“They Are Worth Their Weight in Gold”: Families and Clinicians’ Perspectives on the Role of First Nations Health Workers in Paediatric Burn Care in Australia

Round 1

Reviewer 1 Report

Thank you for replying to my questions.

Reviewer 2 Report

Thank you for the paper improvement

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.

Round 1

Reviewer 1 Report

This qualitative analysis of perspectives on roles of First Nations Health Workers in pediatric burn care in Australia. Given that it describes the perspectives of different groups on burn care and aftercare to First Nations people, it is interesting and worthy of consideration.  However, there are a number of concerns that must be addressed before being suitable for publication.

Comments for author File: Comments.pdf

Reviewer 2 Report

The paper reports an interesting view about the interplay between westernized health care and Australian First Nations health workers concerning aboriginal families' needs in burns aftercare, which is an essential issue for Aboriginal Australian children. The work is mainly narrative and reports only a few numbers and no statistics is necessary for this kind of paper.

My suggestions:

1) introduction:

• most readers will not be familiar with the concept of "First Nations", so it should be explained at the beginning of the introduction
• at the end of the introduction, the importance of conducting such a study should be reported and highlighted; I think that the role of colonialism and the connected issues including racism should be mentioned starting from the introduction
• paragraph 1.1 (The Coolamon study) should be moved to the methods section

2) methods:

• inclusion and exclusion criteria should be added
• how did the authors choose the sentences that they report in the results section? I could not find an explanation, please add
• lines 120-128 should be moved to the discussion

3) results

• the reported sentences are interesting, but it is not clear how they have been chosen; I think they should be moved to a Supplementary section

4) discussion

• I think that widening the concept of "First Nations children" to other ethnic minorities worldwide would improve much this paper. It should be explained how the Australian experience with FN children and HWs can be expanded to other minorities that might have somehow similar cultural and integration issues
• the importance of studying burn aftercare in Australian Aboriginal children should be stated and explained in detail
• are there similar studies in other ethnic minorities worldwide?

Reviewer 3 Report

I have accepted with great interest the revision of this article for four reasons. It is about analysing data on burn care. It is about adapting health care to minorities by respecting and learning from all the cultural and traditional background that enriches them. It is about bringing together and promoting cooperation between two groups that jointly care for burned children, but are very different in their way of approaching and solving the problems. Finally, because it is a question of seeking solutions which make access to health possible for all. The four things are certainly and preferably in my field of interest and experience.

However, after reading the text repeatedly, I am not sure I can make a proper analysis. I am certainly not at all an expert in what the authors call "The Indigenous research methodology". I understand that it is based on a technique of “yarning and Dadirri, a way of deep listening and learning, as the basis for interviewing”.

My concern arises when, apparently, there is a mix that takes for granted the benefits of both approaches so that the authors choose the one that best suits them for each step of the research work

If the data collection has a particular indigenous methodology. Above all, if the analysis of this data has a particular indigenous methodology, that is not explained to us in the text, it does not seem coherent to consider the results in a “western” research methodology. It seems that we are adding pears with bacon. The way the results are presented, it seems not results but personal opinions and judgements, no like an unbiased list of raw data to, further be discussed or interpreted. The random combination of the two methods, far from facilitating a global understanding of the problem and far from achieving a merge between "two worlds", distances them and makes comprehension even more difficult

In this way, an approach that could be of maximum interest loses all credibility. Surely, if the authors were able to be consistent with the method they have adhered to, both in the collection of data, in their presentation of results, and in their further interpretation and discussion, the result would be appropriate. In the form in which the study is set out, it seems to me impossible to judge the appropriateness, value, bias or adequacy of this work.