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054 Co-design and cultural governance in developing ‘finding your way’: a culturally adapted shared decision-making resource for aboriginal communities in New South Wales, Australia
  1. David Follent1,
  2. Tara Dimopoulos-Bick1,
  3. Catherine Kostovski1,
  4. Val Middleton1,
  5. Regina Osten1,
  6. Cory Paulson2,
  7. Shazza Taylor3,
  8. Lyndal Trevena4,
  9. Melissa Cawley1
  1. 1NSW Agency for Clinical Innovation (NSW Health) – Australia
  2. 2Royal Flying Doctors Service – Australia
  3. 3Health and Training Institute (NSW Health) – Australia
  4. 4The University of Sydney – Australia

Abstract

Introduction Finding Your Way is a shared decision making (SDM) resource created with and for Aboriginal People in NSW Australia, in 2021. It is the only culturally adapted SDM resource for Aboriginal People in Australia and one of few examples developed with First Nations people internationally.

Methods A two-round modified e-Delphi approach, incorporating yarning techniques, was used to gather expert opinions and reach a consensus on the capabilities (knowledge and skills) required to effectively use Finding Your Way and engage in SDM with Aboriginal People. A set of 29 predefined capabilities were gleaned from the research evidence and a yarning session, forming the basis of the e-Delphi process.

Results 138 panel members completed Round 1 of the e-Delphi process between 19–27 January 2023, and 113 completed Round 2 between 9–20 February 2023. The panel member retention rate was 82% across the two e-Delphi rounds, and the consensus threshold was 75% strongly agree for each capability. Consensus was reached for 10 capabilities, and a learning map was developed to reflect Aboriginal ways of valuing, being, knowing and doing as represented in the 8 Aboriginal Ways.

Discussion The study builds on the current evidence by providing a consensus on the capabilities required to engage in SDM with Aboriginal People. It provides a nuanced understanding of Aboriginal-specific SDM capabilities which has been achieved by grounding their development in the Aboriginal 8 Ways. Cultural imagery was used to create the learning map to present the foundational knowledge and skills required to use Finding Your Way in a symbolic and non-linear way.

Conclusion The results signal the importance of navigating two worlds—working through Aboriginal knowledge and processes to generate cultural responsiveness and safety at the intersection of traditional cultural knowledge and the Western paradigm of SDM.

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