Cultural safety is critical to addressing healthcare disparities for Aboriginal and Torres Strait Islander peoples. The Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) programme was developed to support Aboriginal and Torres Strait Islander Nurses and Midwives through culturally responsive mentorship. This pilot study evaluates the feasibility and acceptability of the DANMM programme and its impact on cultural safety knowledge and workplace experiences.
A mixed-methods exploratory study research design was employed. Data collection methods were underpinned by the Ngaa-bi-nya evaluation framework.
Four Local Health Districts in New South Wales, Australia.
20 participants completed the Ganngaleh nga Yagaleh (GY) cultural safety tool (n=12 pre-DANMM programme and n=8 post-DANMM programme), between June 2023 and October 2024. Five of these participants also took part in individual yarns between August and November 2024.
Changes in median cultural safety knowledge scores (pre- to post-programme), measured using the GY tool, were analysed using the Wilcoxon rank-sum test for unpaired data (p
Statistically significant positive changes in median GY tool scores (pre to post) were observed for item 13 (median pre=4.5, post=5.0; p=0.02), item 32 (median pre=4.0, post=5.0; p=0.03) and item 40 (median pre=3.5, post=5.0; p=0.03); with a statistically significant negative change in scores observed for item 6 (median pre=3.0, post=2.0; p=0.01). Qualitative themes included: (1) fostering growth and navigating barriers, (2) the power of connection and (3) navigating prejudice and racism in the workplace. Participants valued the mentorship model, though programme participation was affected by organisational barriers, including time constraints and a lack of managerial support.
The DANMM programme was found to be acceptable and feasible with evidence of enhanced cultural safety knowledge and mentorship benefits. However, the findings highlight the enduring impacts of colonial and cultural load and the need for greater organisational support to ensure the successful implementation and long-term sustainability of cultural safety initiatives. Future research should examine the longer-term effects on workforce retention and overcoming barriers to implementation and scalability.
In Germany, influenza vaccination rates in at-risk groups are well below the 75% coverage recommended by the WHO. Although it has been shown that general practitioners (GPs) can play a key role in increasing their patients’ willingness to be vaccinated, this potential does not seem to have been fully used. This study aims to uncover factors that motivate GPs to vaccinate their patients against influenza, investigate the role of financial incentives in achieving higher vaccination rates and determine how the daily practice of GPs can be made more vaccination friendly.
A mixed-methods approach is employed to reach the research aims. Literature reviews will be conducted to identify factors that motivate GPs to vaccinate against influenza and to identify studies in which preferences are elicited. This is followed by semistructured interviews with GPs (n=6–10). The scoping reviews and interviews serve as a basis for the development of a quantitative survey directed at GPs which includes a discrete choice experiment. The quantitative survey will be sent to a total of 3760 GPs.
The study will be conducted in accordance with the Declaration of Helsinki. A positive vote has been received from the Ethics Committee of the Medical Association North Rhine (2024259). Study participants will only be included in the study after being given informed consent. Manuscripts will be prepared for the scoping review on motivating factors and after completion of the quantitative survey, which will be submitted to peer-reviewed journals. Interim results and final results of the project will be presented at conferences.
Gastroenteropancreatic neuroendocrine tumours (GEP NET) are malignant neoplasms that impact survival. Somatostatin analogues (SSA) are used for treating hormonal symptoms caused by GEP NET and have antiproliferative effects. They are used as first-line therapy in patients with advanced GEP NET, but disease control is limited to a median progression-free survival (mPFS) of 14–32 months. Second-line treatment options include targeted therapy (everolimus or sunitinib), or peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTATATE. In patients suffering from a NET-related hormonal syndrome, SSA is generally continued life-long. However, there is no consensus on whether it is beneficial to continue SSA in non-functional NET upon disease progression. Due to the ongoing activity of the somatostatin receptor pathway in GEP NET progressing on first-line SSA, we hypothesise that SSA have an added efficacy in second-line therapy.
The SAUNA trial is an international, multicentre, open-label, randomised, controlled, pragmatic clinical trial. 270 patients with advanced, non-functional GEP NET and progression under first-line SSA will be included in substudy 1 (PRRT; n=142) or substudy 2 (targeted therapy (everolimus/sunitinib); n=128) per investigator’s choice of second-line therapy and will be randomised (1:1) per substudy between SSA continuation or SSA withdrawal arms. Co-primary endpoints are the difference in progression-free survival (PFS) according to the RECIST (Response Evaluation Criteria In Solid Tumours) V.1.1 criteria and difference in time to deterioration (TTD) in quality of life (QoL) per substudy after initiating second-line therapy with or without SSA. Secondary endpoints include the PFS rate at 18 months, the difference in pooled PFS and TTD combining both substudies, overall survival, response rates, QoL, costs, cost-effectiveness and toxicity. The study design was developed in cooperation with the Belgium and Dutch patient organisations.
The study has been approved on 31 May 2023 by the Ethical Committees and Regulatory Authorities of the concerned member states (EU CT number 2022-502703-30-00). Both the trial management group and the steering committee will oversee good governance of this trial. Results of the study will be published in peer-reviewed international journals and presented at international conferences.