Ngalaiya Boorai Gabara Budbut: A Qualitative Study With Primary Care Providers to Understand Perceived Needs, Enablers, Barriers and Opportunities to Strengthen Care

Objective: To explore primary care providers' perspectives on (i) healthcare needs and barriers to care for Aboriginal and Torres Strait Islander children and adolescents; and (ii) enablers and opportunities to strengthen care. Study Design: A qualitative study; interviews and open-ended survey responses. Setting: Primary care providers who work with Aboriginal and Torres Strait Islander children and young people in health and education settings in New South Wales and the Australian Capital Territory. Data were collected between 23 March 2022 and 13 October 2023. Main Outcome Measures: Sixteen interviews and 33 open-ended survey responses were analysed using reflexive thematic analysis with a hybrid inductive/deductive approach. Results: Participants reported that some of the most important health needs for children and young people related to mental health. They recognised that the presenting complaint was not always the underlying or only concern, demonstrated an understanding of trauma-informed care and acknowledged the importance of collaborative services that engaged support networks. Barriers to care included a lack of cultural safety in mainstream services, challenging social circumstances, financial concerns, being unaware of available services and privacy and confidentiality concerns. To improve care, staff identified several areas needing change including having a package of services tailored for young people; additional training for providers in child and adolescent health, particularly for mental healthcare, trauma-informed care and communication with young people; providing a safe and engaging environment; support for staff self-care; and additional resources. Conclusions: Supporting mental health needs is a key aspect of caring for children and adolescents. To provide optimal primary healthcare, service providers require specialist skills. To support adolescents and children, participants identified a need for ongoing training, professional development and organisational support to ensure best practice care is sustained. This work has informed the development of training and other resources for partner health services.