Due to the ongoing impact of colonisation, Aboriginal and Torres Strait Islander people live with a greater burden of cardiovascular disease (CVD) than non-Indigenous Australians. Shared decision-making is recognised as an essential component of person-centred care. However, the previous guidelines for CVD risk assessment and prevention did not engage Aboriginal and Torres Strait Islander people. Additionally, there has been a lack of tools to support clinician communication and shared decision-making to address CVD prevention in this important "at-risk" population. We developed the Heart Health Yarning Tool, an online shared decision-making resource co-designed with Aboriginal and Torres Strait Islander people, to be implemented alongside the new Australian guidelines for primary CVD risk assessment and management. This was a three-phase project: Phase 1 consisted of a stakeholder consultation and co-design process, including consumer yarning workshops (n=21), individual yarning sessions with Aboriginal and Torres Strait Islander Health Workers/Practitioners (n=8), consumers (n=17), and interviews with general practitioners (n=5). Phase 2 involved a mapping process, where qualitative interview data was integrated into the conceptual framework of an existing culturally adapted shared decision-making model, 'Finding Your Way,' in order to tailor the model to the CVD context. Phase 3 involved developing and testing content for the new tool, based on findings from Phases 1 and 2, using evidence-based shared decision-making formats. The resulting tool supports health professionals to make shared decisions about heart health with Aboriginal and Torres Strait Islander people. It can be used as a conversation guide in primary care consultations or as a training tool for health professionals. Future research will assess whether use of the Heart Health Yarning Tool improves health professionals' cultural and shared decision-making competencies as well as cardiovascular outcomes in Aboriginal and Torres Strait Islander people.

Judith Parnham and David Follent are board members of the National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners (NAATSIHWP). Rosemary Wyber received support from the Department of Health and Aged Care, Commonwealth of Australia. Carissa Bonner received support from the Department of Health and Aged Care, Commonwealth of Australia; National Heart Foundation of Australia; and the National Health and Medical Research Council. Carissa Bonner was a member of the Expert Advisory Sub-Committee for the 2023 CVD prevention guidelines and risk calculator development for the Australian Chronic Disease Prevention Alliance and the National Heart Foundation of Australia.

This work was supported by funding from the Australian Government Department of Health and Aged Care - First Nations Health Division. The funding body had no role in the writing of this article.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Research Ethics Committee at the Australian Institute of Aboriginal and Torres Strait Islander Studies gave ethics approval (EO294-20210826)

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