Background: Preventable chronic diseases are the main contributor to the health gap between Aboriginal and Torres Strait Islander people and the wider Australian population. Deadly Choices is a school-based chronic disease education program that encourages Indigenous young people to be positive role models in reshaping health, lifestyle and physical activity choices among family, friends and networks. The aim of this study was to investigate the effectiveness of the Deadly Choices school-based program in improving participant’s knowledge, attitudes, self-efficacy and behaviours regarding chronic disease and associated risk factors.

Methods: The Deadly Choices program was delivered weekly at six education facilities in Brisbane, Australia to participants from years seven to 12 over seven weeks. Each session involved an icebreaker activity, an education component and participation in physical activity. A mixed-methods approach was adopted for this evaluation which included pre/post surveys and semi-structured interviews.

Results/Discussions: Quantitative findings of this evaluation show that the Deadly Choices school-based program was successful in improving knowledge, attitudes and self-efficacy regarding leadership, chronic disease and risk factors. The program was also very promising in terms of improving health behaviours, particularly in the areas of diet (breakfast, fruit and vegetables), physical activity and smoking. Qualitative data supports the positive findings and also indicates that participants were empowered to be role models in improving the health status of friends, family and the wider community.  The program also facilitated 30 health checks (MBS item 715) for participants.

Conclusions/implications: By providing education in leadership and chronic disease prevention, engaging students in physical activity and facilitating health checks, the Deadly Choices program has great potential to improve health outcomes for young Indigenous people. While the Deadly Choices seven-week program was originally developed for Indigenous young people in urban areas, future application of this program in other settings should also be considered.