Cracks in the Ice resources for Aboriginal and Torres Strait Islander peoples: Development of a culturally appropriate evidence-based online community toolkit about crystal methamphetamine (Preprint)

BACKGROUND Crystal methamphetamine (‘ice’) is a drug of significant concern across Australia, however, access to culturally appropriate, community-led, and co-developed resources is limited for Aboriginal and Torres Strait Islander communities. To meet this need, the Cracks in the Ice Resources for Aboriginal and Torres Strait Islander peoples web-based toolkit was developed to support Aboriginal and Torres Strait Islander peoples, families, and communities affected by crystal methamphetamine. OBJECTIVE This paper describes co-development and beta-testing of the Cracks in the Ice Resources for Aboriginal and Torres Strait Islander peoples web-based toolkit METHODS The community-led development of the toolkit was overseen by an Expert Advisory Group and involved a broad-reaching, inclusive, and iterative process, with three phases over a 6-year period (from funding in 2016 to launch in 2021). The development phases with, and for, Aboriginal and Torres Strait Islander communities involved: (1) initial focus groups (30-45 mins, n = 15) conducted by an Aboriginal researcher across 6 locations including metropolitan cities, rural regional towns, and towns servicing remote Aboriginal communities across Australia; (2) content and web development in collaboration with First Nations digital agencies; and (3) beta-testing of the web-based toolkit via a 15-25 min online survey among website end-users and experts to evaluate the toolkit’s acceptability, relevance, and usability. RESULTS Themes identified through Phase 1 community consultations (n = 166) highlighted the need for culturally appropriate information and resources about methamphetamine use harms, impacts, and support options. This guided Phase 2, where resources were developed to address knowledge gaps (e.g., drug effects) and practical needs of communities (e.g., yarning about drugs). Phase 2 also guided development of content specific meaningful First Nations artwork and designs, interactive features, and other resources in response to Phase 1. Overall, Phase 3 beta-testing results were positive with Aboriginal and Torres Strait Islander end-users (n=73) reporting that the toolkit was easy to navigate and provided appropriate and relevant information. The majority (67/73, 91.8%) of participants reported that it was clear what information the toolkit provided, and most (54/73, 73.9%) were “very likely” to recommend the website to others. Areas for improvement were identified (e.g., content explaining the artwork development, improving the clarity of text) and addressed prior to launch. The web-based toolkit (cracksintheice.org.au/aboriginal-and-torres-strait-islander-peoples) was officially launched on 21 July 2021(reach as of June 2025: >2.74M page views, >1.44M unique website users, >366K hardcopy resources distributed to >1,793 organisations across Australia). CONCLUSIONS It is critical that health resources for First Nations people are community-led and iteratively co-developed with experts and health workers supporting communities. Conducted over 6 years and involving > 240 Aboriginal and Torres Strait Islander community members, elders, experts, researchers, and health workers, such a process was used to develop this culturally appropriate, relevant, and acceptable web-based toolkit about crystal methamphetamine for Aboriginal and Torres Strait Islander peoples. Whilst focussed on an area of high need within Australia, this process provides an effective and strengths focused roadmap to achieve this in other areas of health and in other countries working with First Nations peoples.