Abstract for: A Community-Engaged Systems Approach to Safer Primary Healthcare Spaces for Rural LGBTQA+ Youth

A robust evidence base documents persistent health and social disparities affecting LGBTQA+ populations. However, most research focuses on adults and non-Australian contexts. Emerging Australian evidence indicates compounded inequities for rural LGBTQA+ youth, including limited access to safe quality healthcare. This study therefore applies a community-engaged systems approach (CE-SA) to co-design safer primary healthcare spaces (S-PHC-S) with rural LGBTQA+ youth in Western Victoria, Australia, and identify the dynamics shaping S-PHC-S. Applying community-based system dynamics (CBSD) and co-design methods, rural LGBTQA+ youth aged 12-25 and system collaborators across Western Victoria will create a causal loop diagram of S-PHC-S in group model building (GMB) workshops, which will be translated into a quantitative simulation model, informed by empirical data, a systematic review and further community engagement to build model confidence and test the co-designed dynamic hypothesis and strategies to improve the safety of PHC spaces. In extensive community engagement an accessible and youth-centred GMB process has been co-designed. A preliminary reference mode of PHC safety was developed and recruitment began in February 2026 through trusted networks. The integration of CBSD, community engagement and co-design has not previously been applied in LGBTQA+ or healthcare research, elevating underrepresented voices and building community capacity. By co-designing S-PHC-S through an innovative CE-SA, this project addresses LGBTQA+ healthcare disparities, supports health equity and provides guidance for community-informed systems change in healthcare while laying the groundwork for CE-SAs with LGBTQA+ rural youth across Australia and internationally. as an editorial tool to check grammar, spelling and punctuation