An online toolkit about crystal methamphetamine received positive early feedback from Aboriginal and Torres Strait Islander people who tested it: 91.8% said the information was clear, and 73.9% said they were very likely to recommend it. The results came from 73 end-users and describe acceptability, relevance and usability, not whether the toolkit changes knowledge, behaviour or health outcomes.
A long co-development process
The work describes the co-development and beta-testing of the Cracks in the Ice web toolkit for Aboriginal and Torres Strait Islander peoples. An Expert Advisory Group oversaw an iterative process that lasted six years, from funding in 2016 to launch in 2021, and was organised in three phases.
Phase 1 used 15 focus groups across six locations. Sessions lasted 30 to 45 minutes and included 166 participants; 54.8% were female, and 10 people attended two groups. The sessions were audio-recorded and transcribed verbatim. An independent researcher then carried out thematic analysis, producing 72 categories and 10 broad groupings that were reviewed and amended by consensus.
Participants wanted material tailored to people who use crystal methamphetamine, family and friends, health workers and community members. They asked for information about effects, signs of use, impacts on families, local services and how to navigate the health system, along with practical prevention and ways to reduce harm.
Content and web development were done with First Nations digital agencies. The toolkit included four hard-copy brochures, one for each end-user target group, as well as an interactive poster builder and quiz features that provided feedback and explanations. Twenty-eight fact pages were adapted or developed into three languages: Warlpiri, Torres Strait Islander Creole and Pitjantjatjara.
What the early test found
For the beta test, Aboriginal and Torres Strait Islander adults aged 18 or over in South Australia, Western Australia and New South Wales were invited to provide feedback through an online survey that included the beta toolkit and design options. In Phase 3, 116 people consented and started the survey; 88 completed it in full and 28 completed it partly. The analysis presented data from 73 Aboriginal and/or Torres Strait Islander participants, whose mean age was 47 and 68% of whom were female.
Among the 73 end-users, 67, or 91.8%, said it was clear what information the toolkit provided. Fifty-four, or 73.9%, were very likely to recommend it. The paper also reports positive views of navigation and relevance, and says the improvements identified during testing were addressed before launch.
Among health workers, 86% thought the landing page would be helpful, 57% reported daily relevance and 35% reported relevance on most days. The health-worker subgroup was small, and the results paragraph did not report its denominator.
Reach is not the same as impact
The toolkit launched on 21 July 2021. By May 2025, it had more than 1.44 million unique website users and more than 2.74 million page views. More than 366,000 hard-copy resources had been distributed to more than 1,793 organisations across Australia.
That reach shows distribution, not whether people engaged with the material or benefited from it. The beta findings came from a relatively small, convenience-recruited sample, limiting how confidently they can be generalised across Aboriginal and Torres Strait Islander communities. The authors also warned that group discussions can be shaped by people giving socially acceptable answers, groupthink and dominant voices.
The evidence therefore supports a report of what participants needed and how they viewed an early version of the resource, not a claim that it improves knowledge, attitudes, help-seeking, treatment uptake or health outcomes. The large usage figures likewise show reach rather than benefit.
The Australian Government Department of Health provided additional funding to develop the toolkit. The supplied front matter identifies the manuscript as an unpublished, non-peer-reviewed preprint submitted to the Journal of Medical Internet Research on August 7, 2025.
Paper data and sources
Original title: Development of Cracks in the Ice Resources for Aboriginal and Torres Strait Islander Peoples, a Culturally Appropriate Evidence-Based Online Community Toolkit About Crystal Methamphetamine: Mixed Methods Study.
Authors: Steph Kershaw, Katie Dean, Jessica Deng et al.
Journal/Repository: JMIR formative research
Status: Peer-reviewed
First online: 2026-08-21
DOI: 10.2196/75957
Original paper · Full text