Authors: Emma Weaver, Menzies, Shiree Mack, Menzies, Caroline Miller, Menzies, Louise Maple-Brown, Menzies The Merne Mwerre Artweye Areye-ke (MMAA) diabetes prevention program was developed for Aboriginal and Torres Strait Islander children aged 6-11 years and their caregivers in Central Australia in response to community concerns about the increasingly high rate of youth obesity and type 2 diabetes in the region. The program is being delivered and evaluated in partnership between Central Australian Aboriginal Congress, the Aboriginal community-controlled health service, and Menzies School of Health Research across ten communities. While grounded in community leadership and co-facilitation by Aboriginal staff, the program is being delivered through a randomised controlled trial (RCT) to facilitate evaluation of clinical effectiveness.
This creates an ethical tension; RCTs privilege pre-specified outcomes, standardisation, and methodological control, whereas community-led initiatives require relational accountability, flexibility, and responsiveness to local priorities. The evaluation therefore confronts questions of power - whose knowledge counts, who defines success, and how competing accountabilities are balanced.
To navigate these tensions, the evaluation framework integrates adaptive qualitative inquiry alongside quantitative measures. Iterative feedback loops, reflective field notes, and ongoing dialogue with local leaders have supported transparency and ethical responsiveness. Program adaptations have included prioritising relationship-building, embedding local language and strengths-based framing, providing practical supports for participation, and reframing outcomes to reflect change valued by families and communities. The evaluation has also shifted from conventional semi-structured interviews to culturally grounded yarning approaches, recognising Indigenous ways of knowing as critical forms of evidence.
This presentation, delivered as a dialogue between an Aboriginal facilitator and a non-Indigenous evaluator, will critically reflect on trade-offs, missed assumptions, and lessons learned. It will explore how evaluators can uphold methodological rigour while prioritising differing voices, acknowledging power, and remaining accountable to community-defined values. Transferable strategies will be shared for ethically navigating complex, culturally grounded evaluations.
