Barriers and Facilitators to Timely Detection and Optimal Management of Chronic Wet Cough in Aboriginal Children Across Australia From the Perspectives of Carers of Aboriginal Children: A Qualitative Study

ABSTRACT Objective To identify barriers and facilitators to the timely detection and optimal management of chronic wet cough (CWC) in children from the perspectives of carers, across multiple, diverse First Nations Australian communities. Study Type Qualitative participatory action research study. Setting and Participants Eight Australian communities across three states and territories. Semi‐structured interviews and focus groups with 167 parents and carers of Aboriginal children were conducted between May 2021 and July 2023. Main Outcome Measures Barriers to and facilitators of detection and management of CWC in Aboriginal children in a primary care setting. Results Key barriers identified included inadequate health promotion, the common perception that CWC is normal and high turnover among health staff, leading to mistrust of newly onboarded health staff. The overarching facilitator identified was knowledge dissemination through health promotion, delivered in person by Aboriginal health staff using culturally secure resources, supplemented by posters placed in the community and the use of radio and social media. Individual communities expressed varied preferences regarding specific health promotion methods and designs. Communities valued staff who had spent considerable time within the community, allowing for the development of trust and rapport. Conclusion The barriers and facilitators to detecting and managing CWC in children were generally consistent across the settings we studied. Implementation approaches to facilitate care require tailoring to local settings. Further, to reduce identified barriers for the detection and management of CWC in children, the incorrect perception that CWC is normal must be addressed and the potential harms of staff turnover need to be recognised.