Translation of culturally and contextually informed diabetes training for Aboriginal primary health care providers on Aboriginal client outcomes: Protocol of a cluster randomized crossover trial of effectiveness

PLoS One. 2024 Jul 23;19(7):e0305472. doi: 10.1371/journal.pone.0305472. eCollection 2024.

Abstract

Background: Indigenous populations globally have significantly high rates of type 2 diabetes compared to their non-Indigenous counterparts. This study aims to implement and evaluate the effectiveness of a culturally and contextually informed Aboriginal Diabetes Workforce Training Program on Aboriginal primary health care workforce knowledge, attitude, confidence, skill and practice relating to diabetes care.

Methods: A Cluster Randomised Crossover Control Trial with two arms (Group A and Group B) will be conducted with Aboriginal primary health care services in South Australia. These services primarily provide primary health care to Aboriginal and Torres Strait Islander people. All healthcare service sites will be randomised into groups A and B to receive the training program. The training program consists of three components: 1) Peer support network, 2) E-Learning modules and 3) onsite support. Aboriginal Health Workers of participating sites will be invited to participate in the monthly online peer support network and all chronic disease staff are eligible to participate in the E-Learning modules and onsite support. The Peer Support Network runs for the entirety of the study, 17 months. Training components 2 and 3 occur simultaneously and are 2.5 months in length, with a six-month washout period between the two randomised groups undertaking the training. All primary outcomes of the study relate to diabetes management in a primary health care settings and measure participants' knowledge, attitude, confidence, practice and skills. These will be collected at seven time points across the entire study. Secondary outcomes measure satisfaction of the peer support network using a survey, interviews to understand enablers and barriers to participation, health service systems characteristics through focus groups, and medical record review to ascertain diabetes patients' care received and their clinical outcomes up to 12 months post training intervention.

Discussion: The findings will explore the effectiveness of the training program on Aboriginal primary health care provider knowledge, attitude, confidence, skill and practice relating to diabetes care. The final findings will be published in 2027.

Trial registration: The study was prospectively registered in The Australian New Zealand Clinical Trials Registry (ANZCTR), with registration number ACTRN12623000749606 at ANZCTR - Registration. Universal Trial Number (UTN) U1111-1283-5257.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Australian Aboriginal and Torres Strait Islander Peoples
  • Cross-Over Studies
  • Culturally Competent Care*
  • Diabetes Mellitus, Type 2* / therapy
  • Health Knowledge, Attitudes, Practice
  • Health Personnel* / education
  • Health Services, Indigenous
  • Humans
  • Primary Health Care
  • Randomized Controlled Trials as Topic
  • South Australia

Grants and funding

This research is Funded by National Health and Medical Research Council - Medical Research Future Fund (MRFF) Primary Health Care Research Initiative (PHCRI) [APP1200314]. The sponsor does not have any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.