Abstract
Background: Chronic wet cough (CWC) is highly prevalent among Indigenous children. It is often due to protracted bacterial bronchitis, which can lead to bronchiectasis if left untreated. Timely detection and management of CWC in primary care is crucial, but often lacking. In 2018, we implemented a program in a regional town in Australia which improved CWC outcomes through health promotion, clinician training, and practice changes. However, given Indigenous communities' cultural and geographical diversity, what was effective in one may not be elsewhere. We studied the barriers and facilitators to implementing the program in multiple communities.
Method: An Indigenous co-led, participatory action research study with semi-structured interviews at seven Australian sites guided by the Consolidated Framework for Implementation Research. Data were analysed using NVivo.
Results: 169 Indigenous family members and 95 health care practitioners (HCPs) participated. Families wanted culturally secure health information from Indigenous health staff delivered through tailored methods (home visits in small communities, events in larger ones), communication methods (spoken/visual) in local language and aligned with local culture. HCPs wanted regular best-practice-aligned training and diverse educational resources. Barriers included high staff turnover and intermittent doctor presence in remote areas. Desired practice changes included adding CWC to routine health screening, electronic prompts, and policies for non-medical HCPs to prescribe treatment.
Conclusion: Strategies for timely detection and management of CWC are broadly consistent across contexts, but tailored approaches are essential due to diverse community characteristics.