Stephen Paull

Background: Communication of research findings often lacks appropriately tailored messaging to meet participants' expectations and needs. Guidelines for communicating with Aboriginal and Torres Strait Islander Peoples exist but are not widely applied in practice. An April 2024 workshop with 29 Aboriginal advisors explored barriers, enablers and mitigation strategies for locally adapting an evidence‐based Healthy Lifestyle Program. A book was recommended as a culturally appropriate mode to share workshop findings with participants. This study explored Aboriginal Elders' experiences of receiving study findings, guidance for researchers and produced a user‐friendly book reporting the cultural and place‐based program considerations. Methods: Participatory action research guided the co‐creation of the book. Nine Elders from the Healthy Lifestyle Program Cultural Advisory Group, who had participated in the April 2024 workshop, took part in the June 2025 workshop. An Aboriginal facilitator conducted the workshop, supported by three non‐Aboriginal researchers. Previous workshop findings were summarised. The workshop was audio‐recorded, transcribed verbatim and data were analysed using reflexive thematic analysis. The Cultural Advisory Group were involved throughout the research and book development. Findings: An overarching theme of knowledge sharing across research partnerships, communities and families connects the two themes identified. Working in partnership outlines the need for Aboriginal participants' contexts and lived realities to be recognised by researchers, and the group's previous and current research experiences. Leaving a legacy highlights the importance of the book as a lasting record, incorporating artwork and multiple formats to broaden accessibility and reach to diverse audiences, including younger generations, ensuring that community voices and values continue to guide research. Conclusion: Prioritising Aboriginal and community voice in communicating findings is critical to genuine partnership in research. Consumer and community involvement within participatory action research is important to effectively implement unique research recommendations. Through this work, a book was co‐created, hard copies were made available to the April 2024 participants, and an online version is available. Future research recommendations are provided. Practical tips are also provided to support researchers in building trust and collaborating effectively with Aboriginal participants/community members. Lived Experience or Public Contribution: An established Cultural Advisory Group (10 Aboriginal Elders) were involved throughout the research using a participatory action research approach, embedding consumer and community involvement. In their advisory role, the Elders guided key decisions, including endorsing the development of the book to report findings from the April 2024 workshop. The group reviewed the study findings and co‐created the book with the research team. Three Elders were nominated for additional oversight, with two reviewing the final manuscript and book, and one reviewing the book's Acknowledgement of Country. This work was also supported by a representative consumer organisation, Health Consumers' Council WA.

Background: Childhood obesity prevalence is increasing globally, with Aboriginal and Torres Strait Islander children over‐represented in Australian data. Evidence‐based, community healthy lifestyle programs require culturally safe adaptation when implemented in new First Nations contexts, where prioritising access and engagement of First Nations groups is critical. This study aimed to identify Aboriginal community representatives' perspectives on potential barriers and enablers to recipient engagement and program implementation, and to identify cultural and place‐based considerations to inform culturally safe adaptation of Whānau Pakari from Aotearoa/New Zealand for delivery as the Healthy Lifestyle Program in Boorloo/Perth, Western Australia. Methods: A 3‐h workshop was conducted with 29 Aboriginal advisors, with whole‐group discussions and 5 facilitated breakout groups, to obtain Aboriginal community guidance on cultural and place‐based considerations needed to adapt the program locally. Data were analysed by Framework Analysis using the updated Consolidated Framework for Implementation Research (CFIR) to identify barriers and enablers (determinants) of program engagement and implementation. Determinants were then reclassified inductively into themes to enhance participant relatability, supporting communication and feedback. Results: A total of 44 potential determinants (16 barriers and 28 enablers) were mapped to 18 CFIR constructs across all five domains of innovation, outer setting, inner setting, individuals and implementation process. Three themes were identified from these determinants: acknowledging cultural context encompassed healing and self‐determination, reclaiming knowledge and culture, and addressing limited access to health‐promoting environments; guiding values included mutual respect, building and earning trust, and intergenerational learning; and program considerations included culturally secure practice, specific ways of working, and keeping families engaged. Conclusions: Aboriginal community guidance highlighted cultural and place‐based priorities for program adaptation, and potential determinants of successful implementation within a prevailing healthcare service, iteratively informing program adaptation. This study used a unique methodological approach, prioritising participant voice alongside CFIR terminology, to provide rare evidence of pre‐implementation First Nations engagement outcomes when adapting a program to integrate into the prevailing healthcare service. Partnership with First Nations communities is essential to implementing accessible, culturally safe models of care, thereby addressing health inequities. Lived Experience or Public Contribution: An established Cultural Advisory Group of 12 Aboriginal Elders worked in partnership with the Healthy Lifestyle Program, 10 of whom reviewed the identified themes and sub‐themes throughout the analysis process. Two members were nominated by the group and reviewed the final draft manuscript. Identified determinants iteratively informed program adaptation, guided by the Cultural Advisory Group. This work was also supported and guided by a representative consumer body, Health Consumers' Council WA.

Aim: School time represents a significant component of overall glycaemia for children with type 1 diabetes (T1D), and glucose levels during instructional time may be important for optimising academic progress. There is, however, limited literature regarding glycaemia during school hours. This study aimed to evaluate glucose levels during school in primary school‐aged children with T1D in Western Australia (WA) and to compare these with non‐school days. Methods: A 12‐week cross‐sectional cohort study was performed comprising a WA school term and subsequent school holidays, utilising demographic, clinical and continuous glucose monitor data from the WA Children's Diabetes Database for primary school children with > 1 year of diagnosis of T1D. Results: A total of 235 children, mean age 9.54 ± 1.67 years and duration of T1D of 4.08 ± 2.31 years met inclusion criteria. Children had higher mean ± standard deviation time in range (3.9–10.0 mmol/L) during school (58.0% ± 15.8%) than equivalent hours during school holidays (53.5% ± 18.8%, p < 0.001) and weekends (56.6% ± 17.3%, p = 0.006). Children had lower mean sensor glucose, SD sensor glucose and time above range (> 10.0 and > 13.9 mmol/L) during school compared to school holidays and weekends. Time below 3.9 mmol/L was higher during school time compared with weekdays during school holidays ( p = 0.024), but lower than on school term weekends ( p = 0.009), and < 4% in all periods. There was no significant difference in time below 3.0 mmol/L. Conclusions: Primary school‐aged children in WA had modestly improved glycaemia during school compared with weekends, with more pronounced improvements compared with school holidays.