The Safer Spaces Project: a whole of community systems approach to co-designing and implementing a 'Safer Spaces model of primary healthcare for LGBTQ+ young people in Western Victoria - a protocol for a mixed-methods study

Introduction LGBTQ+ young people in rural Australia face significant health challenges due to stigma, discrimination and structural barriers that hinder effective access to care. The inaccessibility or altogether absence of tailored primary healthcare services exacerbates poor health outcomes.

Methods Safer Spaces will use a mixed-methods approach combining participatory systems science with health economics methods to co-design and implement a ''Safer Spaces' Model of Primary Healthcare (SSMPH) targeting LGBTQ+ young people aged 12 - 25 years in rural Western Victoria. Phase 1 co-design of the SSMPH will be achieved through the establishment of a Queer Health Alliance, engagement in Group Model Building workshops via Deakin's STICKE platform and the administration of a Discrete Choice Experiment to ascertain LGBTQ+ young people's primary health service preferences.

Phase 2 will implement strategies co-designed in phase 1 supporting primary healthcare for LGBTQ+ young people that are equitable, accessible and responsive to local needs. Implementation efficacy will be evaluated using participatory qualitative methods, systems-based monitoring (including causal loop diagrams and social network analysis) and stakeholder-led evaluation.