Aims
Australia’s social, structural, and political context, together with the continuing impact of colonisation, perpetuates health care and outcome gaps for First Nations peoples, including in cancer. A new approach is required to overcome these disparities, led by First Nations peoples. Co-design is emerging as a valued method for First Nations communities to drive change in health policy and practice to better meet their needs and priorities. However, it is critical that a co-design processes and outcomes are culturally safe and effective. This project aimed to develop a set of evidence-based key principles and best practice approaches to co-design with First Nations peoples applicable to the Australian cancer context.
Methods
A First Nations co-led team conducted a two-phase project. In Phase 1, a systematic search was conducted to identify peer-reviewed and grey literature reporting elements of co-design by and with First Nations peoples. Thematic analysis was conducted on key findings from the papers to elicit key principles and best practice approaches to co-design. In Phase 2, Online Yarning Circles with key stakeholders were utilised to refine Phase 1 findings.
Results
Phase 1: After full-text screening, 99 studies were included. Thematic analysis elicited six key principles and 30 best-practice approaches relevant to co-designing with First Nations peoples. Phase 2: These outcomes were refined and consolidated by 25 stakeholders in Online Yarning Circles. A final set of six key principles were identified: Aboriginal and Torres Strait Islander leadership; Culturally grounded approach; Respect; Benefit to community; Inclusive partnerships; and Transparency and evaluation. Thirty-seven best practice approaches were also identified, which provide guidance for embedding the principles into practice.
Conclusion
This set of principles and approaches offers a constructive foundation to commence a process of co-design with First Nations peoples to be integrated into a toolkit for application across cancer policy and research design.