1 Chamberlain C, et al. BMJ Open 2019;9:e028397. doi:10.1136/bmjopen-2018-028397 Open access 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 Catherine Chamberlain,  1,2,3 Graham Gee, 2,4 Stephanie Janne Brown,  2,5 Judith Atkinson, 6 Helen Herrman, 7 Deirdre Gartland,  2,8 Karen Glover, 2,5 Yvonne Clark, 1,5 Sandra Campbell, 9,10 Fiona K Mensah, 2,8,11 Caroline Atkinson, 6 Sue E Brennan, 3 Helen McLachlan, 1 Tanja Hirvonen, 12 Danielle Dyall, 13 Naomi Ralph, 1 Stacey Hokke, 1 Jan Nicholson 1 To cite: Chamberlain C, Gee G, Brown SJ, et al. 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. BMJ Open 2019;9:e028397. doi:10.1136/ bmjopen-2018-028397 ► Pre-publication history and additional material is published online only. To view, please visit the journal online (http://dx.doi. org/10.1136/bmjopen-2018- 028397). Received 10 December 2018 Revised 28 March 2019 Accepted 9 May 2019 For numbered affliations see end of article. Correspondence to Dr. Catherine Chamberlain; c.chamberlain@latrobe.edu.au, chamberl@ihug.com.au Protocol © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. ABSTRACT 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. Refection and planning stages of four action research cycles will be undertaken in four key stakeholder workshops aligned with the frst 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, beneft, 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 refective questions to guide research decisions. INTRODUCTION Child maltreatment and other adverse child- hood experiences (ACEs) are an international health priority, 1 contributing to a wide range of long-lasting physical, social and emotional Strengths and limitations of this study ► Demonstrates a comprehensive formative action re- search process to co-design acceptable and feasible perinatal awareness, recognition, assessment and support strategies for Aboriginal parents experienc- ing complex trauma. ► A conceptual framework to guide this project in- cludes core values of safety, trustworthiness, empowerment, collaboration, culture, holism, com- passion and reciprocity. ► Indigenous Research Excellence criteria infuence ethics and dissemination protocols. ► Assessment of safety, acceptability and feasibility of an awareness, recognition and assessment process for Aboriginal parents experiencing complex trauma in three Australian jurisdictions. ► Formative study to set the foundation for implemen- tation and evaluation of the co-designed support strategies. on June 11, 2020 by guest. Protected by copyright. http://bmjopen.bmj.com/ BMJ Open: first published as 10.1136/bmjopen-2018-028397 on 11 June 2019. Downloaded from