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Table 3 Consensus ranking of elements needed for self-determination in policy development

From: First Nations Australians’ self-determination in health and alcohol policy development: a Delphi study

Themes—subthemes
Q1 Support for these existing elements and changes to others would enable First Nations Australians’ self-determination to be recognized
 80–100% support
  Recognition and support for the role of Aboriginal community-controlled organizations is needed to ensure there is a First Nations Australia voice
  Recognition that the First Nations Australian world view and collective identity is different from that of non-Indigenous Australians is needed throughout all processes
  Constitutional recognition of First Nations Australians and a collectively decided voice to parliament are needed
  Democratic processes embedded throughout the policy development system are needed
  Treaty/ies between First Nations Australians and the state and Australian governments that recognize the sovereignty of First Nations Australians are needed
  Change across the wider government and policy systems is needed to address and remove the structural determinants of healtha
Q2 There were a number of values identified that should underpin policy development processes for it to be seen as self-determination
 80–100% support
  The human rights of First Nations Australians are meaningfully considered
  The human rights of First Nations Australians are protected
  First Nations Australian culture and decision-making processes (consensus) are evident throughout the process
  The process is informed by the priorities and needs of First Nations Australian community/ies that are affected/impacted
  The diversity of First Nations Australians is recognized and accepted
  There is improvement of First Nations Australian individuals’ and communities’ lives
  The process is driven and directed by First Nations Australian leadership and governance
  First Nations Australians have significant influence and power over the process
Q3 Self-determination in alcohol policy requires the policy-makers to use processes that ensure First Nations Australian/s…
 80–100% support
  Are given adequate time for decision-making
  Receive feedback promptly and in a suitable format
  Are involved in the codesign/co-development of policy
  Are consulted early in the policy-making process
  Have the opportunity to contribute to the policy-making process
  Are involved in parts of the policy-making processa
  Communities are able to hold the policy-makers accountable
  Policy-makers can develop and build trust throughout
  Are involved throughout the policy-making process
  Are resourced and funded to be included at all stages
  Two-way sharing (decision-making power and being informed of what has worked elsewhere)a,b
  Are involved in evaluating the policy
  Are involved in monitoring the policy
  Local culture and language/s are considered and adjusted for in the policy-making process
 Less than 80% support
  Are involved in ALL data processes relating to alcohol policy (data sovereignty)b
  Community/ies have autonomy in the policy-making process
  Communities define the policy-making process
  Communities can control the policy-making process throughout
Q4 Self-determination in alcohol policy development requires decision-making processes that…
 80–100% support
  Are participatory and transparent for all parties
  Involve First Nations Australians
  Are evaluated and monitored, with prompt response to feedback
  Recognize the cultural obligations and expectations of First Nations Australians
  Are adapted for local context
  Are led by First Nations Australians
  Are defined by First Nations Australians
 Less than 80% support
  Are not circumvented or changed at higher tiers of governmentb
  Are democratic
  Are balanced between the evidence base and community preferencesb
  Are consensus-based
  Give First Nations Australian communities/participants veto power at all levels
  Give First Nations Australian community-controlled organizations collective veto power at all levelsb
Q6 At implementation, alcohol policy should include approaches that ensures it…
 80–100% support
  Is evaluated and monitored, with prompt response to feedback
  Is not discriminatory against First Nations Australians’ human rights
  Is respectful of the priorities of First Nations Australians and their communities
  Involves First Nations Australians in the implementation decision-making
  Results in the changes desired by the affected community/ies
  Involves First Nations Australians in the resource allocation decision-making
 Less than 80% support
  Supports First Nations Australian leading service provision
  Is translatable across the wider government and policy systems
  1. a> 80% consensus was reached in survey 3
  2. bElement only in survey 3