'Beyond core business': A qualitative review of activities supporting environmental health within remote Western Australian schools.

Background: Aboriginal children and families contend with higher rates of preventable infectious diseases that can be attributed to their immediate living environment. The environments in which children spend most of their time are their homes and schools. We aimed to understand the opportunities in the school setting to support student skin health and wellbeing through environmental health activities, how these activities were completed, and the barriers to their implementation. Methods: Recognising the importance of healthy skin for educational success, this work was embedded within a larger cluster randomised stepped-wedge Trial aimed at reducing the rate of skin infections among Aboriginal children living in the Kimberley region of Western Australia by 50 %. We used qualitative data collected via a culturally appropriate yarning methodology during trial evaluation interviews. The data from 35 yarns with 41 individuals were thematically analysed. Findings: Data indicated that schools serve as a hub of health and hygiene support and maintenance, with school staff balancing teaching responsibilities while also meeting the basic health and wellbeing needs of students. Uncertainties regarding funding and policies governing these activities remained; ongoing exploration is required. Interpretation: Staff in remote Kimberley schools devote substantial time and resources to supporting student hygiene needs, often stepping in when health infrastructure at home is inadequate. These activities are seen as necessary to support student wellbeing and participation in learning. While schools are well-positioned to respond in this way, these responsibilities extend beyond their core role and place additional pressure on staff and budgets. There is a need to better understand how such work is resourced and to consider how policy and funding frameworks might more formally support it.