Healing the Past by Nurturing the Future—co-designing perinatal strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma: framework and protocol for a community-based participatory action research study

Abstract

IntroductionChild maltreatment and other traumatic events can have serious long-term physical, social and emotional effects, including a cluster of distress symptoms recognised as ‘complex trauma’. Aboriginal and Torres Strait Islander (Aboriginal) people are also affected by legacies of historical trauma and loss. Trauma responses may be triggered during the transition to parenting in the perinatal period. Conversely, becoming a parent offers a unique life-course opportunity for healing and prevention of intergenerational transmission of trauma. This paper outlines a conceptual framework and protocol for an Aboriginal-led, community-based participatory action research (action research) project which aims to co-design safe, acceptable and feasible perinatalawareness, recognition, assessmentandsupportstrategies for Aboriginal parents experiencing complex trauma.Methods and analysisThis formative research project is being conducted in three Australian jurisdictions (Northern Territory, South Australia and Victoria) with key stakeholders from all national jurisdictions. Four action research cycles incorporate mixed methods research activities including evidence reviews, parent and service provider discussion groups, development and psychometric evaluation of a recognition and assessment process and drafting proposals for pilot, implementation and evaluation. Reflection and planning stages of four action research cycles will be undertaken in four key stakeholder workshops aligned with the first four Intervention Mapping steps to prepare programme plans.Ethics and disseminationEthics and dissemination protocols are consistent with the National Health and Medical Research Council Indigenous Research Excellence criteria of engagement, benefit, transferability and capacity-building. A conceptual framework has been developed to promote the application of core values of safety, trustworthiness, empowerment, collaboration, culture, holism, compassion and reciprocity. These include related principles and accompanying reflective questions to guide research decisions.

Community Perspectives of Complex Trauma Assessment for Aboriginal Parents: ‘Its Important, but How These Discussions Are Held Is Critical’

“…Key considerations included: ensuring emotional, physical and cultural safety; building a relationship and trust; having capacity to respond effectively; incorporating gentle, indirect cultural methods of communication; using strengths-based empowering approaches and employing respect, caring and compassion. These issues align with the core values of the HPNF project's conceptual framework (Chamberlain et al, 2019a), including; safety, empowerment and choice, trustworthiness and relationships, collaboration, culture, holistic care and compassion.…”

“…Color coding was used in a conceptual map to illustrate codes under 'why, by whom, where and how, ' and shapes to illustrate emergent analytic themes; • Preliminary analytic themes and supporting quotes were reviewed with the authorship team, to refine and reflect on the themes in relation to the conceptual framework (Chamberlain et al, 2019a). • Preliminary findings were circulated to seek feedback from workshop participants on the perceived accuracy of the themes, and invite further contribution to the manuscript (anonymously, as a co-author or in the acknowledgments).…”

“…The Healing the Past by Nurturing the Future (HPNF) project is an Aboriginal-led community-based participatory action research (action research) project and is described in detail elsewhere (Chamberlain et al, 2019a). Indigenous research methodologies underpin the conceptual framework for the overall HPNF project and the specific study outlined in this manuscript.…”

“…Trauma responses may cause confusion and compound parental distress, as the original trauma may have occurred much earlier in life and not be consciously linked to their current experience. The parenting transition offers a unique opportunity for emotional development and recovery (Violence Prevention Alliance, 2016;Chamberlain et al, 2019a). For many who have experienced childhood maltreatment, becoming a parent is an opportunity for a 'fresh start' (Chamberlain et al, 2019c).…”

Respiratory, birth and health economic measures for use with Indigenous Australian infants in a research trial: A modified Delphi with an Indigenous panel

“…The strong interest to include a developmental measure raises the question of what other measures may be important, and perhaps more meaningful to Indigenous communities. Other less commonly reported measures in child respiratory studies include child parent quality of life (47,48) and child functioning (49).…”