Aim | Challenges | Responding strategies |
---|---|---|
To gain access to participants | Rural | |
Vast, sparsely populated area remote communities | Priority of dry season community assessments | |
Poor unsealed roads and runways | Self-sufficient four wheel drive travel, fuel, food, water and satellite phone | |
3-4 months monsoon flooding of roads and airstrips | Researchers trained in four wheel driving | |
Local research assistants help navigate unmarked roads to community | ||
Road travel supplemented by light aircraft charter or commercial travel to larger hubs | ||
A research assistant with pilots licence an advantage | ||
Urban | ||
Failure to respond to letter | Door to door transport provided | |
Difficulties getting to appointments | Central clinic used for assessment | |
To consult and negotiate with communities to gain approval and fit with community activities | Multiple and support required | Generic flow chart developed to be used for each community (Figure 2) |
To organise researcher team and satisfy needs | Limited space | Small multi-skilled research team |
Limited food outlets | Personal breakfast and lunch food, team roster for night meals | |
To transport equipment | Space and weight restrictions | Light equipment e.g., hand held ultrasound and vitalograph |
Researchers’ personal possessions limited | ||
Travel unsealed rough roads | Robust equipment purchased and wrapped in bubble wrap | |
To have constant power supply | Power unreliable in communities | All equipment capable of running with battery power |
To explain procedures | English second language, participants unfamiliar with scientific terms and procedures | Visual aids, pictures drawings and demonstrations |
Simple English assisted by employment of local Aboriginal | ||
assistant | ||
Explanations in groups, max 4 gender matched with researcher | ||
To collect data | Participants shy and unfamiliar with procedures | Siblings, cousins and friends data collection scheduled together for procedures |
Growth and nutritional data considered first priority | Triage of data collection making sure primary growth and nutritional data always obtained | |
Lack of private space | Researchers carry multiple sarong lengths to screen off private spaces | |
To do a venepuncture | Participants scared of procedure | Local anaesthetic cream used |
Observation of others consenting to be watched during procedure | ||
To transport biological specimen to distance laboratory | Preserving blood and urine samples | Blood centrifuged at point of collection |
Serum separated and placed in specific testing tubes | ||
Specimens maintained at low temperature in cold storage boxes or fridges | ||
Transported to central laboratory on government planes from hub if delays expected | ||
To gain informed consent | English second language, participants unfamiliar with scientific terms and procedures | Staged consent form (Additional file 1) accompanied by visual aids explained by gender matched research assistant |
To avoid clashing with community activities to | Ceremonies and “sorry business” Other agency and government department visits | Day before a planned community visit check still appropriate to visit |
Flexibility of researchers to change plans at short notice to accommodate unexpected traditional ceremonies and other important community visitors | ||
To use local Aboriginal interpreters and research assistant | Kinship and avoidance issues | Researchers understand and accommodate kinship and avoidance issues when working with Aboriginal people in a community |
Reimbursement for time spent | Concerns of coercion or inappropriate use of given money | Food and drink after fasting |
Wave-3 Canvas bag with wrist band and water bottle with study logo, tooth brush, tooth paste and health promotion flyers | ||
Later, urban participants given $AUD20 voucher for retail department store |