Diverse approaches and shared benefits: A scoping review of co‑designed chronic disease interventions with Indigenous People
1
Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Kaurna Yerta, Adelaide, Australia
2
Translational Health Research Institute, Western Sydney University, Dharawal land, Campbelltown, Australia
3
Riverland Mallee Coorong Local Health Network, South Australia Health, Ngarrindjeri Ruwe, Murray Bridge, Australia
4
Moorundi Aboriginal Community Controlled Health Service, Ngarrindjeri Ruwe, Murray Bridge, Australia
5
Coorong Medical Centre, Ngarrindjeri Ruwe, Meningie, Australia
6
The George Institute for Global Health, University of New South Wales, Gadigal, Sydney, Australia
7
School of Population Health, University of New South Wales, Gadigal, Sydney, Australia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Co designed health interventions are increasingly applied to redress the sustained chronic health inequities experienced by Indigenous Peoples amidst ongoing colonisation. Despite its growth in popularity, the outcomes of co-designed interventions have not been evaluated. This review sought to identify and synthesise the evidence base of evaluated co designed chronic and complex disease interventions among Indigenous adults.
METHODS:
Peer-reviewed studies published in English between January 2002 to May 2025 evaluating chronic or complex disease interventions for Indigenous adults (≥18 years) developed using co-design or related approaches were eligible. The Aboriginal and Torres Strait Islander Quality Appraisal Tool (CREATE) was used to appraise the quality of research from an Indigenous perspective. A narrative synthesis was conducted and reporting adhered to PRISMA ScR guidance. The protocol was prospectively registered (https://osf.io/j8abr).
RESULTS:
Of 3,978 records screened, 39 studies were included. Most emanated from the United States, with others from Australia, Canada, and Aotearoa. Diabetes and cancer were the most common chronic conditions addressed. Analysis revealed an array of co design approaches, with Community Based Participatory Research the most frequently reported. Intervention formats ranged from single session education to long term programs. Despite methodological diversity, most studies reported improved clinical outcomes, greater health knowledge, and better self management, social, and emotional wellbeing. Community level benefits included increased capacity, employment, and access to culturally grounded resources. Quality appraisal showed strong engagement and two way learning, but limited reporting of Indigenous governance and data sovereignty.
CONCLUSIONS:
Co designed interventions show meaningful benefits for Indigenous peoples and communities, improving chronic disease outcomes while strengthening cultural connection, community capacity, and wellbeing. Advancing the field requires clearer articulation of co design processes, stronger Indigenous leadership, and adherence to best practice frameworks to ensure ethical, culturally grounded, and community driven approaches that support long term health equity.
Co designed health interventions are increasingly applied to redress the sustained chronic health inequities experienced by Indigenous Peoples amidst ongoing colonisation. Despite its growth in popularity, the outcomes of co-designed interventions have not been evaluated. This review sought to identify and synthesise the evidence base of evaluated co designed chronic and complex disease interventions among Indigenous adults.
METHODS:
Peer-reviewed studies published in English between January 2002 to May 2025 evaluating chronic or complex disease interventions for Indigenous adults (≥18 years) developed using co-design or related approaches were eligible. The Aboriginal and Torres Strait Islander Quality Appraisal Tool (CREATE) was used to appraise the quality of research from an Indigenous perspective. A narrative synthesis was conducted and reporting adhered to PRISMA ScR guidance. The protocol was prospectively registered (https://osf.io/j8abr).
RESULTS:
Of 3,978 records screened, 39 studies were included. Most emanated from the United States, with others from Australia, Canada, and Aotearoa. Diabetes and cancer were the most common chronic conditions addressed. Analysis revealed an array of co design approaches, with Community Based Participatory Research the most frequently reported. Intervention formats ranged from single session education to long term programs. Despite methodological diversity, most studies reported improved clinical outcomes, greater health knowledge, and better self management, social, and emotional wellbeing. Community level benefits included increased capacity, employment, and access to culturally grounded resources. Quality appraisal showed strong engagement and two way learning, but limited reporting of Indigenous governance and data sovereignty.
CONCLUSIONS:
Co designed interventions show meaningful benefits for Indigenous peoples and communities, improving chronic disease outcomes while strengthening cultural connection, community capacity, and wellbeing. Advancing the field requires clearer articulation of co design processes, stronger Indigenous leadership, and adherence to best practice frameworks to ensure ethical, culturally grounded, and community driven approaches that support long term health equity.
| eISSN: | 2654-1459 |
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