How can realist approaches help us understand culturally safe, community-led healthcare? And how can storytelling, lived experience, and clinical practice come together to make research more responsive and relational?In this rich and reflective conversation, Alejandro is joined by Dr Katherine Zippel, a General Practitioner, DPhil student at the University of Oxford, and researcher working at the intersection of clinical care, cultural safety, social prescribing, Aboriginal health, and realist research.Katherine shares how realist approaches helped her move beyond asking “does it work?” to exploring what works, for whom, in what circumstances, and why. Drawing on herexperiences in remote Aboriginal communities in the Northern Territory, she reflects on how care is shaped by trust, cultural legitimacy, relational continuity, and community control.Katherine discusses powerful examples from her work, including HIV testing in Ghana, COVID-19 vaccine rollout in remote Aboriginal communities, and cancer survivorship. She highlights how realist thinking can reveal why interventions succeed in some settings but not others, especially when programmes are implemented in complex cultural and structural contexts.Drawing on narrative medicine, Katherine also explores how stories can surface mechanisms that might otherwise remain hidden. She reflects on the importance of listening deeply, honouring lived experience, and resisting one-size-fits-all models ofcare.Whether you’re a researcher, clinician, or interested in culturally safe and community-led approaches to healthcare, this episode offers rich insights into embracing complexity, valuing stories, and using realist thinking to supportmeaningful change.

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