Author: Victoria Thanasos, Menzies School of Health Research Introducing new tools into complex health service environments is rarely straightforward, particularly where they intersect with diverse ways of knowing, being, and valuing. This short paper shares insights from piloting the What Matters 2 Adults (WM2A) tool with dialysis patients in the Top End of the Northern Territory, focusing on how feasibility, appropriateness, and potential risks are assessed in practice.
Drawing on a formative evaluation approach, the project combined yarning circles, interviews, and reflective sessions with renal patients and stakeholders. Rapid qualitative analysis, informed by implementation science, was used to identify key barriers, enablers, and contextual factors shaping the tool’s potential use.
Three key insights emerged. First, feasibility is not just about logistics, but about meaning – how questions are understood and experienced. Second, appropriateness is not fixed but negotiated in place, requiring ongoing adaptation to language, delivery, and context. Third, introducing new tools carries risks – including burden, misinterpretation, and unintended consequences – that must be actively surfaced and managed.
Rather than presenting final outcomes, this paper focuses on the decisions, tensions, and trade-offs that shaped the pilot, including the deliberate decoupling of tool administration from routine service delivery to minimise burden on patients and staff while enabling deeper exploration. Participants will be invited to reflect on how they assess feasibility, appropriateness, and risk in their own contexts.
Overall, this paper positions evaluation as critical to assessing not just whether a tool works, but whether it fits – offering practical insights for context-sensitive, responsible approaches in complex, culturally diverse settings.
