Optimising digital solutions to improve access to comprehensive primary health care services in remote Indigenous communities: A participatory action research project protocol (Preprint)
Authors: Khanal Dr. Vishnu , Sauman Emily , Russell Deborah J. , Newton Nicki , Coombes Karina , Puruntatameri Alexandar , Norris Sarah , Huben Amy Von , Cockyane Tamsin , Burgess Paul , Wakerman John , Shaw Timothy 
Published: November 2024

BACKGROUND

Background: Aboriginal and Torres Strait Islander (Indigenous) peoples living in remote Australia experience a heavy burden of ill health and multiple barriers to accessing health care. Digital health technologies (DHTs) have the potential to help overcome some of these challenges and increase access to comprehensive primary health care (CPHC), thereby improving equity of health outcomes. However, little is known about the community and provider preference of the use of digital technologies for improving health and wellness.

OBJECTIVE

The aim of this project is to co-design, implement, and evaluate how DHTs can improve access to CPHC in remote Indigenous communities in the Northern Territory.

METHODS

Methods: This multi-phased project will take a participatory action research approach to co-design and optimise digital health solutions with local community members and health services staff in two communities. Our mixed methods approach will include pre- and post-implementation focus group discussions, interviews, quantitative analysis of CPHC utilisation administrative data and surveys administered by Indigenous community-based researchers to understand the use of digital devices and connectivity, eHealth literacy, preferences for different attributes of DHTs using best-worst scaling, and consumer satisfaction and experiences with DHT interventions. Priority DHTs will be selected for implementation based on consumer and health staff preferences. Focus group discussions and interview data will explore community and health service staff preferences, experiences and satisfaction with implemented DHTs. A realist approach will be taken to identify how DHT interventions work, for whom and in what circumstances, so that understanding of why some interventions work while others do not is expanded. Economic analyses will be conducted to calculate the incremental costs and benefits of implemented DHT interventions. The scalability of digital health solutions will be tested in two additional communities. Project partners include key funding, service and support agencies in the NT and nationally.

RESULTS

As of November 2024, we have selected two implementation sites. Digital health initiatives are underway at the implementation sites, and evaluation activities are progressing. The initial findings from these sites have informed our scalability assessment in additional two sites.

CONCLUSIONS

Knowledge translation is integral to the study design which involves partnering with consumers, CPHC service providers, and a range of key stakeholders to inform health service providers and policymakers about what DHTs work for which groups of consumers, and under what circumstances, to improve access to CPHC. This unique study will accommodate consumer and provider preferences regarding the use of DHTs to improve CPHC access and address the lack of knowledge about how to deploy digital solutions to best support CPHC in remote Indigenous Australia.

CLINICALTRIAL

Not applicable.