'We gout your back': a qualitative study to co-design educational gout resources with Pacific people in Aotearoa New Zealand.

Pacific peoples in Aotearoa New Zealand experience some of the highest rates of gout worldwide. Although understanding gout and urate-lowering therapy is a key component of ensuring uptake and adherence to medication, Pacific communities have identified a lack of resources and tools to support this. The objective of this qualitative study was to co-design education resources for Pacific patients and communities in Aotearoa New Zealand, aiming to increase awareness of gout and of urate-lowering therapy. A Pacific Research Collective, comprising Pacific community members, health professionals, and researchers, led this study. Guided by the Samoan Fa'afaletui model, six co-design workshops were undertaken using semistructured talanga (interactive talk with a purpose), and this paper presents the results from the latter three workshops. Participants included Pacific community members and health professionals aged 20-75 years and included Samoan, Tongan, Cook Islands Māori, and Niuean ethnicities. Participants reviewed existing gout resources, developed prototypes, and provided iterative feedback. Data was collated in NVIVO, and reflexive thematic analysis was used to inductively develop five key themes: (i) a disconnect between existing gout resources and community needs, (ii) Pacific-centred approaches to improve understanding of gout, (iii) benefits of video resources, (iv) recognizing diverse Pacific audiences, and (v) reflections on final co-designed resources. This co-design process prioritized Pacific views and lived experiences to develop culturally grounded gout education resources that can be utilized in healthcare settings and community outreach programmes. Future research should continue to partner with communities to ensure education approaches are relevant, appropriate, and impactful.