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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
  1. Catherine Chamberlain1,2,3,
  2. Graham Gee2,4,
  3. Stephanie Janne Brown2,5,
  4. Judith Atkinson6,
  5. Helen Herrman7,
  6. Deirdre Gartland2,8,
  7. Karen Glover2,5,
  8. Yvonne Clark1,5,
  9. Sandra Campbell9,10,
  10. Fiona K Mensah2,8,11,
  11. Caroline Atkinson6,
  12. Sue E Brennan3,
  13. Helen McLachlan1,
  14. Tanja Hirvonen12,
  15. Danielle Dyall13,
  16. Naomi Ralph1,
  17. Stacey Hokke1,
  18. Jan Nicholson1
  1. 1 Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
  2. 2 Intergenerational Health Group, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
  3. 3 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  4. 4 Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
  5. 5 Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
  6. 6 We Al-li Pty Ltd, Goolmangar, New South Wales, Australia
  7. 7 Orygen, The National Centre of Excellence in Youth Mental Health and the Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
  8. 8 Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
  9. 9 Centre for Chronic Disease Prevention, James Cook University, Cairns, Queensland, Australia
  10. 10 Centre for Indigenous Health Equity Research, Central Queensland University, Rockhampton, Queensland, Australia
  11. 11 Clinical Epidemiology & Biostatistics Unit, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
  12. 12 Centre for Remote Health, Flinders University, Darwin, Northern Territory, Australia
  13. 13 Aboriginal Medical Services Alliance Northern Territory, Darwin, Northern Territory, Australia
  1. Correspondence to Dr. Catherine Chamberlain; c.chamberlain{at}, chamberl{at}


Introduction Child 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 perinatal awareness, recognition, assessment and support strategies for Aboriginal parents experiencing complex trauma.

Methods and analysis This 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 dissemination Ethics 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.

  • complex trauma
  • perinatal
  • parents
  • indigenous
  • community-based participatory action research
  • intergenerational

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  • Contributors CC is the study Principal Investigator and drafted this protocol based on the project proposal and other relevant project planning documents involving many people as outlined in acknowledgements and author contribution statements. GG, SJB, JA, DG, HH, KG, YC, SC, FKM, CA, SEB, HM, TH and JN are study investigators who contributed to development of the project proposal, project planning and drafting the manuscript. FKM conducted sample size estimate calculations for psychometric evaluation of the assessment tool. DD assisted with development of the conceptual framework, study planning and drafting the manuscript. NR, SH and YC are employed on the project and have contributed to development of planning documents, conceptual framework, ethics submissions which involved many considerations outlined in this protocol, and drafting the manuscript. All authors read and approved the final manuscript.

  • Funding This work was supported by the Lowitja Institute Aboriginal and Torres Strait Islander Health Cooperative Research Centre (CRC) and the National Health and Medical Research Council (NHMRC) (1141593). CC was supported by an NHMRC Early Career Fellowship (1088813). SJB was supported by an NHMRC Research Fellowship (1103976). HH was supported by an Australian NHMRC Practitioner Fellowship (1080820). FKM was supported by an NHMRC Career Development Fellowship (1111160). JN was supported by the Roberta Holmes donation to La Trobe University. Research at MCRI is supported by the Victorian Government’s Operational Infrastructure Support Program.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.