We aimed to understand support needs for Aboriginal and Torres Strait Islander parents experiencing complex trauma.Becoming a parent is an exciting yet challenging transition, particularly for parents who have experienced past hurt in their own childhood which can have long lasting effects, including complex trauma. Complex trauma-related distress can make it harder to care for a baby, but the parenting transition offers unique opportunities for recovery.

This formative research is part of a community-based participatory action research project which aims to co-design perinatal awareness, recognition, assessment and support strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma. We used an Indigenist approach and grounded theory methods. Aboriginal and Torres Strait Islander parents who were pregnant and/or have children up to two years old were recruited through perinatal care services and community networks in three Australian sites (Alice Springs, Adelaide and Melbourne). Parents were offered a group discussion or individual interview, facilitated by Aboriginal researchers. Third-person scenarios and visual tools were used to facilitate reflections about the impact of past experiences, what keeps parents strong, hopes and dreams, and what is needed to achieve those dreams. Parents were also shown themes from a previous systematic review of parents’ experiences as a prompt to identify any additional key issues.

Seventeen Aboriginal and Torres Strait Islander parents participated in August to September 2019. Most were mothers (n = 15).  The study’s grounded theory methods provided the foundation of a theoretical supposition that positions the transformation of the compounding cycle of trauma, to a reinforcing cycle of nurturing at the intersection of: 1) parents’ connectedness; 2) social and emotional wellbeing; and 3) the transition to parenting. Unique opportunities and challenges situated at the interface are bound to the compounding or reinforcing nature of the intersecting factors. Findings reveal complexity, differing experiences by gender and age, as well as within and between communities.

Aboriginal and Torres Strait Islander holistic health represents the interconnection of social, emotional, spiritual and cultural factors on health and well-being. Social factors (education, employment, housing, transport, food and financial security) are internationally described and recognised as the social determinants of health. The social determinants of health are estimated to contribute to 34% of the overall burden of disease experienced by Aboriginal and Torres Strait Islander people. Primary health care services currently ‘do what it takes’ to address social and emotional well-being needs, including the social determinants of health, and require culturally relevant tools and processes for implementing coordinated and holistic responses. Drawing upon a research-setting pilot program, this manuscript outlines key elements encapsulating a strengths-based approach aimed at addressing Aboriginal and Torres Strait Islander holistic social and emotional well-being.

The Cultural Pathways Program is a response to community identified needs, designed and led by Aboriginal and Torres Strait Islander people and informed by holistic views of health. The program aims to identify holistic needs of Aboriginal and Torres Strait Islander people as the starting point to act on the social determinants of health. Facilitators implement strengths-based practice to identify social and cultural needs (e.g. cultural and community connection, food and financial security, housing, mental health, transport), engage in a goal setting process and broker connections with social and health services. An integrated culturally appropriate clinical supervision model enhances delivery of the program through reflective practice and shared decision making. These embedded approaches enable continuous review and improvement from a program and participant perspective. A developmental evaluation underpins program implementation and the proposed culturally relevant elements could be further tailored for delivery within primary health care services as part of routine care to strengthen systematic identification and response to social and emotional well-being needs.

Health research remains a vital activity of Indigenous health workforces. This paper reports on the main findings of yarning interviews with 14 Indigenous researchers, that was central to a project analysing the role of research training infrastructures in strengthening the Indigenous health research workforce in Australia. The findings highlighted Indigenous researcher peers as core sources of inspiration, moral support and sustenance in academia and in life. Peer generative power arising from peer groups provide a unique enriching to the educational and research experience. Indigenous researcher peers have a strong shared aspiration to champion change to health research and higher education as a key pathway to widespread positive impacting on health and well-being. We suggest the (revived) development at a collective level of a strategic and planned approach to capitalising on the positive outcomes of peer generated leadership and support.

To improve healthcare practices and increase cultural safety when working with First Peoples, it is essential that students engage with challenging discourses that critically engage their social, political, personal, professional and historical positioning. Such engagement may provoke emotional responses in students. However, little is known about the nature of non-indigenous students’ emotional engagement when learning First Peoples health content that integrates cultural safety principles. The pedagogy of discomfort is a process of self-examination that requires students to critically engage their ideological assumptions and may be useful in examining the emotional dimension that occurs when learning this content. Eighty-two non-indigenous health students gave permission for their critical reflective essays, submitted as an assessment requirement of a First Peoples health course to be analysed. Elements of the pedagogy of discomfort informed the analytical and theoretical framework. The emotional engagement by students was captured in the following overarching themes: Acknowledging preconceived ideas; Uncomfortable emotions; Fragile identities; Spectating and Witnessing. Findings highlight how students' emotional engagement may contribute to changes in perspective and frames of reference, transpiring to a ‘call to action’ that challenges systems of differential privilege. While many students expressed discomfort when learning about key cultural safety concepts, the extent of transformative potential varied.

We conducted probabilistic data linkage of three population datasets for the Northern Territory (NT), Australia, to describe the incidence of preterm births, stillbirths, low birthweight and small for gestational age (SGA) per 1000 NT births; and influenza and pertussis hospitalisations per 1 00 000 NT births in infants <7 months of age, in a pre-maternal vaccination era. The Perinatal Trends dataset (1994–2014) formed the cohort of 78 382 births. Aboriginal mother–infant pairs (37%) had disproportionately higher average annual rates (AR) for all adverse birth outcomes compared to their non-Aboriginal counterparts; rate ratios: preterm births 2.2 (AR 142.4 vs. 64.7); stillbirths 2.3 (AR 10.8 vs. 4.6); low birthweight 2.9 (AR 54 vs. 19); and SGA 1.7 (AR 187 vs. 111). Hospitalisation (2000–2015) and Immunisation Register datasets (1994–2015), showed that influenza hospitalisations (n = 53) and rates were 42.3 times higher in Aboriginal infants (AR 254 vs. 6); and that pertussis hospitalisations (n = 37) were 7.1 times higher in Aboriginal infants (AR 142.5 vs. 20.2) compared to non-Aboriginal infants. These baseline data are essential to assess the safety and effectiveness of influenza and pertussis vaccinations in pregnant women from the NT. Remote living Aboriginal women and infants stand to benefit the most from these vaccines.

Footprints in Time: The Longitudinal Study of Indigenous Children (LSIC) is a national study of 1759 Australian Aboriginal and Torres Strait Islander children living across urban, regional and remote areas of Australia. The study is in its 11th wave of annual data collection, having collected extensive data on topics including birth and early life influences, parental health and well-being, identity, cultural engagement, language use, housing, racism, school engagement and academic achievement, and social and emotional well-being. The current paper reviews a selection of major findings from Footprints in Time relating to the developmental origins of health and disease for Australian Aboriginal and Torres Strait Islander peoples. Opportunities for new researchers to conduct further research utilizing the LSIC data set are also presented.

This paper integrates the findings of two evaluations into the effectiveness of human health workforce training delivery and outcomes. In the period 2012–2015, Wontulp-Bi-Buya College ran the Certificate III in Addictions Management and Community Development and the Certificate IV in Indigenous Mental Health: Suicide Prevention. The key findings are presented under three thematic areas: personal to community wellbeing, enrolment and completion and withdrawal and employment and voluntary sector engagement. The outcomes of both evaluations are combined to build a picture of successful course delivery, satisfaction and completion rates that well exceed the national average. The significant contribution the authors draw from these is the problematisation and theorising of the concept of ‘empowerment’. A term claimed by the College in its mission statement, the term ‘systemic empowerment’ has been co-developed with the College to both reclaim the concept of empowerment and to make sense of the personal and collective empowerment approach that serves as a framework for the trainer's pedagogy and course structures. Systemic empowerment contributes to the Colleges’ theory of change to tackle very important contemporary social and political issues holistically and at their root and serves as an important model of adult vocational education and training for Aboriginal and Torres Strait Islander people

In Australia, Aboriginal and Torres Strait Islander people score poorly on national mainstream indicators of wellbeing, with the lowest outcomes recorded in remote communities. As part of a ‘shared space’ collaboration between remote Aboriginal communities, government and scientists, the holistic Interplay Wellbeing Framework and accompanying survey were designed bringing together Aboriginal priorities of culture, empowerment and community with government priorities of education, employment and health. Quantitative survey data were collected from a cohort of 841 Aboriginal people aged 15–34 years, from four different Aboriginal communities. Aboriginal community researchers designed and administered the survey. Structural equation modelling was used to identify the strongest interrelating pathways within the framework. Optimal pathways from education to employment were explored with the concept of empowerment playing a key role. Here, education was defined by self-reported English literacy and numeracy and empowerment was defined as identity, self-efficacy and resilience. Empowerment had a strong positive impact on education (β = 0.38, p < .001) and strong correlation with employment (β = 0.19, p < .001). Education has a strong direct effect on employment (β = 0.40, p < .001). This suggests that education and employment strategies that foster and build on a sense of empowerment are mostly likely to succeed, providing guidance for policy and programs.