# Working Right Ways in Foot Health With and for First Nations Peoples: Research Method Guided and Governed by First Nations Ways of Knowing, Being, and Doing in Cross‐Sectional Qualitative Study Design

## TL;DR

This paper outlines a First Nations-led research approach to improve foot health services for Indigenous communities in Australia by centering Indigenous knowledge and co-design.

## Contribution

The study introduces a culturally responsive, First Nations-led co-design method for foot health research grounded in Indigenous ways of knowing.

## Key findings

- A First Nations-led co-design process was developed for culturally responsive foot health research.
- Indigenous methodology and data sovereignty were central to the study's design and analysis.
- The approach empowers First Nations Peoples to counter systemic inequities in foot health.

## Abstract

Underpinning ongoing colonisation of the lands now known as Australia, scientific racism in colonial research delivered flawed results by building Indigenous inferiority into methodology to produce dehumanising conclusions of First Nations Peoples. Scientific racism facilitated exclusion of First Nations Peoples from systems design and development; foregrounding ways exclusive and enforced colonial health systems cause First Nations health and wellbeing inequality. Inequities in foot health contribute to this inequality. This work describes and documents a process of First Nations‐led authentic co‐design for foot health research. This study represents ways and means to develop culturally responsive foot health research as judged by First Nations Peoples which will translate into improved and more responsive ways of delivering foot care.

Non‐Indigenous and First Nations Peoples sought authentic First Nations‐led co‐design process in foot health research methods, a governing First Nations Advisory Group, and broader First Nations governance and ethics approvals. Indigenous methodology, data sovereignty, and redistribution of power were imperative in ways of working. First Nations‐led co‐design developed culturally responsive semi‐structured interviews to collect data. Talking with 10 registered health practitioners who work closely with lower limb and foot health represented the right mix of participants and enough data to convey a more complicated mosaic of multi‐faceted stories. First Nations expertise informed analytic induction and the use of inductive reasoning and constant comparison to identify common and overarching themes, and to perform thematic analysis.

Authentic First Nations‐led ways of working in cross‐sectional qualitative study design are documented. Results of data analysis following these ways of working will be published subsequently.

This work provides insights into working right ways in research which will underpin good foot health services with and for First Nations Peoples. The paper highlights ways of working that empowers First Nations Peoples in authentic co‐design. First Nations‐led foot health research changes ways of working to counter inequities in foot health caused and maintained by ongoing colonisation and systemic racism. This study provides qualified voiced lived experience which foot health researchers must listen to and receive learning and direction from.