The aim of this study was to investigate the effectiveness of a school-based health promotion and education program in improving knowledge, attitudes, self-efficacy and behaviours of urban Indigenous young people regarding chronic disease and associated risk factors. A mixed methods approach was adopted for this evaluation; however, this paper will focus on the quantitative aspect of the study. The Deadly Choices™ health education program was delivered weekly at six education facilities in Brisbane, Australia to participants from years seven to 12 over seven weeks. One school that received the Deadly Choices program the following term acted as the control group. Questionnaire data was collected immediately pre and post intervention to assess program impact. As self-reported by participants there were mostly significant improvements over time for questions relating to knowledge, attitudes and self-efficacy regarding leadership, chronic disease and risk factors within the intervention group. There were also significant changes within the intervention group regarding breakfast frequency (P = 0.002), physical activity frequency (P ≤ 0.001), fruit (P = 0.004) and vegetable (P ≤ 0.001) intake. Overall, there were few significant differences between the control and intervention groups regarding health attitudes and behaviours; however, there were considerably more improvements relating to self-efficacy and knowledge of chronic disease and associated risk factors between groups. The program also facilitated 30 Aboriginal and Torres Strait Islander health checks for participants. Deadly Choices is an innovative and comprehensive school-based program which has great potential to improve the health outcomes of Indigenous young people in urban areas by providing education in leadership and chronic disease prevention; engaging students in physical activity participation; and collaborating with health services to facilitate health checks.

The present study was an evaluation of the effectiveness of Deadly Choices™ community events for improving participants' short-term knowledge of chronic disease and risk factors, and increasing community engagement with local health services. Surveys were completed directly before and after participating in health education activities (pre and post surveys, respectively) assessing knowledge of chronic diseases and risk factors at three Deadly Choices community events and four National Aboriginal and Islander Day Observance Committee (NAIDOC) events in south-east Queensland where Deadly Choices health education activities took place. An audit trail was conducted at two Deadly Choices community events in Brisbane to identify the proportion of participants who undertook a health screen at the event who then followed up for a Medicare-funded health check (MBS item 715) or other appointment at an Aboriginal and Torres Strait Islander clinic in the local area within 2 months. Results were compared with a sample of participants who attended one Deadly Choices community event but did not complete a health screen. There were 472 community members who completed a pre and post survey. All knowledge scores significantly improved between baseline and follow up. Although based on a small sample, the audit trail results suggest individuals who participated in a health screen at the community day were approximately twice as likely to go back to a clinic to receive a full health check or have an alternative appointment compared with attendees who did not participate in a screen. Community events that include opportunities for health education and health screening are an effective strategy to improve chronic disease health literacy skills and appear to have the potential to increase community engagement with local Aboriginal and Torres Strait Islander health services.

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