The Stay Strong app as a self-management tool for First Nations people with chronic kidney disease: A qualitative study

Tricia Nagel, Kylie M. Dingwall, Michelle Sweet, David Kavanagh, Sandawana W. Majoni, Cherian Sajiv, Alan Cass

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
79 Downloads (Pure)

Abstract

Background: The high burden of chronic kidney disease in First Nations peoples requires urgent attention. Empowering people to self-manage their own condition is key, along with promotion of traditional knowledge and empowerment of First Nations communities. This study explores the potential of a culturally responsive tool, already found to have high acceptability and feasibility among First Nations people, to support self-management for First Nations people with kidney failure. The Stay Strong app is a holistic wellbeing intervention. This study explores the suitability of the Stay Strong app to support self-management as shown by the readiness of participants to engage in goal setting. Data were collected during a clinical trial which followed adaption of research tools and procedures through collaboration between content and language experts, and community members with lived experience of kidney failure. 

Methods: First Nations (i.e., Aboriginal and Torres Strait Islander) participants receiving haemodialysis in the Northern Territory (n = 156) entered a three-arm, waitlist, single-blind randomised controlled trial which provided collaborative goal setting using the Stay Strong app at baseline or at 3 months. Qualitative data gathered during delivery of the intervention were examined using both content and thematic analysis. 

Results: Almost all participants (147, 94%) received a Stay Strong session: of these, 135 (92%) attended at least two sessions, and 83 (56%) set more than one wellbeing goal. Using a deductive approach to manifest content, 13 categories of goals were identified. The three most common were to: ‘connect with family or other people’, ‘go bush/be outdoors’ and ‘go home/be on country’. Analysis of latent content identified three themes throughout the goals: ‘social and emotional wellbeing’, ‘physical health’ and ‘cultural connection’. 

Conclusion: This study provides evidence of the suitability of the Stay Strong app for use as a chronic condition self-management tool. Participants set goals that addressed physical as well as social and emotional wellbeing needs, prioritising family, country, and cultural identity. The intervention aligns directly with self-management approaches that are holistic and prioritise individual empowerment. Implementation of self-management strategies into routine care remains a key challenge and further research is needed to establish drivers of success.

Original languageEnglish
Article number244
Pages (from-to)1-14
Number of pages14
JournalBMC Nephrology
Volume23
Issue number1
DOIs
Publication statusPublished - Dec 2022

Bibliographical note

Funding Information:
This project was supported by a National Health and Medical Research Council (NHMRC) project grant (GNT# 1098311). The funding source had no input into the design of the study or the preparation of this manuscript and the views expressed in this publication are those of the authors and do not reflect the views of NHMRC.

Publisher Copyright:
© 2022, The Author(s).

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