With substantial support and planning, such approaches can play an important role in engaging young people and bridging the gap between clinical interventions and improvements in health deriving from community-driven strategies. SO WHAT? This paper contributes to existing literature by identifying key elements of an effective approach to using performing arts in sexual health promotion in Aboriginal and Torres Strait Islander settings. It also provides guidance when consideration is being given to investment in resource-intensive health promotion initiatives.

This initiative, the Indigenous Hip Hop Project, although accompanied by opportunity costs including alternative, more core business uses of staff time and program budget, has demonstrated the power of tapping the creative energy of young people at risk and the potential for mobilizing communities to activism around sexual health disadvantage.

Objective: To evaluate the Indigenous sexual health promotion program in the Torres Strait 2006-2012 that culminated in an education-entertainment radio drama, Kasa Por Yarn (KPY). Methods:A mixed methods approach applied to unpublished program documents and program-derived peer-reviewed publications was utilised.Results: Early initiatives established a strong partnership with Torres Strait Islander stakeholders. Significant community engagement throughout ensured a positive process. Telephone survey data (n=100, TSI, 15-24 years) found: 95% had heard of KPY and 80% listened to 2 or more episodes (reach); 86% recalled storylines/characters (recall); and 54% talked about KPY to family/friends (resonance). There was improvement in sexual health knowledge scores (p<0.00) in the 15-19-year-old Torres Strait Islander population between 2007 and 2012. The 2012 15-24-year-old population exposed to KPY had higher sexual health knowledge scores compared with those unexposed (p=0.02).Conclusions: This is an uncommon comprehensive evaluation of population-based sexual health communications strategies delivered over years in a remote Australian setting. The findings are encouraging but demonstrate that positive shifts take time and are incremental. Implications:In addition to clinical strategies, strategic and sustained investment in sexual health promotion expertise that leads community partnership and program development is required to reduce youth risk and prevent HIV/AIDS in remote populations.

The differential outcomes of evidence-based tobacco treatment programs in non-mental-health versus mental health settings may suggest the need to modify existing tobacco treatment approaches for those with MIs in community settings.

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