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Background Diversity and inclusivity have become increasingly important in the design and implementation of clinical trials. However, those from culturally and linguistically diverse (CALD) backgrounds are still underrepresented in the research landscape. Failing to include diverse participants can result in treatments and interventions that are not accessible to all who need them. Researchers in Australia and internationally are innovating new ways to address the barriers to increased participation of people from CALD backgrounds in clinical trials. Consultation and review We conducted a brief review, augmented by consultation with experts who have engaged CALD communities in research and who hold positions in diversity and inclusivity improvement. Through this, we identified three pillars that must be considered in all areas of design and implementation of trials and research projects: co-design the process of engagement, build trust, invest the time. We also identified seven areas for action where organisations and research teams can focus their activities to improve inclusion and diversity: toolkits and study design, building trust with CALD communities, education and awareness, staff training and communication, language and consent, logistics, resources: funding and time. Importantly, accurate collection of data related to CALD status is also needed to improve inclusivity. Conclusion Experts provided valuable insights from their own experiences of the most effective methods for improving the inclusion of CALD communities in clinical trials. Early and thorough planning, building long-term, mutually beneficial relationships with CALD communities and top-down changes to funding are all necessary elements to creating effective, sustainable improvements to the diversity of clinical trials.

Background Lung transplantation improves survival and quality of life in young people with end‐stage lung disease. Few studies have investigated the clinical care experiences of young people after lung transplantation. Design This qualitative study aimed to explore the experiences of young people who underwent lung transplantation. Semi‐structured interviews were conducted with 16 lung transplant recipients (< 25 years at transplant). Interviews were analysed to identify themes and categorize and describe the experience of young lung transplant recipients. Results The themes that emerged were (1) Hope and spectre: The transplant dilemma; (2) Information delivery and comprehension; (3) Independence and navigating care; and (4) Continuity and youth‐appropriate care. Findings suggest that young people have distinct care needs that consider the many parallel life transitions that occur in addition to transplantation. They value consistent and familiar teams, which nurture autonomy and independence in the context of post‐transplant survivorship and highlight the importance of feeling that they can relate to the healthcare process. Conclusion The results highlight key areas where adolescent lung transplant recipients can be supported by clinicians, enabling the development of youth‐friendly services that cater to this group's healthcare and psychosocial needs. Patient or Public Contribution Sixteen lung transplant recipients participated in the study by completing a semi‐structured interview. Two additional lung transplant recipients who received lung transplants as adolescents and one parent of an adolescent lung transplant recipient participated in a Project Advisory Group (PAG) with six clinicians representing paediatric, adolescent, and adult healthcare experience. They provided advice on research design including the development and revision of the interview guide and recruitment methods. They additionally provided feedback on the preliminary findings and outline of the manuscript. A summary of results was presented to the PAG who in conjunction with the writing group developed a list of recommendations based on the themes identified and the tenets of youth‐appropriate care as set out by the World Health Organization. One lung transplant recipient was an author on the manuscript contributing to its writing and review before submission. The clinicians who participated in the PAG did not have direct healthcare relationships with the study participants.

Background The limited allocation of resources to rural and regional communities is a major contributor to healthcare inequities in Australia. Distribution of health service resources between metropolitan and rural communities commonly sees highly populated areas prioritised over more sparsely populated and geographically vast areas. As such, challenges impacting dementia diagnosis, management, and care in metropolitan areas are experienced more acutely in rural areas. This study aimed to examine equity of access to dementia diagnosis, management, and care services amongst people who experienced the process of dementia diagnosis as a patient or significant other (partner/spouse, adult children, siblings, and friends) throughout rural and metropolitan Australia. Methods This exploratory qualitative study consisted of thirty-three online semi-structured interviews with thirty-seven people with experience of the dementia diagnosis process as a patient and/or significant other. Interviews explored symptoms of dementia, health professionals consulted, tests conducted, and challenges faced throughout the diagnosis and post-diagnosis process. Rurality was defined by the Australian Statistical Geography Standard Remoteness Areas (ASGS-RA) and the Modified Monash Model (MMM). Thematic analysis was conducted, with Russell’s (2013) Dimensions of Access framework (geography, affordability, availability, acceptability, accommodation, awareness, and timeliness) guiding data analysis. Results Participants were distributed across various regions of Australia: seven interviews from inner regional Australia, five interviews from outer regional Australia, and twenty-one interviews from metropolitan areas. Disparities in access between metropolitan and rural areas emerged in five key dimensions: 1) geography impeding ability to access services; 2) affordability of travel expenses; 3) availability of healthcare and support services; 4) acceptability of available health professionals and services; and 5) awareness of local services and resources. The dimensions of accommodation and timeliness of care were experienced as challenges irrespective of location, with lengthy appointment wait times and difficulty navigating complex systems. However, rurality often compounded the challenges in dementia diagnosis, management, and care. Conclusions Significant health inequities persist between rural and metropolitan communities that must be prioritised in endeavours to promote equitable dementia diagnosis, management, and care. Targeted action to address disparities is vital to mitigate the impact of rurality, particularly as clinical practice evolves with research advancements.