Anderson, KateGall, AlanaButler, TamaraNgampromwongse, KhwanruethaiHector, DebraTurnbull, ScottLucas, KerriNehill, CarolineBoltong, AnnaKeefe, DorothyGarvey, Gail2025-05-312025-05-311661-7827PubMed:36612467ORCID:/0000-0001-6507-8157/work/175313620http://www.scopus.com/inward/record.url?scp=85145974806&partnerID=8YFLogxKhttps://hdl.handle.net/1885/733755944Background: While co-design offers potential for equitably engaging First Nations Australians in findings solutions to redressing prevailing disparities, appropriate applications of co-design must align with First Nations Australians’ culture, values, and worldviews. To achieve this, robust, culturally grounded, and First Nations-determined principles and practices to guide co-design approaches are required. Aims: This project aimed to develop a set of key principles and best practices for co-design in health with First Nations Australians. Methods: A First Nations Australian co-led team conducted a series of Online Yarning Circles (OYC) and individual Yarns with key stakeholders to guide development of key principles and best practice approaches for co-design with First Nations Australians. The Yarns were informed by the findings of a recently conducted comprehensive review, and a Collaborative Yarning Methodology was used to iteratively develop the principles and practices. Results: A total of 25 stakeholders participated in the Yarns, with 72% identifying as First Nations Australian. Analysis led to a set of six key principles and twenty-seven associated best practices for co-design in health with First Nations Australians. The principles were: First Nations leadership; Culturally grounded approach; Respect; Benefit to community; Inclusive partnerships; and Transparency and evaluation. Conclusions: Together, these principles and practices provide a valuable starting point for the future development of guidelines, toolkits, reporting standards, and evaluation criteria to guide applications of co-design with First Nations Australians.This research was funded by Cancer Australia, grant number F21/412. Cancer Australia was established by the Australian Government in 2006 to benefit all Australians affected by cancer, and their families and carers. G.G. was funded by a NHMRC Investigator Grant (#1176651).enPublisher Copyright: © 2022 by the authors.Aboriginal and Torres Strait Islander peoplecancerco-designcommunity engagementFirst Nations peoplesparticipatory action research202310.3390/ijerph2001014785145974806