About the research

It involves Aboriginal and Torres Strait Islander people in all stages of the research, including:

• funding submissions
• governance
• project leadership
• data collection
• analysis
• distribution.

Community leaders, service providers, policy makers and families are involved in the co-design process, working with investigators from 12 institutions.

Conceptual framework

We have developed a conceptual framework drawing on holistic Aboriginal constructs of social and emotional wellbeing to illustrate the aims and values of the project, with two main elements.

1. Four main domains of recognition, assessment, awareness and support 

The four main domains were developed during the initial consultation stages of the project which revealed concerns about the use of language such as ‘screening’ and ‘intervention’. The domains of ‘recognition’ and ‘assessment’ more accurately articulate ‘screening’ strategies that incorporate a feasible two-tiered process for care providers to recognise parents who may require more in-depth assessment for complex trauma; and ‘intervention’ approaches to improve trauma-informed perinatal care and minimise the risks of re-traumatising parents (awareness), and provide trauma-specific support.

2. Eight core values with related principles and questions

We identified seven frameworks that included trauma-informed values and principles using online searches and team members’ knowledge. Further values and principles relating to cultural and emotional safety were identified in the first key stakeholder workshop. These were mapped and consensus reached by the project team. This process resulted in identification of eight core values: safety, trustworthiness, empowerment, collaboration, culture, holism, compassion and reciprocity. Each contains action-oriented principles that enable the core values to be realised, and are accompanied by questions developed to aid reflection on whether the activity under consideration is consistent with the core value. See HPNF conceptual framework values, principles and reflective questions – Table 1 [PDF 158.66KB]

Research plan

The research plan is designed in accordance with:

• Intervention mapping ¹ which uses theory and evidence as the foundations for taking an ecological approach to assessing and intervening in health problems and engendering community participation¹. This research addresses steps one to four. Steps five and six (implementation and evaluation) will form the basis of a subsequent project.
• Power threat meaning framework ²(PTMF), “an over-arching structure for identifying patterns in emotional distress, unusual experiences and troubling behaviour, as an alternative to psychiatric diagnosis and classification”. We will incorporate the PTMF by reframing behaviours related to complex trauma as normal self- protective responses to threatening situations rather than pathological deficits.
• Principles for population-based screening³ to assess the benefits, risks, costs, acceptability, accuracy and harms of recognising and assessing parents' experiencing complex trauma.
• Indigenous research methodologies⁴ that privilege Aboriginal worldviews, self-determination and Aboriginal community control.

References

1. Bartholomew Eldrigde LK, Markham CM, Ruiter RAC, et al. Planning health promotion programs: An Intervention Mapping approach. 4 ed. Hoboken, NJ: Wiley 2016.
2. Johnstone L, Boyle M, Cromby J, et al. The Power Threat Meaning Framework: Towards the identification of patterns in emotional distress, unusual experiences and troubled or troubling behaviour, as an alternative to functional psychiatric diagnosis. Leicester: British Psychological Society, 2018.
3. Australian Health Ministers' Advisory Council. Population based screening framework. Barton: Commonwealth of Australia, 2008.
4. Rigney L. Indigenous Australian views on knowledge production and Indigenist research. In: Runnie J, Goduka N, eds. Indigenous peoples' wisdom and power: Affirming our knowledge. Burlington, USA: Ashgate Publishing 2006:32-48.