Co-Designing an Antiracist Dental Health System: Protocol for an Aboriginal and Torres Strait Islander-Led Mixed Methods Study.

Background: Racism arrived in Australia with colonization and its intentionally oppressive policies and actions toward Aboriginal and Torres Strait Islander Peoples. To a large extent, colonial and biomedical agendas are maintained by Australia's health system that underlies much of the racialized health inequities in the country. Dentistry significantly lags behind medicine and other health care areas in the uptake of antiracism, with the dental accreditation body only acknowledging racism as a determinant of oral health in 2022.

Objective: This project will comprehensively co-design strategies for an antiracist dental health system in Australia through the following objectives: (1) development of an antiracist curriculum for dental students; (2) workforce strategies that support the attraction, retention, and well-being of the Aboriginal and Torres Strait Islander dental workforce; and (3) oral health promotion training for Aboriginal Health Workers/Practitioners.

Methods: This project is grounded in decolonizing and Indigenous methodologies, which guide our ways of working at the knowledge interface. Co-design Yarning sessions will inform the development and implementation associated with each of the objectives through tabulation and narrative synthesis of sessions. Objectives will be evaluated with both quantitative and qualitative measures and analyzed accordingly with inverse probability of treatment weighting, content analysis, or reflexive thematic analysis.

Results: The study received ethical review approval in February 2024 and received funding in June 2024. The co-design phase for each objective will run from July 2024 to February 2025. The dental curriculum will be developed in 2025 and delivered to the 2026 student cohort. Evaluation data will be collected from the comparator student cohort in 2025 and the implementation cohort in 2026. Data collection for the development of workforce strategies will be collected from October 2024 to July 2025; the framework will be developed from August to December 2025 and disseminated in 2026. Oral health promotion training will be developed from August to February 2024, implemented from March to June 2025, and qualitative evaluation data will be collected between July and September 2025.

Conclusions: The proposed research will develop an antiracism curriculum for dental students, a tailored Aboriginal and Torres Strait Islander dental workforce framework, and an oral health promotion training program for Aboriginal Health Workers/Practitioners. The processes and final outcomes of this research will be scalable and able to be tailored to different contexts. Together, these strategies will build oral health knowledge at the Community level, in turn supporting Aboriginal and Torres Strait Islander self-determination of oral health.

International registered report identifier (irrid): PRR1-10.2196/69012.