Replanting the Birthing Trees to Support Aboriginal and Torres Strait Islander Parents and Babies: Protocol for developmental evaluation of a comprehensive culturally responsive, trauma-aware, healing-informed, continuity of care(r) model

Abstract

Background Aboriginal and Torres Strait Islander people experience intergenerational trauma as a legacy of the impacts of colonisation. Replanting the Birthing Trees (RBT) aims to transform compounding cycles of intergenerational trauma and harm to positively reinforcing cycles of intergenerational nurturing and recovery for Aboriginal and Torres Strait Islander parents and babies. This paper describes the protocol for developmental evaluation of the culturally responsive, trauma-aware, healing-informed, continuity of care(r) model to support Aboriginal and Torres Strait Islander parents during the first 2000 days (pregnancy, birth and the first five years after birth). Methods The RBT project will be conducted in partnership with seven health services across Victoria (Royal Women’s Hospital and Mercy Hospital for Women) and Western Australia (WA) (Armadale Hospital, Western Australian Country Health Service (Northam, Narrogin, Moora and Merredin)), Australia. The RBT project consists of five workstreams: a resource repository including support framework; culturally validated sensitive enquiry tools; workforce development and training; continuity of care(r) toolkit; and strategies to support families to stay together from the start. The Consolidated Framework for Implementation Research (CFIR) informs implementation strategies. Acceptability, feasibility, costs and effectiveness will be evaluated using mixed methods analysis of qualitative and quantitative data, collected using key stakeholder interviews; parent and service provider discussion groups and interviews; cost audit; knowledge attitude and practice surveys; pre and post implementation outcome data; interrupted time series analysis of routinely collected administrative linked data; and co-design workshops. Competitive funding and human research ethics committee approval were assessed against Indigenous research excellence criteria with protocols to ensure the cultural and emotional safety of participants and communities. Discussion Participatory action research approaches are used to foster reflective cycles on data within the research process. Findings will be shared in project newsletters, plain language summaries, presentations and publications.