4. Discussion
The current study used a community-based, participatory research approach to develop a best-evidence, service-level practice change process, supported by a program-logic framework previously developed by the authors [An important strength of the project is that the co-design and implementation was led by an Aboriginal researcher and AoD worker, with extensive consultation with senior Aboriginal AoD clinicians (via the Aboriginal Advisory Group), funders, researchers, as well as links with workers (via the peak organisation for the NGO AoD sector) [In addition to measuring change in audit scores (reflecting change in cultural responsiveness), future studies should also aim to examine the impact of these changes on service delivery or utilisation outcomes, potentially through using routinely collected administrative data. Previous reviews of cultural responsiveness programs have highlighted the need for valid indicators of change and objective outcome measures [The project used a methodologically strong assessment process involving a standardised audit tool that reflected the best-evidence guidelines and a double-scoring system to enhance inter-rater reliability [Participating services were self-selected, and it is possible that they may have had a pre-existing active interest in and/or resources to dedicate to improving their cultural responsiveness. The significant improvements in audit scores achieved by these services may not occur so quickly in other services. However, the participating services do represent a broad geographic and demographic area of NSW (including both urban and regional locations), as well as a variety of service delivery types. Service frontline and managerial staff rated the project as highly acceptable [