Introduction: Reduced licence participation in Aboriginal and Torres Strait Islander communities contributes to transport disadvantage, higher rates of transport-related morbidity and mortality. This study will incorporate a social ecology framework to better understand the economic, social inclusion and cultural impacts of licensing at all levels of the system from individuals, families, communities and the socio-political environment. Methods: Qualitative methods underpinned by a social ecology approach triangulates in-depth interviews (n = 17) and community discussion groups (n = 21). Analysis was inductive and deductive. Results: The impacts of licence participation were evident at multiple levels of the social ecology and it emerged that licensing greatly impacts the mobility of individuals, families and communities. Beyond mobility, the data amalgamated into four main themes: 1) Social and economic opportunity; 2) Access to services; 3) Cultural identity; and 4) Autonomy and the justice system. Discussion: Reduced driver licensing is impacting individuals, families and communities with an immense cost to multiple levels of the social ecology. This study has highlighted the value of licence participation for cultural identity and community wellbeing. Further, licence participation interacts with persistent inequity in the licensing and justice system and impacts on the capacity of individuals, families and communities to function autonomously within the parameters of the law. Accordingly, policy should be directed at facilitating equitable access to driver licensing to promote social inclusion. Licensing is not simply a "Transport" problem; addressing this complex issue of health and social justice is a prime example of the need for an intersectoral approach that targets change at the socio-political level to improve the equity, health and wellbeing of Aboriginal and Torres Strait Islander people.

The Driving Change programme was developed to facilitate access to licensing in Aboriginal communities in Australia. This process evaluation aimed to explore whether Driving Change was implemented as intended and was addressing the needs of the communities. A mixed methods approach was used, with triangulation of client data (n = 984), semi-structured interviews (n = 18) and client discussion groups (n = 21). Descriptive and regression analyses of quantitative and thematic analysis of qualitative data were drawn together to develop an integrated understanding of implementation barriers and facilitators. The programme reached 984 clients, with the majority from the target age group 16-24 years (56-89%). In multivariate analysis, clients who had supervised driving practice were 2.4 times more likely to attain a licence (95% CI: 1.9-3.1) and clients who received a high level of case management were 1.8 times more likely to progress to attain a licence than those who received low levels of case management (95% CI: 1.3-2.6). Implementation was facilitated by community partnerships and this was attributed to local delivery, Aboriginal leadership, connections with community networks and community ownership of solutions. Driving Change is engaging communities and reaching clients with a high level of need for licensing support. The programme is working with communities, benefiting from the input of cultural values and sharing ownership of local solutions. Community partnerships were critical to successfully supporting clients to overcome challenging barriers to participation. The learnings from this programme are relevant to complex community programme implementation and evaluation, particularly with diverse or hard to reach populations.

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