Table 1 Summary of challenges experienced and major learnings in a periodontal intervention among Aboriginal Australians with kidney disease in Central Australia

Insufficient engagement with the Aboriginal community and Aboriginal community-controlled organisations

Engage with Aboriginal Australians with kidney disease and their ACCHO to ascertain if periodontal and oral health care is a priority

If yes, work in partnership to derive feasible study aims, objectives and design, ensuring the research methodologies involved will be culturally acceptable

Involve those with lived experience of kidney disease to be both investigators on subsequent study grant applications and involved with the study’s consumer representative group/Aboriginal reference group

Facilitate regular Aboriginal reference group meetings, being aware of competing demands and expectations on reference group members

Engage in regular knowledge exchange forums with all stakeholder groups; Aboriginal Australians with kidney disease, ACCHOs, and health provider stakeholders

Facilitate opportunities for Aboriginal Australians with kidney disease, ACCHOs and health provider stakeholders to be involved in data interpretation, analysis, write-ups for publication and presentation at local, national and international conferences

Co-ordinating around patient commitments, general health and wellbeing, and medical treatment

Consider if, in light of the many comorbidities and social vulnerabilities experienced by those eligible, a periodontal intervention requiring multiple visits for dental care is, in fact, feasible

If it is considered to be feasible, carefully take into account the general health and well-being, patient commitments and medical care required (especially for dialysis) and the logistical planning required to ensure the study objectives can be met without compromising participant health and wellbeing

It may be more practical/ethical to spread out the study recruitment and treatment phases so that the impost of participants re: dental care is reduced

Study staff not primarily from the Northern Territory

Consider conducting the study in the state or regional location in which the CIA is located (in this case, South Australia)

Consider increasing the number of study sites to involve multiple jurisdictions, and have the study team based in the CIA’s location operate on a ‘fly in/fly out’ model

Ensure the Aboriginal Reference Group is involved in selection of study staff and that appropriate training in Aboriginal cultural competency is provided

Potential participants not having the required number of teeth

Co-ordinate with local public dental health providers and/or dentists employed by local ACCHOs to ascertain, broadly, the anticipated number of teeth among Aboriginal Australians with kidney disease

Consult the literature/periodontal disease experts to ascertain if a threshold of less than 8 teeth might in fact be reasonable for a periodontal intervention involving Aboriginal Australians with kidney disease

Invasive intervention that involved travel to, and time at, a dental clinic

As much as can be accommodated, plan for the provision of dental care to take place in the minimal time possible

Ascertain with each participant their preferred time of day/day of week for dental care and how long they can realistically spend at each dental visit

If possible, work with providers of dental care facilities to enable dental care to study participants on weekends

If access to dental vans is possible, consider this as an option to move the dental clinic closer to participant locations