Experiences and Perceptions Within a Co-Created Drone Transport Initiative With Rural First Nation and Non–First Nation Communities: Semistructured Interview Study

Background: People living in rural areas of British Columbia experience inequities in access to health care that impact health and well-being. Since time immemorial, Indigenous peoples have had a holistic understanding of health and wellness, and knowledge of healthful ways of living. However, in a rural context, Indigenous peoples contend not only with inequitable access to health care, but also with the historical and ongoing impacts of colonization. Virtual health innovations enable access to care closer to home, yet the need for diagnostic tests and essential medicines remains limited by supply chains. In this context, transport of medical supplies by drone offers a promising solution and has the potential to improve access to health care in rural and First Nations communities in British Columbia. Objective: The Drone Transport Initiative is a co-created health care innovation project between the Stellat'en First Nation, the Village of Fraser Lake, the University of British Columbia, and other health system partners that investigated the feasibility of drones to transport medical supplies in a rural British Columbian context. This analysis aimed to understand the experiences and perceptions of the Project Team, people directly involved in the Initiative. Methods: Twenty members of the Project Team, including representatives from the Steering Committee and Operational Team having diverse roles within the project, participated in semistructured interviews. Eleven interviews were conducted either individually (n=5), in pairs (n=5), or in a group of 5 (n=1). Interviews were audio-recorded, transcribed verbatim, and anonymized. A reflexive thematic analysis was conducted to understand the Project Team's experiences and perceptions of the project. Initial results were shared with coauthors, including project cosponsors and community members, to interpret the findings and formulate discussion topics. Results: Participants generally expressed positive experiences from being part of the Drone Transport Initiative, despite remarking on various challenges. Major themes derived from the analysis centered upon (1) building respectful and trusting relationships, (2) mutual benefits that enabled effective and engaged partnerships, (3) meaningful community engagement that facilitated community acceptance and ownership of the project, and (4) this project is "the first step of something big." Themes were further divided into subthemes characterized as processes or outcomes. Conclusions: In this work, we highlight a health innovation project grounded in relational approaches and partnerships, where rural and First Nations communities are champions of advancing their development goals and co-creating solutions that address key social determinants of health. We contribute to the literature by emphasizing the relational foundation that is necessary at the cutting edge of innovation to co-create, implement, and sustain drone projects with rural and First Nations communities.