Phase 2: designing the intervention and developing the implementation plan

The stocktake of Aotearoa/New Zealand gout programmes, including those not published in the peer reviewed published literature, will be updated. These include Counties Manukau DHB Own My Gout; Northland DHB Gout Stop; and a pharmacist-led clinic. A comparison between the Own My Gout and Gout Stop programmes has recently been reported [23].

A series of workshops will be conducted with Collective members and other key Pacific stakeholders and community representatives to explore their views on interventions currently available, their perceived barriers to Pacific people taking ULT, and to brainstorm innovative alternatives. All PPHAG members, PPBRN research officers, relevant AH+ staff and other relevant stakeholders such as community members and pharmacists will be invited to participate. Participants in the workshops will receive participant information sheets and sign consent forms. Summaries of the interventions identified by the stocktake and systematic review will be produced to show what has already been tried, and what has been effective in different contexts. This will be presented in concise, user-friendly ways, for example in PowerPoint presentations, posters, storyboards or role-plays. The intervention will be co-designed by workshopping with the Collective using qualitative enquiry and nominal group technique where possible to ensure all voices are heard.

Pacific community members, patients and families will be engaged using appropriate cultural processes and protocols. Talanga [24] (interactive talk with a purpose) will be used to ensure two-way dialogue takes place when communicating with Pacific people [25]. The Luva approach (presentation to others), as exemplified in the Kakala research framework [26] will be used to feed back the synthesised material to the Collective group at a subsequent workshop. The novel intervention will be informed based on Pacific people’s holistic view of health as in the fonofale model [27]. This model addresses social, physical, mental and spiritual well-being, grounded by family, and overlaid by the Pacific cultural values of relationship, collectivity and collaboration, to create an innovative approach feasible to implement within South Auckland Pacific communities.

Workshops will take place either in-person or via virtual means such as zoom, depending on availability, preferences, and COVID-19 restrictions. Results may be collected on paper and through photographs of whiteboard workings. Key themes may be identified and analysed in NVivo software using a general inductive approach [28]. Suggested interventions will be discussed with study advisers to assess feasibility. Once an intervention has been drafted, the Collective will refine it into a strategy that can be implemented in South Auckland. Factors to be addressed in the intervention include what components it entails (e.g., health promotion, education, prescribing, dispensing, serum urate monitoring, patient reminders, family/whanau involvement), who leads it (e.g., doctor, nurse, pharmacist, team, community-led), and where it takes place (e.g., health premises, community location) and any possible digital modes of delivery (e.g., app, txt messages).

A framework to map the intervention implementation will be developed [29, 30]. A logic model of change [31] will be created using an intervention mapping framework [30]. The logic model will define the inputs (resources, investment needed to implement intervention); key activities (tasks needed to successfully implement the intervention); outputs (measures to be made to demonstrate that activities have been undertaken), and short-term outcomes (changes expected to result).