Background: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are caused by Strep A bacterial skin and throat infections. The high burden of Strep A infections, ARF and RHD experienced by Aboriginal and Torres Strait Islander peoples is strongly associated with inadequate housing and living conditions and underpinned by colonisation and socioeconomic marginalisation.
Multiple health promotion activities have attempted to address the inequitable burden of Strep A, ARF, and RHD for Aboriginal and Torres Strait Islander people. However, there has been limited consolidation of this work to better understand ethical and effective health promotion for these conditions and to help guide future health promotion initiatives.
Methods: We conducted an integrative scoping review of health promotion activities about Strep A, ARF and RHD conducted in Australia between 2009-2025 and focusing on Aboriginal and Torres Strait Islander communities. Comprehensive searches of peer-reviewed databases and grey literature were conducted. Information was synthesised according to activity methodologies, cultural safety, evaluation and the Ottawa Charter for Health Promotion Action Areas.
Governance: This project has taken shape within an NHMRC-funded program of work focused on environmental health (STARFISH Synergy Grant). The hallmark STARFISH is leadership by an Indigenous Governance Council (IGC). Ongoing review and input from the STARFISH IGC continue to guide the direction of this project.
Results: The health promotion activities identified were predominately associated with outbreak responses or research projects. There was wide variation in key messages about Strep A, ARF and RHD and few initiatives were formally evaluated. In this presentation, we discuss six enabling factors to support effective health promotion for Strep A, ARF and RHD including: co-design, adaptation to local language, generation or sharing of data, consideration of stigmatisation, evaluation and community development.
Conclusion: Findings from this work will establish much-needed good-practice guidance to inform health promotion that is ethical, culturally appropriate, effective and non-stigmatising in this critical space.