# 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

## TL;DR

This paper outlines a protocol to evaluate a culturally responsive care model for Aboriginal and Torres Strait Islander parents and babies aimed at addressing intergenerational trauma.

## Contribution

The study introduces a comprehensive, culturally tailored continuity of care model with trauma-aware and healing-informed approaches.

## Key findings

- The RBT project includes five workstreams to support Aboriginal and Torres Strait Islander families during the first 2000 days of a child's life.
- Mixed methods will assess acceptability, feasibility, costs, and effectiveness of the care model.
- Participatory action research will ensure cultural and emotional safety for participants and communities.

## Abstract

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 5 years after birth).

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 for primary and secondary outcomes; 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.

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.