Healthy Newborn Project: investigating the feasibility and impact of a targeted Antenatal Point of Care Ultrasound (ApoCUS) training to Aboriginal Healthcare workers (AHWs) and practitioners (AHPs) on antenatal care attendance of pregnant Aboriginal women.

This project aims to: Phase 1 - iteratively co-design a culturally safe, 1-day training package for Aboriginal Health Workers (AHW)/Practitioners (AHP) on how to provide Antenatal Point of Care Ultrasound (APoCUS) scans for pregnant Aboriginal and Torres Strait Islander women Phase 2 - assess the feasibility and effectiveness of the above training module Phase 1: one-on-one interviews/yarns will be conducted in person or online by experienced interviewers (some of whom are of Aboriginal and/or Torres Strait Islander descent) via Teams/Zoom with 18-24 participants using semi-structured moderator guides. Three rounds of interviews will be conducted (with 6-8 participants in each) to enable the iterative co-design of the culturally tailored APoCUS training module. After the first round of interviews/yarns has been completed, feedback from participants will be used to revise existing APoCUS training materials, with these revised materials then used as the demonstration resources for the second round of participants. This process will be undertaken a third time for the final 6-8 participant interviews/yarns, whereby their feedback will be incorporated to produce a finished co-design APoCUS training package to be considered for use in a future feasibility study. It is not necessary that the participants from round 1 will also be interviewed for each iteration of the materials in rounds 2 and 3. We intend to recruit different participants from each cohort in each round of interviews/yarns to enhance representatives and have variety of perspective from as many participants as possible. Phase 2 will involve training of AHWs/AHPs to use the equipment in a safe and appropriate manner to identify intrauterine pregnancy and heartbeat in the pregnancy. The trainees will be taught basic principles of ultrasound, turning on and off the ultrasound machine, and the use of knobs on the machine. The basics of ultrasound appearance of a normal intrauterine pregnancy including detecting the fetal heartbeat will be explained and demonstrated with the use of presentations, ultrasound simulators, and human pregnant volunteers. The training model (APoCUS module first-trimester identification of fetal heartbeat) is a scaled back version from this particular POCUS module from ASUM: https://www.asum.com.au/files/public/Education/CAHPU/CAHPUSyllabi/CAHPU-Basic-Early-Pregnancy-Assessment-Syllabus.pdf . Ultrasound training will be conducted face to face at the University of South Australia, City East Campus as a 1-day workshop, by a team of experienced ultrasound educators in a small group workshop, with a trainer to trainee ratio of 1:4. The participants will have an opportunity at the end of the training module to practice their skills on a pregnant volunteer (note that the only role Aboriginal pregnant women play in Phase 2 is to assist AHW/Ps with practicing ultrasound skills at the end of the 1-day training workshop). The learning objective for this workshop is to enable participants to feel confident using a portable ultrasound machine to identify and show pregnant women their baby on ultrasound. Learning materials will be provided before and after the workshop. The material for the workshops and follow up mentoring sessions will be developed through the co-design process, as well as the evaluation surveys for the trainees. The training model (APoCUS module first-trimester identification of fetal heartbeat) will be delivered to AHWs and AHPs with the provision of online mentoring/teaching and remote supervision for 6 months following training. This will involve group Zoom sessions by an experienced sonographer within the research team.