Jones, Y.Truong, M.Preece, C.Cass, A.Heerink, F.McDonald, S.Jones, S.Mallett, A.J.Majoni, S.W.Sajiv, C.Patankar, K.Mulholland, E.Woldeyohannes, S.Lawton, P.2025-04-012025-04-012024BMJ Open, 2024; 14(11):e095727-1-e095727-112044-60552044-6055https://hdl.handle.net/2440/144060Introduction In Australia, kidney failure treatment disparities exist between Aboriginal and/or Torres Strait Islander (First Nations) and non-First Nations people. Despite persistent calls from First Nations patients with kidney failure, they are less likely to have treatment that allows them to live at home. Methods and analysis This is a prospective, multicentre study based in Australia. The aim of the study is to characterise the socioeconomic, environmental, health service and biomedical factors driving the health outcomes and patterns of health service utilisation experienced by First Nations patients and investigate whether health service changes to address these identified barriers can achieve higher rates of renal replacement therapy at home on country. This will be achieved by mixed-methods data collection at health service (audit and process data), staff (surveys and qualitative interviews) and patient (survey testing, feedback sessions, health outcomes) levels. A process evaluation will identify barriers and enablers to health services changes in relation to cultural safety. Baseline and follow-up data will be compared to assess the extent to which health services change their service delivery and the impact on health outcomes for First Nations patients with kidney failure. Qualitative and quantitative data will be integrated to provide an in-depth understanding of project outcomes and impacts.en© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.kidney failure; treatment; Aboriginal and Torres Strait Islander Peoples; disparitiesHumansRenal Replacement TherapyProspective StudiesHealth Services, IndigenousHealth Services AccessibilityAustraliaRenal InsufficiencyMulticenter Studies as TopicObservational Studies as TopicAustralian Aboriginal and Torres Strait Islander PeoplesJournal article10.1136/bmjopen-2024-095727719898McDonald, S. [0000-0001-6103-1386]