Table 1.

Study objectives and outcome measures

Objectives	Outcome measure	Purpose	Description	Participants	When administered
Implementation
Objective 1: Enhance health provider knowledge, skills and confidence	BE WELL Health Provider Impact Questionnaire	To evaluate the effects of the BE WELL workshop on health care provider knowledge, confidence and skills	The questionnaire will include a Likert scale to assess self-reported knowledge of COPD, and skills in assessing people with COPD (including spirometry and 6MWT), and confidence in exercise prescription (EP/PTs only) and providing an exercise program and education for Indigenous people with COPD	AHWs and EPs/PTs who attend the BE WELL workshop	Before and immediately after the BE WELL workshop, and at 3, 6 and 12 months post-workshop
	Online education survey	To evaluate the AHW and EP/PT experience of the online education sessions for developing ‘yarning’ educational resources for BE WELL participants undertaking the PR program	A 15-question survey using a 5-point Likert scale evaluating the mode of delivery, structure of the sessions, and engagement	AHWs and EPs/PTs who attend the BE WELL online education sessions	After completion of the online education sessions at each participating ACCHS
	Online education semi-structured interviews	To explore the AHW and EP/PT experiences of the online education sessions to completement the responses from the online education survey	To guide discussion, 13 interview questions covering context, co-design, engagement, knowledge and understanding, cultural integration and impact will be used. The interviews will be conducted by a member of the research team experienced in qualitative interviews and who is not involved in the delivery of the online education sessions	AHWs and EPs/PTs who attend the BE WELL online education sessions	After completion of the online education sessions at each participating ACCHS
Objective 2: Identify factors that influence successful implementation	Focus groups	To explore the local structural, system level and other contextual factors that could influence successful implementation within each ACCHS	To guide discussion there will be questions relating to the elements of the RE-AIM framework i.e. Reach, Effectiveness, Adoption, Implementation, Maintenance	ACCHS staff involved in BE WELL project	At project inception and at 12-months after the BE WELL workshop
	Survey	To gain feedback from patients about the BE WELL PR program	Survey using 5-point Likert scale to evaluate patients’ knowledge of lung disease, confidence in self-management, program satisfaction and suggestions for improvement	Indigenous patients enrolled in the BE WELL PR program	At the completion of each patient’s PR program
	Focus groups	To gain a more in-depth understanding of the patient experience of the BE WELL PR program	To guide discussion there will be questions relating to patients’ experiences of the BE WELL PR program and patients’ perceived changes in knowledge of lung disease, confidence in self-management, and their degree of satisfaction with the program. Advice will be sought from each ACCHS to determine the most culturally appropriate method of engaging with patients	Indigenous patients enrolled in the BE WELL PR program	After completion of PR by a group of participants
Objective 3: Uptake of new services for COPD management	BE WELL Service Delivery Inventory	To evaluate the extent of respiratory services at each ACCHS and the impact of the BE WELL program on the services provided	The inventory will cover the following services: spirometry for assessment of COPD, assessment of smoking status, provision of evidence-based smoking cessation advice and/or treatment, provision of pulmonary rehabilitation programs that include exercise training and patient education	Executive staff of each ACCHS	At initial consultation and at project completion
Intervention
Objective 4: Impact of BE WELL PR program on patient outcomes and health care costs	6MWT (23)	To evaluate functional exercise capacity	Measures distance walked in 6 min on a flat, indoor track. Two tests will be performed at baseline and one test at program completion. Oxygen saturation and pulse rate will be recorded continuously using a pulse oximeter (MIR Spirodoc Spirometer, Rome, Italy)	Indigenous patients attending the BE WELL PR program	Before and after participation in the 8-week BE WELL PR program
	SGRQ (24)	To evaluate HRQoL	A 50-item questionnaire with domains of impact, symptoms and activity impairment associated with COPD
	EQ5D-5L (25)	To evaluate HRQoL	A generic quality of life questionnaire consisting of five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) which will be used in cost-effectiveness analysis
	CAT (26)	To evaluate the impact that COPD on wellbeing and daily life	An 8-item questionnaire evaluating symptoms, activity limitations, sleep, confidence
	Hospitalisations	To evaluate the impact of the BE WELL PR program on hospitalisations	Hospital separation data will be collected from the NSW Centre for Health Record Linkage (CHeReL). Administrative hospital records including information on the Diagnostic Related Group (DRG) classification and International Classification of Disease (ICD-10) codes for hospital separations will be used to estimate a cost using local cost weights	Indigenous patients who participated in the BE WELL PR program	In the periods 12 months preceding and following participation in the BE WELL PR program
	Other healthcare costs (GP visits, medications)	To evaluate the impact of the BE WELL PR program on other healthcare costs	Costs of medical services and medications will be recorded from patients who consent to access of their administrative health care use data through the Medical and Pharmaceutical Benefits Schedules (PBS) from Medicare Australia. Additional primary health care and medication use data will be abstracted from primary health care histories particularly in sites where the PBS have limited implementation, e.g. very remote Australian health care services
	Costs of BE WELL pulmonary rehabilitation program	To determine the costs of provision of the BE WELL PR program for comparison with any costs savings	Costs of program delivery will include staff time, facility costs, training resources	Executive staff of the ACCHS	During the BE WELL project

ACCHS Aboriginal community controlled health services, AHW Aboriginal health worker, BE WELL Breathe easy walk easy lungs for life, CAT COPD assessment test, COPD Chronic obstructive pulmonary disease, EP/PT Exercise physiologist/physiotherapist, EQ5D-5L EuroQual 5 dimensions-5 levels, GP General practitioner, HRQoL Health-related quality of life, PR Pulmonary rehabilitation, SGRQ St George’s respiratory questionnaire, 6MWT Six-minute walk test