Untreated Psychosis and Healthcare-Seeking Behaviour in Pakistan: A Qualitative Study With Young People, Carers, Traditional Healers, and Healthcare Professionals.

Diabetic foot ulcers (DFUs) are a major driver of morbidity, loss of mobility, and reduced quality of life, and remain one of the most serious complications of diabetes. Over the past decade, prevention guidance has become increasingly clear, emphasising risk identification, regular surveillance, protective footwear and offloading, and timely access to specialist care []. However, ulceration rates have remained largely unchanged or increased in roughly half of the countries studied over the past 2 decades [], and recurrence rates remain high at approximately 42% within 1 year and 65% within 5 years of healing [, ]. This indicates a persistent gap between the goals of prevention guidance and what is achieved in practice. DFU prevention has largely been shaped by clinicians, researchers, and policy bodies []. Recent priority‐setting work has begun to broaden whose voices contribute to the prevention agenda, including a national Delphi study of Australian stakeholders that identified markedly different research priorities between consumers and health professionals, with no shared questions in their respective top 10 lists [, ]. However, consumers from culturally and linguistically diverse (CALD) communities and socioeconomically disadvantaged populations remain particularly underrepresented in shaping prevention [, ] while carrying a disproportionate burden of disease. Type 2 diabetes is around three to four times more prevalent among Aboriginal and Torres Strait Islander peoples [] and, after adjustment for age and socioeconomic status, 6.3 to 7.2 times higher in Pacific Island–born Australians []. Diabetic foot ulceration and amputation are three‐ to six‐fold more common in Aboriginal and Torres Strait Islander Australians [], and are also more common among people on lower incomes and in the most disadvantaged areas []. Underrepresentation matters because consumers carry the daily work of prevention, and that work looks different across populations. What is feasible, meaningful, or sustainable for one group may not hold for another []. Defining DFU prevention without their perspectives risks producing strategies, guidance, and outcome measures that do not reflect what works for the people who need prevention most. To address this gap, we used a co‐design approach with consumers at high risk of DFU, including Aboriginal and Pacific Islander participants and those from areas of socioeconomic disadvantage. This study aimed to (i) characterise consumer‐perceived barriers and enablers to DFU prevention, (ii) establish consumer‐derived prevention research priorities, (iii) identify and prioritise implementation strategies for the highest‐ranked priorities, and (iv) prioritise outcome measures for DFU prevention research.