Developing and evaluating Birthing on Country services for First Nations Australians: the Building On Our Strengths (BOOSt) prospective mixed methods birth cohort study protocol

BMC Pregnancy and Childbirth

Study Protocol

Kristie Watego¹  Carmel Nelson²  Sophie Hickey³  Nerida Grant³  Sarah-Jade Maidment³  Donna Hartz³  Yu Gao³  Juanita Sherwood³  Jyai Allen³  Roianne West⁴  Liz Wilkes⁵  Lesley Barclay⁶  Penny Haora⁷  Melanie Briggs⁷  Yvette Roe⁸  Sue Kruske⁹  Sue Kildea⁹  Mark Tracy^1,10  Sally Tracy^1,10  Faye Worner^1,11 

[1] Institute for Urban Indigenous Health, Cox Road, 4030, Windsor, QLD, Australia;Institute for Urban Indigenous Health, Cox Road, 4030, Windsor, QLD, Australia;Poche Centre for Indigenous Health, University of Queensland, Brisbane, QLD, Australia;Molly Wardaguga Research Centre, Charles Darwin University, Ann Street, 4000, Brisbane, QLD, Australia;Molly Wardaguga Research Centre, Charles Darwin University, Ann Street, 4000, Brisbane, QLD, Australia;Congress of Aboriginal & Torres Strait Islander Nurses and Midwives, Lytton Road, 4172, Murarrie, QLD, Australia;Molly Wardaguga Research Centre, Charles Darwin University, Ann Street, 4000, Brisbane, QLD, Australia;My Midwives Brisbane, Windsor Road, 4059, Red Hill, QLD, Australia;Molly Wardaguga Research Centre, Charles Darwin University, Ann Street, 4000, Brisbane, QLD, Australia;The University of Sydney, 2006, Camperdown, NSW, Australia;Molly Wardaguga Research Centre, Charles Darwin University, Ann Street, 4000, Brisbane, QLD, Australia;Waminda South Coast Women’s Health & Wellbeing Aboriginal Corporation, Kinghorne Street, 2541, Nowra, NSW, Australia;Molly Wardaguga Research Centre, Charles Darwin University, Darwin, Australia;Molly Wardaguga Research Centre, Charles Darwin University, Grevillea Drive, 0870, Sadadeen, NT, Australia;The University of Sydney, 2006, Camperdown, NSW, Australia;Waminda South Coast Women’s Health & Wellbeing Aboriginal Corporation, Kinghorne Street, 2541, Nowra, NSW, Australia;

关键词: Midwifery;    Health services research;    Aboriginal and Torres Strait islander;    Indigenous;    First Nations;    Health disparities;    Birthing on Country;    Prospective birth cohort;    Preterm birth;   

DOI  :  10.1186/s12884-022-05277-8

 received in 2022-11-07, accepted in 2022-12-01,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundWith the impact of over two centuries of colonisation in Australia, First Nations families experience a disproportionate burden of adverse pregnancy and birthing outcomes. First Nations mothers are 3–5 times more likely than other mothers to experience maternal mortality; babies are 2–3 times more likely to be born preterm, low birth weight or not to survive their first year. ‘Birthing on Country’ incorporates a multiplicity of interpretations but conveys a resumption of maternity services in First Nations Communities with Community governance for the best start to life. Redesigned services offer women and families integrated, holistic care, including carer continuity from primary through tertiary services; services coordination and quality care including safe and supportive spaces. The overall aim of Building On Our Strengths (BOOSt) is to facilitate and assess Birthing on Country expansion into two settings - urban and rural; with scale-up to include First Nations-operated birth centres. This study will build on our team’s earlier work - a Birthing on Country service established and evaluated in an urban setting, that reported significant perinatal (and organisational) benefits, including a 37% reduction in preterm births, among other improvements.MethodsUsing community-based, participatory action research, we will collaborate to develop, implement and evaluate new Birthing on Country care models. We will conduct a mixed-methods, prospective birth cohort study in two settings, comparing outcomes for women having First Nations babies with historical controls. Our analysis of feasibility, acceptability, clinical and cultural safety, effectiveness and cost, will use data including (i) women’s experiences collected through longitudinal surveys (three timepoints) and yarning interviews; (ii) clinical records; (iii) staff and stakeholder views and experiences; (iv) field notes and meeting minutes; and (v) costs data. The study includes a process, impact and outcome evaluation of this complex health services innovation.DiscussionBirthing on Country applies First Nations governance and cultural safety strategies to support optimum maternal, infant, and family health and wellbeing. Women’s experiences, perinatal outcomes, costs and other operational implications will be reported for Communities, service providers, policy advisors, and for future scale-up.Trial registrationAustralia & New Zealand Clinical Trial Registry #ACTRN12620000874910 (2 September 2020).

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

41116_2022_35_Article_IEq326.gif

41116_2022_35_Article_IEq325.gif

41116_2022_35_Article_IEq309.gif