Closing the gap through research co-design

The Australian Journal of Rural Health (AJRH) is deeply committed to the health and broader wellbeing of Aboriginal and Torres Strait Islander peoples. Many First Nations people live in rural and remote regions, especially including those living on Country.

Rural and remote health services and research can and do play a key role in closing the gap in health outcomes. Readers will fully understand that rural and remote health services are directly related to targets such as ensuring Indigenous people live long and healthy lives, ensuring healthy and strong mothers and babies, ensuring that children thrive, and promoting social and emotional wellbeing.

However, we also know that health and wellbeing is completely interwoven with strong culture, self-determination, early years and ongoing education, meaningful employment, economic participation, housing, justice, social inclusion and non-discrimination.

Against this broad understanding, we also acknowledge that many rural and remote health services and interventions have a long way to go towards closing the gap. The targets remain frustratingly elusive. We see that the AJRH can play a role in fostering and encouraging possible advances in rural health services and research relevant to First Nations populations. We hope it can also have a key role in documenting and celebrating any achievements and advances in this area.

We realise that, for the AJRH, this requires meaningful actions and partnerships. It requires co-design of research with First Nations communities and individuals. It requires First Nations researchers leading rural health research programs. It requires greater use of innovative, culturally relevant and suitably rigorous research methods in rural and remote contexts. It requires First Nations researchers leading key publications.

At the AJRH, we are ensuring that we meet our commitments in this area in a number of ways. For example:

• We recently published an article (alongside sister publications) proposing the development of the Indigenous Cultural Identity of Research Authors Standard (ICIRAS) for health research publications. This article has great potential implications for academic publications like AJRH. It spells out a number of ways in which editorial boards of Journals can systematically improve their process, to ensure that there is ‘nothing about Indigenous people, without Indigenous people’.
• We are actively encouraging the use of co-design and appropriate methodologies. This topic was the focus of a recent special issue of the AJRH. When the principles of co-design are adopted, it creates meaningful opportunities for interactions between service users, service providers, communities and researchers. In co-design, the researcher or health service provider becomes the learner. In particular, in First Nations research the principles of participant leadership, developing a shared understanding, ensuring self-determination, working iteratively and building relationships with communities are vital.
• We are exploring new ways for culturally appropriate review of manuscripts. We have started discussions with Indigenous researchers about what a ‘yarning’ approach to peer review of First Nations-related research manuscripts might look like.
• Importantly, we are also looking forward to welcoming a new First Nations Associate Editor onto our Editorial Board in coming weeks.

We trust that these steps will help us contribute in a small way towards closing the gap.