Wearables for early detection of atrial fibrillation and timely referral for Indigenous people ≥55 years: mixed-methods protocol

Connie Henson, Boe Rambaldini, Ben Freedman, Bronwyn Carlson, Carmen Parter, Vita Christie, John Skinner, David Meharg, Morwenna Kirwan, Katrina Ward, Sophia Nala 'Ḵixsisa 'las Speier, Kylie Gwynne

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Introduction: Digital health technologies have the potential to provide cost-effective care to remote and underserved populations. To realise this potential, research must involve people not traditionally included. No research focuses on the acceptability and feasibility of older Indigenous people using wearables for early atrial fibrillation (AF) detection. This protocol compares digital augmentation against standard practice to detect AF, evaluate heart health self-efficacy and health literacy changes and identify barriers in collaboration with Aboriginal Community Controlled Health Organisations. It will establish a framework for implementing culturally safe and acceptable wearable programmes for detecting and managing AF in Indigenous adults ≥55 years and older.

Methods: This mixed-methods research will use the Rambaldini model of collective impact, a user-centred, co-design methodology and yarning circles, a recognised Indigenous research methodology to assess the cultural safety, acceptability, feasibility and efficacy of incorporating wearables into standard care for early AF detection.

Analysis: Qualitative data will be analysed to create composite descriptions of participants' experiences and perspectives related to comfort, cultural safety, convenience, confidence, family reactions and concerns. Quantitative device data will be extracted and analysed via Statistical Product and Service Solutions (SPSS).

Conclusion: Prioritising perspectives of older Indigenous adults on using wearables for detecting and monitoring cardiovascular disease will ensure that the findings are effective, relevant and acceptable to those impacted.

Ethics and dissemination: Findings will be published in open-source peer-reviewed journals, shared at professional conferences, described in lay terms and made available to the public. The AHMRC HREC Reference Number approved 1135/15.

Original languageEnglish
Article numbere077820
Pages (from-to)1-10
Number of pages10
JournalBMJ Open
Issue number1
Publication statusPublished - 10 Jan 2024

Bibliographical note

Copyright the Author(s) 2024. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • Adult
  • Humans
  • Atrial Fibrillation/diagnosis
  • Indigenous Peoples
  • Heart
  • Referral and Consultation
  • Wearable Electronic Devices
  • blood pressure
  • adult cardiology
  • health equity
  • chronic disease
  • behavior
  • public health


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