Evaluating the implementation of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) programme: a mixed-methods pilot study conducted across four Local Health Districts in New South Wales, Australia.

Objective: Cultural safety is critical to addressing healthcare disparities for Aboriginal and Torres Strait Islander peoples. The Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) programme was developed to support Aboriginal and Torres Strait Islander Nurses and Midwives through culturally responsive mentorship. This pilot study evaluates the feasibility and acceptability of the DANMM programme and its impact on cultural safety knowledge and workplace experiences.

Design: A mixed-methods exploratory study research design was employed. Data collection methods were underpinned by the Ngaa-bi-nya evaluation framework.

Setting: Four Local Health Districts in New South Wales, Australia.

Participants: 20 participants completed the Ganngaleh nga Yagaleh (GY) cultural safety tool (n=12 pre-DANMM programme and n=8 post-DANMM programme), between June 2023 and October 2024. Five of these participants also took part in individual yarns between August and November 2024.

Primary Outcome Measures: Changes in median cultural safety knowledge scores (pre- to post-programme), measured using the GY tool, were analysed using the Wilcoxon rank-sum test for unpaired data (p<0.05). Thematic analyses of individual yarns were completed using Braun and Clarke's reflexive approach.

Results: Statistically significant positive changes in median GY tool scores (pre to post) were observed for item 13 (median pre=4.5, post=5.0; p=0.02), item 32 (median pre=4.0, post=5.0; p=0.03) and item 40 (median pre=3.5, post=5.0; p=0.03); with a statistically significant negative change in scores observed for item 6 (median pre=3.0, post=2.0; p=0.01). Qualitative themes included: (1) fostering growth and navigating barriers, (2) the power of connection and (3) navigating prejudice and racism in the workplace. Participants valued the mentorship model, though programme participation was affected by organisational barriers, including time constraints and a lack of managerial support.

Conclusion: The DANMM programme was found to be acceptable and feasible with evidence of enhanced cultural safety knowledge and mentorship benefits. However, the findings highlight the enduring impacts of colonial and cultural load and the need for greater organisational support to ensure the successful implementation and long-term sustainability of cultural safety initiatives. Future research should examine the longer-term effects on workforce retention and overcoming barriers to implementation and scalability.