Pathways for Aboriginal & Torres Strait Islander hearing health: The PATHWAY Project

The objective of this study is to integrate Aboriginal research methodologies with Western methods to co-design a comprehensive strategy aimed at improving the ear health patient pathway—from surveillance to management and follow-up—for Aboriginal children living in the far west region of South Australia. Participants will include Aboriginal families with young children aged 0 to 8 years who have a history of ear disease. Data will be collected from medical records to provide a detailed description of the time it takes for children in the study location to move through the ear and hearing health pathway. Additionally, a questionnaire on out-of-pocket health care expenditure (OOPHE) will be administered to determine the impact of ear and hearing-related OOPHE on the children, their families, and themselves. The data collected from medical records will be retrospective information and include the child's name, date of birth, parent/caregiver's name, residential location, gender, clinic name, date of visit, MBS code allocated, fee charged, appointment attendance, healthcare professional seen, tests completed, outcome, and recommendations. Identifying information will be removed from the final dataset prior to analysis. Face-to-face yarning sessions, facilitated by an Aboriginal Research Officer, will be conducted. These sessions will begin with 'social yarning' to build rapport and relationships with participants, followed by 'research yarning' to explore various aspects such as the experience of caring for children with otitis media and its impact on the children, their families, and the community. Other factors to be explored include influences on the patient journey (surveillance, management, follow-up), accessibility of ear health care, and local implementation factors (health priorities, capacity, resources). There will be one yarning session (social and research yarning in one session) per participant conducted one-on-one on the same day as enrolment into the study with a duration of approximately 40 minutes and will be audio recorded and transcribed verbatim, by a professional transcription agency. Data collection for the OOPHE and yarning sessions will occur at the time of enrolment into the study and retrospective data from medical records will occur over different visits to the participating sites following a participant’s enrolment into the study. The anticipated time frame for the completion of this work is one (1) year.