The SISTABIRTH protocol: a co-developed multiple-methods study to design a Birthing on Country model and adapt the SISTAQUIT smoking cessation resources in three regional and remote Aboriginal Community Controlled Health Services
4 affiliations
- 1Southern Cross University, Coffs Harbour, New South Wales, Australia
- 2Southern Cross University, Bilinga, Queensland, Australia
- 3Southern Cross University, Lismore, New South Wales, Australia
- 4University of New England, Armidale, New South Wales, Australia
Abstract
Introduction: Birthing on Country is a culturally grounded maternity care model designed to improve outcomes for Aboriginal and Torres Strait Islander mothers and babies by providing care that is community-led, culturally safe and holistic. Despite strong evidence that these models enhance maternal and infant health, access across Australia remains limited due to a highly centralised maternity system and a lack of services tailored specifically for Aboriginal women. Additionally, smoking during pregnancy continues to be a major contributor to health inequities, with high prevalence rates and significant adverse outcomes. Aboriginal and Torres Strait Islander women often face barriers to accessing culturally appropriate smoking cessation support, particularly in regional and remote areas, highlighting the need for more responsive and integrated approaches.
This project aims to co-develop a culturally grounded Birthing on Country 5-year plan that integrates smoking cessation care across three Aboriginal Community Controlled Health Services (ACCHSs).
Methods and analysis: Using a multiple-methods design, the project will embed research midwives at each site to support community engagement, data collection and the integration of smoking cessation strategies into routine maternity care.
Data will be collected through yarning circles and individual yarns with the community, health professionals and stakeholders. The Supporting Indigenous Smokers To Assist Quitting (SISTAQUIT) Ngurrajili smoking cessation resources will be adapted to the sites and staff will perform the training and evaluate the co-developed resources.
Results will support the development of a Birthing on Country 5-year plan that reflects community priorities and needs.
Ethics and dissemination: Ethics approvals have been obtained from three Aboriginal Ethics Committees.
Findings will be disseminated to communities, services and stakeholders through reports, workshops, peer-reviewed publications, conferences, newsletters and social media. Locally accessible outputs, including an illustrated book of women’s stories with Quick Response (QR)-linked videos, will be distributed. A policy report will be developed to inform stakeholders, and findings will be published in open-access journals and on the SISTAQUIT Ngurrajili website.
Related
- Pilot Feasibility Study of a Community Health Worker-delivered Tobacco Cessation Intervention During Pregnancy: The Smoke-Free HOPE Randomized Controlled Trial
- A randomised controlled trial of Detour: a multi-component app-based intervention for youth smoking cessation
- Remote vs. In-Person Study Evaluation (RISE) Trial 1 of 3 to examine the impact of decentralized trial methods on accrual efficiency, retention, biospecimen capture, and treatment utilization: study protocol for a multi-center randomized controlled trial in the context of smoking cessation (RISE Above Smoking)
- Evaluation of Hand Bioburden and Genomic Features of Staphylococcus spp. Following Handwashing Practice Among Aboriginal Schoolchildren in Rural Malaysia
- Culturally safe care for Aboriginal and Torres Strait Islander peoples with dementia in Trouwerner/Lutruwita (Tasmania): protocol for a scoping review
BibTeX
@article{fuentes2026sistabirth,
title = {{The SISTABIRTH protocol: a co-developed multiple-methods study to design a Birthing on Country model and adapt the SISTAQUIT smoking cessation resources in three regional and remote Aboriginal Community Controlled Health Services}},
author = {Gina La Hera Fuentes and Ratika Kumar and Marilyn J Clarke and Kym Yuke and Rebecca Hyland and Allison Hart and Stuart Barlo and Lisa Charmer and Simone Druitt and Gillian S Gould},
journal = {BMJ Open},
year = {2026},
month = oct,
doi = {10.1136/bmjopen-2025-106101},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2025-106101},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - The SISTABIRTH protocol: a co-developed multiple-methods study to design a Birthing on Country model and adapt the SISTAQUIT smoking cessation resources in three regional and remote Aboriginal Community Controlled Health Services
AU - Gina La Hera Fuentes
AU - Ratika Kumar
AU - Marilyn J Clarke
AU - Kym Yuke
AU - Rebecca Hyland
AU - Allison Hart
AU - Stuart Barlo
AU - Lisa Charmer
AU - Simone Druitt
AU - Gillian S Gould
PY - 2026
DA - 2026/10/29
JO - BMJ Open
DO - 10.1136/bmjopen-2025-106101
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2025-106101
AB - Introduction: Birthing on Country is a culturally grounded maternity care model designed to improve outcomes for Aboriginal and Torres Strait Islander mothers and babies by providing care that is community-led, culturally safe and holistic. Despite strong evidence that these models enhance maternal and infant health, access across Australia remains limited due to a highly centralised maternity system and a lack of services tailored specifically for Aboriginal women. Additionally, smoking during pregnancy continues to be a major contributor to health inequities, with high prevalence rates and significant adverse outcomes. Aboriginal and Torres Strait Islander women often face barriers to accessing culturally appropriate smoking cessation support, particularly in regional and remote areas, highlighting the need for more responsive and integrated approaches. This project aims to co-develop a culturally grounded Birthing on Country 5-year plan that integrates smoking cessation care across three Aboriginal Community Controlled Health Services (ACCHSs). Methods and analysis: Using a multiple-methods design, the project will embed research midwives at each site to support community engagement, data collection and the integration of smoking cessation strategies into routine maternity care. Data will be collected through yarning circles and individual yarns with the community, health professionals and stakeholders. The Supporting Indigenous Smokers To Assist Quitting (SISTAQUIT) Ngurrajili smoking cessation resources will be adapted to the sites and staff will perform the training and evaluate the co-developed resources. Results will support the development of a Birthing on Country 5-year plan that reflects community priorities and needs. Ethics and dissemination: Ethics approvals have been obtained from three Aboriginal Ethics Committees. Findings will be disseminated to communities, services and stakeholders through reports, workshops, peer-reviewed publications, conferences, newsletters and social media. Locally accessible outputs, including an illustrated book of women’s stories with Quick Response (QR)-linked videos, will be distributed. A policy report will be developed to inform stakeholders, and findings will be published in open-access journals and on the SISTAQUIT Ngurrajili website.
SN - 2044-6055
SN - 2044-6055
ER -