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

From: Lessons learned from a periodontal intervention to reduce progression of chronic kidney disease among Aboriginal Australians

Challenges experienced Major learnings
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