Table 1 Core components of chronic wet cough detection and management program

1. First Nations lead^a

• Leadership and advice on all cultural components

• First Nations person

• Operations are culturally secure with First Nations knowledge and wisdom integral

• First Nations lead appointed at commencement for duration of study

2. Barrier identification^a

• Stakeholder engagement (focus groups and interviews) to identify barriers and facilitators to the program

• Inner setting: parents and wider community members, HCPs, executive

• Outer setting: key stakeholders such as First Nations controlled health organisations, local hospital HCPs, including pediatricians, daycares, playgroups, and a consumer reference group

• Qualitative experts will undertake interviews/focus groups and provide analysis

• Interviews and focus groups will gather views of parents, wider community, HCPs

• Identified barriers and facilitators

• Summary of findings, and implementation of program for each site

3. HCP Training (3-month period)

• In-person training/webinar. Series of 3 sessions, 1-month apart

• E-learning i.e., 2 online training modules and a podcast(s) accessible and free of charge (will be available in the long term and after the implementation period)

• Each clinician to attend at least 3 training sessions, where participation in an e-learning module could replace a face-to-face a training session

• In-person clinical training by pediatric respiratory clinician

• Local champion will promote module and podcast at each site

• Module and podcast hosted on website of recognised national body

• Clinical/cultural training accomplished

• Metrics of completions at each site (electronic capture system)

• Percentage of HCPs employed at each site who received training

• Audit and feedback: medical records audited for HCP management of chronic wet cough. Feedback given at monthly intervals

4. Educational resources for HCPs

1. Health information flip chart/leaflets

2. Animated film version of flip chart

3. Flow chart on wall in clinic as reminder

• Champion at each site ensures availability and accessibility of documents

• Educational resources adapted for each site (including language translation)

• Available on internet/intranet

• Record whom information resources are given to

5. Practice changes

• Ensure that clinical practice guidelines easily accessible

• Call-back option (ability to schedule follow-up of patient by same clinician)

• Electronic decision support, if feasible, e.g., prompts to ask about cough quality and duration. Ensuring clinical practice guidelines (a precondition) easily accessible

• Provision for nurses to allow initiation of medication treatment context-specific to chronic wet cough

• Facilitate medication dispensing, e.g., home visits by health staff, patients attending clinic to receive their medication can bypass triage for medication administration

• Clinical manager to implement practice changes

• Booking system for recall of patients operational

• Flow charts placed in clinic rooms

• Flexibility in medication dispensing system

• Record if booking option operational

• Record flow chart placements

• Record of clinic-assisted medication administration

• Record of nurses who complete training and can initiate medication treatment

6. Local champions

Facilitated uptake of new processes by local HCPs

• Identified by research team and/or clinical lead at each site

• Champion is trained and at each site

• Presence of champion and input from champion at each site

7. Health promotion campaign

(Same 3-month period as HCP training)

1. Health promotion messages on chronic wet cough disseminated at places often attended by members of community e.g. via posters in clinic and community; social media (e.g., Facebook); radio, television

2. Health promotion team-leading community discussions i.e., "yarning"

3. Other information materials and booklets

• Research team to coordinate campaign in liaison with local champions and stakeholders

• Health promotion team: respiratory clinician provides training to a central AMS health promotion team (not part of the individual clinics) – trained members and local navigator provide yarning groups. This method of health promotion for regions where social media is limited by slow internet

• Adapted health information materials completed for each site

• Health promotion team mobilised to work in community to yarn in small groups

• Check posters placed as required

• social media analytics

• Number attendees and yarning groups for each community