Co-design of school-based strategies and supports for Aboriginal and Torres Strait Islander youth living with type 2 diabetes: A qualitative study

Aust N Z J Public Health. 2025 Aug;49(4):100265. doi: 10.1016/j.anzjph.2025.100265. Epub 2025 Aug 5.

Abstract

Objective: Youth-onset type 2 diabetes is an emerging condition impacting Indigenous populations worldwide. Schools have an important role in supporting students to manage their health.

Methods: We undertook a qualitative study to (i) explore the lived experience of type 2 diabetes, diabetes management and support in school environments and (ii) co-design recommendations for age-appropriate, culturally safe school-based strategies and supports. Interviews and focus groups were undertaken with Aboriginal and Torres Strait Islander youth, caregivers, health professionals and school-based staff. Aboriginal and Torres Strait Islander youth were involved in determining the research topic.

Results: We found a need for school-based measures to address diabetes stigma, medication management, privacy and confidentiality, healthy eating and social and emotional wellbeing and identified further needs for staff training.

Conclusions: In many cases, schools are providing extensive support to students, but without adequate resources, supportive systems and policies or staff training, current approaches are insufficient.

Implications for public health: Recommendations include whole-of-school responses to address diabetes stigma and to generate sensitive approaches to nutrition, school-based management plans for students with T2D and adoption of Aboriginal and Torres Strait Islander-driven approaches.

Keywords: Aboriginal and Torres Strait Islander peoples; co-design; schools; stigma; type 2 diabetes; youth.

MeSH terms

  • Adolescent
  • Australia
  • Australian Aboriginal and Torres Strait Islander Peoples
  • Child
  • Diabetes Mellitus, Type 2* / ethnology
  • Diabetes Mellitus, Type 2* / psychology
  • Diabetes Mellitus, Type 2* / therapy
  • Female
  • Focus Groups
  • Health Services, Indigenous* / organization & administration
  • Humans
  • Interviews as Topic
  • Male
  • Qualitative Research
  • School Health Services* / organization & administration
  • Schools*
  • Social Stigma
  • Students / psychology