Exploring the contributions and suitability of relational and community‐centered fetal alcohol spectrum disorder (FASD) prevention work in First Nation communities (original) (raw)
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First Peoples Child Family Review, 2013
This article was generated from the research project "Brightening Our Home Fires" (BOHF), a Photovoice project on woman's health and wellness that took place in the Northwest Territories (NT) from 2010-2012. This research was funded by the First Nations and Inuit Health Branch (FNIHB) of Canada. Approximately 30 women from four different communities in the NT participated in this project; Behchokö, Ulukhaktok, Yellowknife and Lutsel 'ke. The method utilized in this study was Photovoice, a Participatory Action Research (PAR) model that is identified as a qualitative research approach. While the research project was a Fetal Alcohol Spectrum Disorder (FASD) prevention project, the broader focus was on issues related to health and healing within a northern context in the NT from the perspective of northern women, and within the construct of health. The primary focus of this article is the presentation of a model that was generated from a review of the research literature gaining a deeper understanding of broader social concerns in the NT. Three key factors are highlighted as critical in developing a deeper understanding of the context of women's health issues that are important to consider in FASD prevention work: 1) trauma, 2) alcohol abuse and 3) child welfare involvement and the impact on communities in the northern territories of Canada as it presently exists in the NT. This research served to provide a broad perspective of social problems that may be mitigating factors in the presentation of FASD in a northern context.
Behaviour Science. and the Law, 2022
Individuals with fetal alcohol spectrum disorder (FASD) experience a range of neurodevelopmental challenges, often compounded by social and environmental adversity. One of the most concerning outcomes that can be associated with FASD is involvement in the justice system, where individuals with FASD are vastly over-represented. Individuals with FASD who are both justice-involved and Indigenous experience added layers of marginalization. In this community-based study, we explored the needs of 16 adults who participated in an FASD-informed restorative justice program in an Indigenous community in Alberta, Canada. Clinical record reviews and client interviews were used to gather information. Diverse needs were identified, including pervasive neurodevelopmental difficulties, notable physical and mental health challenges, complex experiences of psychosocial trauma, and varied criminogenic needs. This study increases our understanding of the unique and complex biopsychosocial and criminogenic needs of Indigenous justice-involved adults with FASD. Such an understanding is a first step in developing tailored interventions for individuals with FASD and has important practice and policy implications for supporting positive outcomes. For Indigenous individuals with FASD, intervention efforts should be integrated within the community context to promote collective healing.
The Canadian Journal of Psychiatry, 2018
Objective:To examine health services, social services, education, and justice system outcomes among First Nations children and youth with fetal alcohol spectrum disorder (FASD).Methods:In this retrospective cohort study, health and social services, education, and justice data were linked with clinical records on First Nations (FN) individuals aged 1 to 25 and diagnosed with FASD between 1999 and 2010 ( n = 743). We compared the FN FASD group to non-FN individuals with FASD (non-FN FASD; n = 315) and to First Nations individuals (matched on age, sex, and income) not diagnosed with FASD (FN non-FASD; n = 2229). Rates and relative risks (RRs) were calculated using generalized linear models.Results:FN FASD individuals had similar health services use to non-FN FASD individuals but had greater involvement with child welfare (RR, 1.20; 95% confidence interval [CI], 1.02 to 1.41) and the justice system (RR, 1.37; 95% CI, 1.07 to 1.74) and were more likely to be charged with a crime (RR, 1.4...
First Peoples Child Family Review, 2013
Since the 1990s, many communities in Canada have worked to develop specialized programs to meet the needs of pregnant and early parenting women who use alcohol and other substances. These programs provide a range of services under one roof (a "single-access" or "one-stop shop" model), address women's needs from a holistic perspective, provide practical and emotional support, and strive to reduce barriers to accessing care and support. Over the years, these programs have trialed new approaches to working with indigenous and non-indigenous women, their families, and their communities. In this paper, we describe the development of single-access programs in four different communities in Canada, discuss some of the elements of what makes these programs successful, and share our "lessons learned" over the years. We use examples from four different programs, including the
ABSTRACT Objective: To build on Evans-Campbell’s [2008. “Historical Trauma in American Indian/Native Alaska Communities: A Multilevel Framework for Exploring Impacts on Individuals, Families, and Communities.” Journal of Interpersonal Violence 23 (3): 316–338. doi:10.1177/0886260507312290.] multilevel framework of historical trauma and health by focusing on the cycle of fetal alcohol spectrum disorders (FASD) in the socio-cultural, historical, and interpersonal context of trauma shared by American Indian and Alaska Native (AI/AN) peoples. Methods: We analyzed qualitative data from focus groups with seventy four urban AI/ANs who were 15 years of age and older. Community-based participatory research methods were used for data collection and analysis. Our study explored knowledge and attitudes about FASD, perspectives on FASD risk factors, and culturally relevant approaches to FASD prevention and healthcare. Results: According to our study’s participants, efforts to address FASD among urban AI/ANs should align with and emerge from community values, promote healing, consider the broader context that influences behaviors, and reflect the community’s understanding that FASD risk behaviors are inextricably linked with historical and contemporary trauma. Conclusion: Effective, multiple-level FASD prevention approaches for AI/ANs may include prioritizing Indigenous culture, supporting intergenerational cohesion, focusing on non-stigmatic healing of traumas, and authentically engaging community knowledge. This work draws on community and cultural strengths in an effort to reduce the occurrence of substance-exposed pregnancies, and encourages transformational changes in systems that serve AI/AN peoples to promote a healthy and thriving community and future generations.
International Journal of Environmental Research and Public Health, 2019
The association between fetal alcohol spectrum disorder (FASD), residential schools and subsequent assimilatory policies in Canada is of such significance that it was included in the groundbreaking Truth and Reconciliation Commission of Canada’s Final Report through Call to Action #33, which focuses on collaboratively developing FASD prevention programs in Indigenous communities. A consensus statement with eight tenets for enacting Call to Action #33 was co-developed in May 2017 using a Two-Eyed Seeing approach during and after a meeting on Indigenous approaches to FASD prevention held in Canada. The consensus statement provides guidance for creating community-based, culture-led FASD prevention programs in Indigenous communities. The eight tenets reflect the diverse perspectives of Indigenous and non-Indigenous participants, are grounded in available research evidence, and align with Indigenous worldviews and wellness models. This paper uses the consensus statement and eight exempla...
The International Journal of Alcohol and Drug Research, 2013
The prevention of Fetal Alcohol Spectrum Disorder (FASD) in a Northern context from a woman's health perspective was explored in the qualitative research study, Brightening Our Home Fires (BOHF). It is recognized that research on the prevention of FASD is a sensitive topic due to stigma associated with alcohol use during pregnancy. Women's health and FASD prevention were identified as the focus of the research, as they are deeply intertwined topics.
Ethnicity & Health
We examined the multidimensional cycle of fetal alcohol spectrum disorders (FASD) in the socio-cultural, historical, and interpersonal context of trauma shared by American Indian and Alaska Native (AI/AN) peoples living in Multnomah County, Oregon. This case study was guided by Evans-Campbell's (2008) multilevel framework of historical trauma and used community-based participatory research methods. Our study explored knowledge and attitudes about FASD, perspectives on FASD risk factors, and culturally relevant approaches to FASD prevention. Effective, multiple-level FASD prevention approaches for AI/ANs may include prioritizing Indigenous culture, supporting intergenerational cohesion, focusing on non-stigmatic healing of traumas, and authentically engaging community knowledge.
First Peoples Child & Family Review, 2013
This article describes the work undertaken by participants in a virtual community, who came together online over a 15-month period to improve supports for First Nations, Métis and Inuit women with substance use problems at risk of having a child affected by Fetal Alcohol Spectrum Disorder (FASD). The project exemplifies a collaborative process, inclusive of people from various geographical locations, cultures and professional sectors, affording participants the opportunity to weave together research, practice wisdom, policy expertise, and Indigenous Knowledge(s) in a voluntary, nonhierarchical context. Such virtual processes have the potential to support the development of nuanced recommendations reflective of the complexities of FASD prevention in Indigenous contexts taking into account multiple influences on women’s substance use, and a continuum of treatment responses. The article includes participants’ recommendations for improving Canada’s substance use system of care to addres...
Alaska medicine, 2007
The objective was to assist with the prevention of Fetal Alcohol Spectrum Disorder through a participatory research approach involving local women and health care workers. Our interest was in understanding how well communities could develop culturally appropriate methods of helping women to reduce their alcohol consumption during pregnancy. Four geographically distant Aboriginal communities were presented with a task of adapting a standard Brief Alcohol Intervention, and in particular to develop a culturally appropriate means of using the Intervention with women in the community. Academic and Aboriginal community researchers worked together in partnership, using a participatory action research approach to address alcohol use during pregnancy. The outcome of the project was the design of four differing models of culturally appropriate community interventions designed to support vulnerable women in their childbearing years. The intervention models developed by the four communities hav...