Codesigning a culturally responsive trauma informed health promotion framework: improving healthcare equity, inclusion and access for Indigenous peoples.
1
Indigenous Health Equity Unit, Onemda: Aboriginal and Torres Strait Islander Health and Wellbeing, University of Melbourne, Melbourne, Australia
2
University of Newcastle, Callaghan, Australia
3
University of Technology Sydney, Sydney, Australia
4
Gippsland Regional Public Health Unit, Latrobe Regional Health, Traralgon, Australia
5
Murdoch University, Perth, Australia
6
University of South Australia, Adelaide, Australia
7
University of Sydney, Sydney, Australia
8
Curtin University, Perth, Australia
Popul. Med. 2026;8(Supplement Supplement 1):A1494
ABSTRACT
INTRODUCTION:
Colonisation and its associated violence and oppression of Indigenous peoples has created cycles of intergenerational trauma and systemic health inequities. Health promotion can help restore social and emotional wellbeing, and reduce health disparities, by creating environments that empower communities to lead healthy lives. While culturally responsive strategies have been developed, the influence of trauma on engagement with health promotion initiatives remains under-explored. We aimed to develop a framework that supports practitioners in creating culturally responsive, trauma-aware, healing-informed health promotion programs to improve accessibility and close gaps in health disparities.
METHODS:
Our Indigenous-led project had two components. First, a narrative review examined frameworks at the intersection of social and emotional wellbeing, trauma and health promotion for Indigenous peoples. Literature was identified through a non-systematic snowballing search of peer-reviewed and grey sources, with prioritisation of evidence most relevant to project aims. Frameworks were analysed for thematic commonalities and synthesised into a pilot framework. This was refined through iterative consensus-building with project investigators and piloted by mapping against existing health promotion programs. Second, a co-design workshop with Indigenous and non-Indigenous health promotion experts identified what healing-informed practice looks like and which principles should underpin a framework. Findings were triangulated to produce the final framework.
RESULTS:
A clear consensus emerged on guiding principles: community governance and partnership; empowerment; culture; holistic wellbeing; connectedness and relational approaches; cultural and emotional safety; and transparency and accountability.
CONCLUSIONS:
This project provides a critical step toward a more inclusive and accessible approach to health promotion. The framework acknowledges the impacts of colonisation while strengthening individual, family and community capacity. It emphasises safety, recovery and community-led healing, while avoiding re-traumatisation, rejecting pathologization of behaviours and addressing structural barriers to behaviour change. It has the potential to support more inclusive health promotion policy and practice globally.
Colonisation and its associated violence and oppression of Indigenous peoples has created cycles of intergenerational trauma and systemic health inequities. Health promotion can help restore social and emotional wellbeing, and reduce health disparities, by creating environments that empower communities to lead healthy lives. While culturally responsive strategies have been developed, the influence of trauma on engagement with health promotion initiatives remains under-explored. We aimed to develop a framework that supports practitioners in creating culturally responsive, trauma-aware, healing-informed health promotion programs to improve accessibility and close gaps in health disparities.
METHODS:
Our Indigenous-led project had two components. First, a narrative review examined frameworks at the intersection of social and emotional wellbeing, trauma and health promotion for Indigenous peoples. Literature was identified through a non-systematic snowballing search of peer-reviewed and grey sources, with prioritisation of evidence most relevant to project aims. Frameworks were analysed for thematic commonalities and synthesised into a pilot framework. This was refined through iterative consensus-building with project investigators and piloted by mapping against existing health promotion programs. Second, a co-design workshop with Indigenous and non-Indigenous health promotion experts identified what healing-informed practice looks like and which principles should underpin a framework. Findings were triangulated to produce the final framework.
RESULTS:
A clear consensus emerged on guiding principles: community governance and partnership; empowerment; culture; holistic wellbeing; connectedness and relational approaches; cultural and emotional safety; and transparency and accountability.
CONCLUSIONS:
This project provides a critical step toward a more inclusive and accessible approach to health promotion. The framework acknowledges the impacts of colonisation while strengthening individual, family and community capacity. It emphasises safety, recovery and community-led healing, while avoiding re-traumatisation, rejecting pathologization of behaviours and addressing structural barriers to behaviour change. It has the potential to support more inclusive health promotion policy and practice globally.
| eISSN: | 2654-1459 |
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