ISSUE ADDRESSED: SWAP IT is a school-based nutrition programme that promotes healthier lunchbox choices for children in Australia. As part of the programme scale-up, ensuring that implementation responds to the social and cultural determinants that shape food and nutrition practices for Aboriginal and Torres Strait Islander communities is important for equitable impact. To inform the cultural adaptation of SWAP IT, this study aimed to explore the experiences and perspectives of Aboriginal school staff regarding the implementation of SWAP IT in schools with high Aboriginal and/or Torres Strait Islander enrolments. METHODS: ) and one of 15 Local Health Districts in NSW. The study was led by an Aboriginal Program Manager from the Population Health Unit of HNE Local Health District, with further cultural oversight provided by programme governance groups. Grounded in Indigenous methodology, data were collected using yarning (an Aboriginal communication method and data collection tool) through individual and group yarns with 11 staff from seven SWAP IT schools. Data were analysed using Thematic Analysis and group yarns to inductively identify and refine key themes. RESULTS: Eight themes were identified. Four themes captured participants' direct experiences and perspectives of SWAP IT, including positive perceptions of its value (1A), and opportunities to strengthen cultural responsiveness in programme processes (1B), resources and content (1C) and distribution methods (1D). A second set of four themes reflected broader contextual considerations that emerged through the yarns and were seen to influence implementation, including preferences for culturally responsive materials and methods (2A), food access and insecurity as a significant challenge (2B), potential barriers to family engagement (2C) and sustainability concerns (2D). CONCLUSIONS: Incorporating surface level adaptations (e.g., Aboriginal artwork) and deep-level adaptations (e.g., cultural food practices) will enhance the programme's cultural responsivity for equitable delivery. Additional implementation strategies that account for the broader considerations may maximise impact for Aboriginal children and communities. Co-designing and piloting an adapted programme with Aboriginal communities is a critical next step. SO WHAT?: These findings highlight opportunities to strengthen cultural responsivity in programme design and delivery to better support Aboriginal and Torres Strait Islander communities.
Groombridge et al. (Tue,) studied this question.