Carer and staff preferences for characteristics of health services delivery for Aboriginal and Torres Strait Islander children: a best-worst scaling study

Background Prioritising the characteristics of health services delivery can guide improvements to the quality of care for Aboriginal and Torres Strait Islander children and their carers. The aim of this study was to estimate the relative importance of 20 health services delivery characteristics for Aboriginal and Torres Strait Islander children. Methods From May 2022 to November 2023, best-worst scaling surveys were distributed in person and online to carers of Aboriginal and Torres Strait Islander children and staff who work at health services used by Aboriginal and Torres Strait Islander children. Preference scores (0-1) were calculated using multinomial logit regression models. Interaction terms were added to a regression model to examine preference heterogeneity. Results A total of 109 surveys were completed. Most participants identified as Aboriginal and Torres Strait Islander (81%), and were aged ≥30years(77%), female (83%) and either worked or used health services at an Aboriginal Community Controlled Health Organisation (84%). For the combined sample of carers and staff, the most important attribute was 'Treatment options are explained, and the carer is involved in decisions about the child's care', followed by 'Clinical staff ask carer about their concerns for their child and respond to them' and 'Clinical staff provide carers with the skills to manage their child's health at home'. Conclusions Our study identified that communication characteristics related to shared decision-making and empowerment are considered the most important characteristics of health services delivery for Aboriginal and Torres Strait Islander children.