Table 3.

Comparison of traditional experience-based co-design with hybrid approach (experience-based co-design incorporating First Nations principles).

	Experience based co-design	Hybrid approach (EBCD incorporating First Nations principles)	Rationale
Setting	Health service or health system	Engagement with Aboriginal Community Controlled Health Services as the entry point for the study team, with inclusion of community members/Elders, and community services Ongoing community engagement is essential	To ensure respect for cultural governance processes; to ensure consideration of broader social determinants of health
Stakeholders	Service users and health professionals work together; Support from organisational champions is also important	Study participants included: Aboriginal and Torres Strait Islander women (ages 16-45); Aboriginal and Torres Strait Islander community members; Community services and health professionals Ongoing reflection on dynamics and prioritising Aboriginal women’s worldviews as required Study also informed by: Study’s Investigators; Aboriginal and Torres Strait Islander leaders; and community consultation	Care was taken to balance numbers and voices of different groups and considered power dynamics Aboriginal and Torres Strait Islander leadership (academic and local) as well as input from study investigators also informed study
Sharing experiences	EBCD aims to keep consumer experience at the centre of the process and recommends: interviews, patient shadowing and observation, and filming and sharing videos of patient experiences with health professionals	De-identified stories and examples were shared between participant groups to ensure a common understanding of experiences	Privacy and cultural safety concerns meant that the study did not share stories in a video format
Dialogue and decision making	Values dialogue with mixed groups of ‘consumers’ and health professionals; uses experiences of service users to identify priorities and solutions	Dialogue happened between groups and by sharing findings between groups Information and experiences from additional stakeholders were incorporated as early findings began to emerge	availability and preferences of participants informed this structure preferences were related to concerns about cultural security and privacy
Stages	Gathering experiences; Understanding experiences; Improving the experience, and Monitoring/Maintaining experience which are implemented in an iterative manner	The study used these broad phases to structure activities	Timelines and research activities varied between sites and there were lags between phases due to contextual factors