3 January 2024

Professor Cath Chamberlain, a Palawa woman of the Trawlwoolway clan (Tasmania), received an NHMRC Early Career Fellowship in 2014 to find culturally safe ways to improve cardiometabolic health outcomes in Aboriginal and Torres Strait Islander mothers.

During the four-year fellowship, Professor Chamberlain discovered that many interventions to reduce cardiometabolic risk in this cohort had failed. She wanted to understand why.

This story is part of our 10 of the Best - fourteenth edition. 10 of the Best is an annual NHMRC publication, showcasing 10 NHMRC-funded health and medical research projects. See more 10 of the Best.

I was trying to find [interventions] that would work for Aboriginal and Torres Strait Islander women, the Melbourne-based researcher says.

There had been quite a lot of things tried, and a lot of time and money spent, but it was mostly all failing Professor Chamberlain

Professor Cath Chamberlain

Cardiometabolic risk refers to risk factors that increase the likelihood of experiencing vascular events or developing diabetes1. Cardiovascular disease is more common among Aboriginal and Torres Strait Islander people than non-Indigenous Australians and its onset tends to occur between 10 and 20 years younger than among non-Indigenous Australians2.

Professor Chamberlain always wanted to be a nurse and a midwife, and worked as a nurse in Perth, Kalgoorlie and Alice Springs, and as a midwife in Africa and back in Western Australia. Her passion for learning and being helpful landed her in the research sector working alongside leading Indigenous researchers.

Following an unexpected move to Melbourne, Professor Chamberlain undertook a Master of Public Health (International Health) at Monash University. Here, she was able to do some reflective learning from her time overseas, before being accepted into the Victorian Public Health Training Scheme. This is where she completed a Master of Science in Public Health Practice and undertook a placement with Professor Judith Lumley.

[Professor Lumley] was really instrumental, and one of my first mentors in research Professor Chamberlain

The pair worked on a rigorous systematic review of smoking cessation interventions, where Professor Chamberlain learnt of the importance of strong evidence from randomised control trials for influencing policy and guidelines, national and internationally.

After a few years of working guideline development and implementation, an opportunity arose to start a PhD.

I was lucky to be able to work with Professor Sandra Eades, as my PhD supervisor, on implications of new guidelines for diabetes in pregnancy Professor Chamberlain

Having gained an understanding of the complex influences on maternal health among Aboriginal and Torres Strait Islander communities, Professor Chamberlain shifted her focus to what could be done to reduce cardiometabolic risk.

The starting point is looking at what is already known about an issue and making sure that you honour and respect all that knowledge and learning that has been before seeing how you can contribute, Professor Chamberlain says.

I was reading those articles around some of the symptoms of complex trauma and intergenerational trauma in describing why [interventions] failed. I thought, "this is something I need to try to understand a bit better" Professor Chamberlain

Next steps

The 2014 fellowship supported Professor Chamberlain to complete the groundwork for her next NHMRC project in 2017, called Healing the Past by Nurturing the Future, followed by her Career Development Fellowship, from 2019–2022.

This 2017 project sought to develop better ways to identify and support Aboriginal and Torres Strait Islander parents who may be experiencing complex trauma.

'Intergenerational and complex trauma is a really critical issue for parents caring for a new baby, and there’s considerable evidence suggesting that compounding cycles of trauma may be driving persistent health inequities.' said Professor Chamberlain.

Her research has led to co-design of a range of perinatal strategies to support Aboriginal and Torres Strait Islander families transform cycles of trauma and hurt to cycles of nurturing and recovery, by improving awareness, safe recognition and assessment. This model of care is currently being piloted across other related initiatives.

1Chatterjee A, Harris SB, Leiter LA, Fitchett DH, Teoh H, Bhattacharyya OK; Cardiometabolic Risk Working Group (Canadian). Managing cardiometabolic risk in primary care: summary of the 2011 consensus statement. Can Fam Physician. 2012 Apr;58(4):389-93, e196-201. PMID: 22611605; PMCID: PMC3325449

2(AIHW 2015; Bradshaw et al. 2011; Brown 2012; Brown & Kritharides 2017; Katzenellenbogen et al. 2014).