‘I have been asking for years for this’: Remote Aboriginal and Torres Strait Islander men’s perspectives on preventive health assessments

Purpose Aboriginal and Torres Strait Islander men demonstrate strong interest in maintaining their health and wellbeing, grounded in holistic concepts of care, responsibility and connection to community. However, men in very remote Australia experience a disproportionate burden of disease and lower life expectancy, alongside lower uptake of preventive health checks, reflecting structural barriers to access. This study aimed to explore factors that enable and hinder Aboriginal and Torres Strait Islander men in a very remote community from accessing health checks, and to explore perspectives on a co-designed health check initiative. Methods This descriptive qualitative study was conducted in Nauiyu, a very remote community in the Northern Territory, Australia. Data were collected between June 2023 and July 2024. A thematic analysis of two linked data sources was undertaken: relevant yarning group transcripts about experiences of preventive healthcare from the overarching ‘Enough Talk, Time for Action' research program and semi-structured interviews conducted after participation in a co-designed, men-only, pop-up health check initiative. The initiative was developed at the request of men in the Nauiyu men's group and co-designed with the local research governance group and community organisations. Main findings Eighteen men contributed data to this study: 13 through 11 yarning groups and 10 through individual semi-structured interviews, with five represented in both datasets. Three global themes were identified: Motivations for accessing preventive healthcare; Preferred model of service delivery; and Strong relationships with key stakeholders. Participants strongly valued services that were co-designed and co-led with the community. Men-only, community-based, pop-up clinics were strongly preferred as they reduced shame, improved privacy and aligned with cultural protocols. Group attendance with peers and kinship networks facilitated engagement, while long waiting times and lack of confidentiality at mainstream clinics were key barriers. Trust in familiar providers and endorsement by respected community members were critical enablers. Principal conclusions Preventive healthcare for Aboriginal and Torres Strait Islander men in very remote settings is most effective when it is co-designed, men-specific, community-based and relationally grounded. Embedding these principles into routine service delivery has the potential to substantially improve rates of uptake for health checks.