiple pituitary hormone deficiencies (MPHD). We aimed to describe the spectrum of presentation, diagnosis, and management practices of CHH spanning 30 years at an Australian tertiary paediatric centre. This is a retrospective cohort study of patients with CHH seen at the Children's Hospital at Westmead between January 1994 and December 2024 (n = 96, 66% male), categorised by diagnostic subtypes: Kallmann Syndrome (KS), normosmic HH, MPHD and other syndromes (including CHARGE). RESULTS: In patients with KS (n = 31, 87% male), the most common presenting features were micropenis and/or cryptorchidism (45%) or pubertal delay (45%), with two peak ages of presentation: 0.6 [IQR 0.3-0.8] and 14.6 [11.5-15.7] years. Patients with MPHD (n = 23, 52% male) presented with neonatal hypoglycaemia in 52%. Comorbidities stratified by diagnostic subtypes (KS, MPHD, and other syndromes) included hearing impairment (10%, 4%, 100%), visual impairment (7%, 17%, 77%), cardiac anomalies (3%, 9%, 77%), and intellectual disability (13%, 26%, 46%). Genetic testing was performed in 32% in 1995-2009 vs 66% in 2010-2024. Pathogenic gene variants associated with HH were found in 61% of those tested, including CHD7 (n = 10), ANOS1 (n = 4), and FGFR1 (n = 3). Pubertal induction was commenced in males at a mean age of 14.1 ± 1.6 years using testosterone (n = 27 oral; 14 intramuscular; 1 subcutaneous) or gonadotropins (n = 5), and in females, at a mean age of 14.6 ± 1.8 years using oestradiol (n = 21 oral; 8 transdermal) ± progesterone. CONCLUSIONS: CHH is a heterogeneous group of disorders, with varying prevalence of associated comorbidities according to diagnostic subtypes. Our data highlight the paediatric-specific modes of presentation of CHH, and in KS, the bimodal distribution of age at presentation in males and the under-representation and delayed diagnoses in females. Despite advances in genetics in the past three decades, there remain areas for further research in the diagnostics and therapeutics of CHH in the paediatric age group.
Indigenous children are seen as an intrinsic, systematic foundation of hope in Aboriginal conceptualisations of hope, yet are grossly overrepresented in Australian suicide statistics. Despite being a target of the Australian Government's almost 20-year-long Closing the Gap campaign, the numbers are only getting worse. 'It's not depression, it's despair' are words that echo a sentiment so ghastly for parents of Indigenous children who only hope to bestow them with the gift of exactly that: hope. It is only sensible to counteract this with holistic, culturally empowered, strengths-based well-being programs to both develop Cultural strength while concurrently instilling a sense of Cultural pride and identity.
Socio-economic status (SES) is strongly linked to health outcomes but remains difficult to measure accurately. Conventional approaches based on large geographical units (e.g. postcodes) may obscure SES effects evident at smaller scales. We aimed to address key limitations of postcode-based socio-economic analyses by developing and demonstrating a more geographically precise small-area approach. We developed an online platform (https://onlinecalc.app/SEIFA_SA1/) that integrates small-area SES data across multiple Australian Census periods and expresses SES as percentile rankings, preserving relative positionality over time and reducing inconsistencies introduced by Census method updates. To illustrate its utility, we analysed Australian participants from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study, linking each participant's residential collection district (~200 households) to Index of Relative Socio-economic Disadvantage (IRSD) and Index of Economic Resources (IER) percentiles 5-yearly from 1986 to 2006. In 5147 participants, lower area-level SES was consistently associated with prevalent cardiovascular disease (CVD) across all census years, while lower SES among participants who experienced new on-trial CVD events was evident in census data from the decade before trial entry (1986-1996) and not in 2001 or later. Among participants randomised to placebo, lower SES tertiles (2001-2006 Census) were associated with higher rates of new on-trial CVD (6.9% vs 9.8% and 7.0% vs 10.0% for upper vs lower IRSD and IER tertiles respectively; both P for trend = 0.027), whereas this association was not observed in fenofibrate-treated participants, in whom total CVD events were reduced overall by 11% (P = 0.035). Assessing SES at smaller geographical scales provides a more sensitive measure of socio-economic disparities influencing cardiovascular risk. This approach underscores the value of high-resolution census data for improving equity-focused health research and policy.
Ongoing colonisation of the land now known of Australia includes Western hegemony in biomedical knowledge systems dominating healthcare provision. Racism remains structurally entrenched in Australian systems of health and wellbeing. This has serious implications for First Nations foot health outcomes. The purpose of this work is to empower First Nations-led codesign of ways of working in foot health research to investigate challenges to attending, and barriers to providing, good foot care with and for First Nations Peoples. Aboriginal Participatory Action Research ways of working in this study are documented in previous publication; 'Working right ways in foot health with and for First Nations Peoples: research method guided and governed by First Nations ways of knowing, being, and doing in cross-sectional qualitative study design'. First Nations-led study design used decolonised language in semi-structured interviewing to talk with consenting participants. Data analysis included all transcripts being anonymised and transcribed verbatim by researchers manually. First Nations-led ways of doing thematic analysis was agreed upon by all authors. Two talking points discussed First Nations and non-Indigenous health practitioners' perspectives of providing good foot care with and for First Nations Peoples: (1) What challenges exist in attending individual/organisational services? (2) What are barriers to providing good foot care? In interviews, themes emerged of relationships, disempowerment, education, and clinical governance. Additionally, racism, distance, and funding were perceived as influencing foot care provision. Although not themed, the constructs of time and their importance, were interwoven through results. Participants described relationships which were not culturally centred, nor longer term, and which therefore limited trust, as being a challenge to attending foot health services. This research identified service barriers to providing good foot care with and for First Nations Peoples as distance and funding. Compounding barriers was lack of health professional cultural capability education impacting clinical services; this being dependant on individuals' behaviours and knowledges, and services' governance. Further work needs to centre the cultures and leadership of First Nations individuals, families, and Communities in working with and for them to keep feet strong.
This scoping review maps the literature on public involvement in pre-registration nursing education, focusing on educational activities and the explicit theories, frameworks or models used to inform or justify these activities to support educational practice. Public involvement is an established and expanding feature of pre-registration nursing education. However, there is limited clarity regarding the range of activities currently undertaken and the extent to which these are informed by theories, frameworks or models. A scoping review. A systematic search was conducted in CINAHL Ultimate, Medline, Scopus, ERIC, PsychINFO, Emcare, Australian Education Index and ProQuest Dissertations. The review followed the principles of the Joanna Briggs Institute methodology, the PRISMA-ScR checklist and guidance on artificial intelligence use in evidence synthesis. The review included 144 sources with diverse methodologies and geographical origins. A wide range of public involvement activities were identified, most commonly direct involvement in educational activities such as storytelling, teaching and developing materials. Few sources provided detailed descriptions of activities, learning outcomes, evaluation mechanisms or required resources. Only a small number of sources explicitly used theories, frameworks, or models to justify involvement or inform their educational design, although many referenced broader conceptual or policy drivers. Public involvement in pre-registration nursing education encompasses diverse activities with varied conceptual underpinnings. Greater transparency in reporting, including clearer descriptions of activities and their evaluation, is needed to strengthen the evidence base, support practice and empower stakeholders.
Sport is frequently promoted as a mechanism for youth development and livelihood enhancement, yet empirical evidence on how sport contributes to sustainable livelihoods, particularly for young women in Pacific Island contexts, remains limited. This study examines how sport shapes livelihood opportunities for young people in Suva, Fiji, with a particular focus on gendered participation and outcomes. Drawing on the Sustainable Livelihood Framework (SLF), this qualitative case study explored how socio-environmental factors, including family dynamics, peer relations, and governance structures, influence youth engagement in sport and access to livelihood assets. Data were collected through participant observation, focus groups, and semi-structured interviews across two less-studied sports (Australian Football League and cricket), involving both active participants and those who had dropped out of sport. Youth vulnerability was shaped by unemployment, fractured family relationships, and peer pressure. Sport contributed to the accumulation of human, social, and cultural capital (vanua), but access to these benefits was uneven. Female participants faced distinct socio-cultural and economic barriers, including domestic responsibilities, limited financial resources, and restrictive gender norms, which constrained both participation and livelihood outcomes. The findings suggest that sport functions as a gendered livelihood pathway rather than a neutral development mechanism. Enhancing the livelihood potential of sport requires addressing the socio-environmental constraints affecting female participation through gender-sensitive sport governance, improved access to resources, and more inclusive physical education systems.
BackgroundClimate change poses significant risks to worker health, especially for outdoor and vulnerable populations. Despite a growing body of research, global trends, thematic priorities, and collaboration patterns in the climate change-occupational health literature remain unclear.ObjectiveThis study aimed to analyze WoS-indexed publications on climate change and occupational health to describe publication trends, key contributors and sources, collaboration structures, and thematic emphases, and to discuss underexplored areas highlighted by the mapping.MethodsA descriptive bibliometric analysis was conducted using the Web of Science Core Collection. Analyses were limited to descriptive indicators (e.g., publication counts, citation metrics) with no inferential statistics. Publications were retrieved using "climate change" AND "occupational health" without restrictions on language, country, or journal. Duplicates and author name variations were manually checked. VOSviewer was used for citation analysis, co-authorship mapping, country/institution output, and keyword co-occurrence analysis.ResultsA total of 380 publications were analyzed, mostly in English. Output increased steadily, with citation peaks in 2023-2024. The most productive countries were the USA, Australia, and Canada; leading institutions included Australian National University, the University of Washington, and the University of Adelaide. Frequent keywords ("heat stress," "outdoor workers," "workplace adaptation") highlighted a focus on heat-related occupational risks.ConclusionResearch linking climate change and occupational health is growing, mainly focused on heat-related risks for outdoor workers, while psychosocial, demographic, and adaptation issues remain underexplored. More targeted studies are needed to guide policy, develop region-specific adaptation strategies, and reduce workforce vulnerability.
Spontaneous adverse drug reactions (ADRs) are underreported. Digital reporting systems are increasingly used to address this issue; however, limited knowledge exists about the barriers and facilitators influencing their use by consumers. To explore facilitators and barriers influencing consumers' use of digital tools for ADR reporting, and to identify the factors, expectations and preferences that affect their engagement with these tools. An exploratory qualitative descriptive study using semi-structured in-depth interviews was conducted among Australian adults who self-reported having experienced an ADR. Interviews were conducted face-to-face or via Zoom, audio-recorded, transcribed verbatim, and analysed inductively using reflexive thematic analysis. Themes were mapped onto domains of the Combined Technology Acceptance Model and Theory of Planned Behaviour (C-TAM-TPB) framework. Fourteen participants were interviewed. Consumers expressed positive intentions to use online ADR reporting tools. Identified facilitators included user-friendly and accessible tools that are simple to complete, the use of images to aid comprehension, integration with existing patient health records, the ability to submit reports to both healthcare professionals and regulators, and a tool designed specifically for consumers using layperson language. Identified barriers included lack of awareness that consumers could report ADRs using online tools, the need for registration, complex medical terminology, compulsory fields, and the absence of feedback after submission. Consumers were willing to use online ADR reporting tools but were largely unaware of their existence. Enhancing usability through user-friendly design, and reporting forms specifically designed for consumers may increase engagement. Addressing barriers such as lack of awareness, registration requirements, medical jargon, and lack of feedback may improve usability and contribute to strengthening pharmacovigilance systems.