Issue addressed Evidence suggests that participation in a Chronic Disease Self‐Management (CDSM) program improves the health of clients. Many factors are known to influence participation in these programs for the broader Australian population. However, less is known about why Aboriginal and Torres Strait Islanders choose to participate. This study identifies key factors that support or enable Aboriginal and Torres Strait Islanders to participate in a CDSM program in an urban setting. Methods Twelve focus groups were undertaken with a total of 102 participants who were diagnosed with or at risk of chronic disease. These participants were recruited from the Work It Out program, a CDSM program comprising exercise and health education. The Work It Out program is specifically designed for Aboriginal and Torres Strait Islanders and delivered by an Aboriginal led and community‐controlled organisation in South‐East and Central Queensland. The study received ethical clearance through the Behavioural and Social Sciences Ethical Review Committee at The University of Queensland (Approval Number 2011001283). Results Findings indicate that key features of program design based on a culturally responsive approach influences participation. The main features are as follows: providing easy access to the program; permitting flexibility in attendance; a group environment; the approach of program staff that prioritises relationship building; personalised and integrated care; communicating result regularly; and ensuring community ownership of the program. Conclusion These findings are useful to consider when designing a health program for Aboriginal and Torres Strait Islanders. Programs which are culturally responsive and include the design features identified in this study are more likely to increase participation amongst Aboriginal and Torres Strait Islanders. So What? Increasing participation of Aboriginal and Torres Strait Islanders in CDSM programs using the design features identified in the paper may contribute significantly in closing the health disparity gap.

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Work It Out is a holistic chronic disease self-management program for urban Aboriginal and Torres Strait Islander people in Queensland, which is part of an integrated and comprehensive system of care for chronic disease management. This study examines differences in primary healthcare services use between Work It Out participants and non-participants. This retrospective observational study of services use, analysed data extracted from the clinical medical records system and Work It Out program assessments. General practitioner and allied health services use were compared among the participants and non-participants using logistic regression models and zero-truncated Poisson and negative binomial regression models. Compared with non-participants, Work It Out participants were more likely to use GP management plans, GP team care arrangements, GP mental health consultation and subsequent allied health services. Among those who used the services more than once, Work It Out participants had higher service use rates than non-participants for Aboriginal and Torres Strait Islander health assessments, GP management plans, team care arrangements and podiatry, physiotherapy and dietetic services. Engagement in Work It Out can facilitate the use of primary healthcare services, which are important for chronic disease management for urban Aboriginal and Torres Strait Islander people.

Objective: The Composite International Diagnostic Interview 3.0 is a standardised diagnostic interview commonly used in population-based mental health surveys, but has not been used in community-residing Indigenous Australians. This paper seeks to determine whether the Composite International Diagnostic Interview 3.0 can produce valid diagnostic information when compared with a diagnostic interview in an urban Indigenous Australian sample. Method: This research was conducted over 10 weeks with adult Indigenous clients of two participating Aboriginal Medical Services in South-East Queensland. Using a cross-sectional, repeated-measures design, participants were administered the Composite International Diagnostic Interview 3.0 by an Indigenous interviewer and within 2 weeks attended a second appointment with an Indigenous clinical psychologist, who produced a diagnostic summary. The Composite International Diagnostic Interview 3.0 diagnoses were compared with the diagnostic summaries and clinical concordance between the two measures was calculated. Results: The diagnostic accuracy of the Composite International Diagnostic Interview 3.0 differed by module. The Post-traumatic Stress Disorder and Major Depression modules had good utility in diagnosing post-traumatic stress disorder and major depressive episodes, respectively; however, the Mania module that provides diagnoses of bipolar disorder was found to be unsuitable for this population. Although there were no identified contraindications for the use of the Generalised Anxiety and Alcohol Use Disorder modules, further research on the diagnostic accuracy of these modules is warranted. Conclusions: The Composite International Diagnostic Interview 3.0 can accurately diagnose some common mental disorders in an Indigenous Australian population, but was found to be unsuitable for others. Given these findings, care should be taken when using the Composite International Diagnostic Interview 3.0 in epidemiological prevalence studies with Indigenous Australian populations.

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