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Prevention Plenary Opening: Moira Plant and Nancy Poole introduce group from Australia

In 7 years, the FASD International Conference has grown to become a truly international event with presenters from six continents and from international health organizations such as the World Health Organization. Current research on clinical topics we’ve come to expect, like prevalence, diagnosis, and neurodevelopment outcomes, were featured this year along with newer topics like biomarkers and epigenetics (See some of the video recorded conference presentations here).

It was the emphasis on prevention, and stigma that took center stage for many attendees. For the first time, there was a specialized prevention plenary – “FASD Prevention Research – State of the Evidence, and Plans for a Global Network” – developed by Nancy Poole (CanFASD; Centre of Excellence for Women’s Health) and Moira Plant (Alcohol & Health Research Unit, University of West England).  Using a model of prevention research used worldwide that Nancy first presented in a poster in 2009, researchers, advocates and birth mothers from around the world talked about where we are and where we need to go.

Watch for upcoming blogs in the next weeks for details on specific prevention presentations.

Objectives for the Prevention Plenary

The Prevention Plenary was divided into 4 areas of presentation and discussion that we will cover in a few posts in the next weeks:

  1. Community-wide FASD prevention with Indigenous communities
  2. International research on discussing alcohol with all women and their partners, and empowering professionals to have these conversations
  3. Research on reaching and engaging women and children at highest risk using approaches that are theory based, and have an equity lens
  4. Plans for international FASD prevention research infrastructure

 

For posts on past International FASD conferences, see:

The 5th International Conference on Fetal Alcohol Spectrum Disorder: Special Session on FASD Prevention, January 14, 2013

Webcasts on 4th Annual International Conference

Best Start Resource Centre in Ontario has published a new guide to help facilitators deliver FASD workshops for First Nations women (Download guide). Using culture as its foundation, the guide focuses on promoting health. It also integrates FASD-informed and trauma-informed approaches. It is set up so that facilitators do not have to be an expert on the subject of FASD. The guide provides detailed background information, instructions and resources so that facilitators can fully prepare themselves for delivering the workshops.

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Topics covered in the training guide include:

  • Preparing for the Workshop – covers information like bringing the workshop to communities where there is a concern about the stigma attached to FASD, planning for participant learning differences, as well as handling logistical details.
  • Facilitating the Workshop – includes welcoming activities, giving background about healthy pregnancy, identifying and building on personal strengths, making a plan for health, and drawing on community for support and self care.
  • Resources, Services and Appendices – provided are weblinks to further information and videos; services for pregnancy, parenting, substance use and FASD; participant handouts, and consent forms.

Best Start Resource Centre is well known for its resources for service providers who work with diverse women and families on preconception health, prenatal health and child development.

For more on related topics, see earlier posts:

FASD is a public safety and justice priority for Aboriginal groups, October 23, 2016

Experiences of Northern British Columbian Aboriginal Mothers Raising Adolescents With FASD, January 20, 2014

Pimotisiwin: A Good Path for Pregnant and Parenting Aboriginal Teens, August 26, 2013

“You are not alone. Support is available.” Alcohol and pregnancy campaign designed by and for Aboriginal women in Manitoba, April 10, 2013

Handbook for Aboriginal Alcohol and Drug Work from Australia, January 9, 2013

The Sacred Journey – new resource for service providers who work with First Nations families, August 1, 2012

Aboriginal Comic Book for Pregnant Women and New Moms, May 1, 2012

Pregnancy and Alcohol Brochure for Aboriginal Families, January 30, 2012

Aboriginal midwifery and Poverty & Pregnancy in Aboriginal Communities, August 17, 2011

Federal, provincial, and territorial ministers met in Halifax, Nova Scotia, on October 14-5 to discuss issues of justice and public safety in Canada including the impact of FASD. Co-chairs of the meeting were Minister of Justice and Attorney General, Jody Wilson-Raybold, Minister of Public Safety and Emergency Preparedness, Ralph Goodale, and the Minister of Justice and Atto2016-09-life-of-pix-free-stock-leaves-red-sky-leeroyrney General of Nova Scotia, Diana Whalen. Five national indigenous groups participated in the meeting: the Native Women’s Association of Canada, the Assembly of First Nations, the Métis National Council, Inuit Tapiriit Kanatami, and the Congress of Aboriginal Peoples.

Vice-Chief Kim Beaudin from the Congress of Aboriginal Peoples outlined the groups’ priorities to the ministers. Stating that “the most significant issue is violence against women and girls” Beaudin further stressed related issues of FASD, Indigenous girls’ health and safety, violence against Indigenous women, and family justice reforms for Indigenous women.

During the meeting, Ministers discussed the Truth and Reconciliation Commission of Canada: Calls to Action. It underscores the need to address FASD in action numbers 33 and 34, in particular. Ministers agreed to collaborate on addressing solutions for the economic and social impacts of alcohol abuse and to release their final report on FASD and Access to Justice.

FASD prevention efforts in Canada call for multiple approaches that are holistic and move beyond just advising women not to drink during pregnancy (See: Four-part Model of Prevention). The impact of violence and trauma in all its forms on the mental and physical health and safety of women and their families and communities informs and shapes these efforts.

For more on related topics, see earlier blog posts:

New Zealand has published an action plan on how best to address FASD. Described as a “whole of government action plan” by Associate Minister of Health, Peter Dunne, Taking Action on Fetal Alcohol Spectrum Disorder: 2016-1019 builds on the best practices being done across communities and service sectors including government policy and partnerships, as well as front line prevention and intervention. According to Fetal Alcohol Network NZ, the government is earmarking an initial 12 million for these efforts, which will increase support and services to women with alcohol and substance use issues.

New Zealand began the process of building the action plan with a discussion document of principles, priorities and action areas. They spent over a year seeking submissions and comments on the plan from professionals, communities, families and whānau (Maori extended family.)  Notable changes to the principles based on those submissions included issues of ethnic and services inequities, as well as stigmatization of women, families and individuals with FASD. The resulting principles defined the core priorities of the plan: prevention, early identification, support and evidence. These priorities framed its action building blocks and designated indications of success of plan outcomes. You can view an analysis of the Ministry of Health action plan submissions here.

By underscoring a collaborative and practical approach, the goal is to make sure that “FASD is prevented and people with FASD and their family/whānau live the best possible lives.”(1) Read more about New Zealand’s efforts:
http://www.health.govt.nz/publication/taking-action-fetal-alcohol-spectrum-disorder-2016-2019-action-plan

To read more about New Zealand’s prevention efforts see these previous posts:

First FEBFAST and Debates about Alcohol Labeling in New Zealand, February 1, 2011


References

  1. FASD Working Group. 2016. Taking Action on Fetal Alcohol Spectrum Disorder: 2016–2019: An action plan. Wellington, NZ: Ministry of Health.

 

 

 

 

FASD Conference 2

Marsha Wilson, Nancy Poole and Dorothy Badry at the 7th National Biennial Conference on Adolescents and Adults with Fetal Alcohol Spectrum Disorder (FASD). Session E3: Developments in Prevention of FASD – The Work of the Can FASD Prevention Network Action Team

At the 7th National Biennial Conference on Adolescents and Adults with FASD in Vancouver on April 9, 2016, Nancy Poole and Dorothy Badry described the work of CanFASD’s Prevention Network Action Team (pNAT).  They provided examples of the pNAT’s work on:

  1. Network building – Sharing expertise and skills through a network of researchers, policy analysts, clinicians, community-based service providers and advocates dedicated to FASD prevention
  2. Research – Building multidisciplinary research teams, developing research proposals, and conducting research
  3. Collaborative knowledge exchange – Developing and implementing strategies for moving “research into action” such as through workshops, curricula development for health and social service professionals, and policy analysis
  4. Influencing policy and service provision  Guiding service and policy improvements with governments and communities

Given the conference focus on adolescents and adults with FASD, the 2011 research led by pNAT member Deborah Rutman on prevention with girls and women with FASD and substance use problems was highlighted.   Treatment and support with girls and women who live with FASD is one of the least researched areas of FASD prevention.

A list of FASD prevention resource materials developed by pNAT members was provided. Reports and infographics that summarize research, and thereby support research-to-practice and -policy are included below.

LINKS

7th National Biennial Conference on Adolescents and Adults with FASD

Research on prevention with girls and women with FASD

CanFASD  – description of the pNAT

FASD Prevention Resources Spring 2016

FASD Resources

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Developed by the Saskatchewan Prevention Institute, the FASD Training Package for Post-Secondary Instructors is a resource  for post-secondary instructors and professors.

The focus of the resource is on understanding and preventing FASD. It can be used to provide information and education about Fetal Alcohol Spectrum Disorder (FASD) to students enrolled in professional programs leading to a career working with women of child bearing age.

Examples of programs include that this resource might be helpful for include: health care, education, justice, addictions, psychology, social work, and other community services’ programs (e.g., Early Childhood Education, Disability Support Worker, and Correctional Studies.)

The teaching package contains 11 modules with references. These modules provide evidence-based information on topics such as “What is FASD”, “Alcohol, Women, and Pregnancy”, “Prevention of FASD”, and “Primary and Secondary Disabilities”.

A downloadable PowerPoint with teaching notes is ready for use in class. Both the PowerPoint and written modules contain case studies, activities, and discussion questions that may be used with any group.

Download the package from the Saskatchewan Prevention Institute’s website.

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Edmonton inner-city program - Aboriginal - CBC'

The Healthy, Empowered and Resilient (H.E.R.) Pregnancy Program in Edmonton, Alberta uses professional staff and peer support workers to reach at-risk pregnant and parenting women in inner city Edmonton. The program, developed by Streetworks, supports street-involved women to access healthcare services before and throughout their pregnancy and address issues such as addiction, poverty and family violence.

CBC News featured the H.E.R. Pregnancy Program last week in the article “Pregnant aboriginal women find ‘world of difference’ in Edmonton inner-city program” (July 27, 2015). Nikki Wiart interviewed staff and clients of the program and learned about the importance of outreach, peer support, and the impact of early engagement with services on pregnancy and parenting outcomes.

90% of the program’s clients are Aboriginal while 50% of the staff is Aboriginal. Morgan Chalifoux, a pregnancy support worker, with the program describes how her personal experiences as a teen mother and living on the streets can make a difference: “”Honestly, if I wasn’t aboriginal, if I didn’t have the experience, if I didn’t use when I was on the street, if I didn’t understand what it was like to have my son threatened to be taken away from me … I wouldn’t be able to have the success that I have now with the clients.”

The program uses a harm reduction approach to addressing alcohol and other substance use during pregnancy. An evaluation of the program found that:

  • 76% of 139 pregnant women who connected with the program reported substance use, typically alcohol (32%), marijuana, and other drugs
  • While connected with the program, women reported elimination of use (40%), safer use (37%), and reduction of substance use (26%) at least once during their pregnancy with the program

The Alberta government has committed to funding the program for another three years as well as developing similar programs in Red Deer and Calgary.

For more on the H.E.R. Pregnancy Program, see earlier posts:

cbc mothering project

Manito Ikwe Kagiikwe (The Mothering Project), located at Mount Carmel Clinic in Winnipeg’s North End, provides prenatal care, parenting and child development support, group programming, advocacy, and addiction support for vulnerable pregnant women and new mothers.

CBC News interviewed Stephanie Wesley and Margaret Bryans about the program earlier this week. Bryans, a nurse and program manager at Manito Ikwe Kagiikwe, discusses the successes of the program since it first opened two years ago. The article focuses on the importance of supportive relationships and the value of a ‘focus on kindness’: “Women who are pregnant, who are using drugs and alcohol are one of the most stigmatized groups in our community.” (The Mothering Project aims to break cycle of addiction, CBC News, April 28, 2015).

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The program is a wonderful example of a integrated and holistic pregnancy program for women with addiction and related concerns. The program is based on principles of harm reduction. (Learn more about harm reduction and similar programs in this booklet, Harm Reduction and Pregnancy: Community-based Approaches to Prenatal Substance Use in Western Canada).

Since the program opened two years ago, 49 women have participated. Early evaluation findings show that, at the beginning of the program, 100% of women were actively using substances, 97% had never completed a substance use treatment program and 56% did not have a prenatal health care provider. Over the course of the program, 36% stopped using alcohol and drugs, 47% reduced their use, 39% attended an addiction treatment facility and 100% accessed prenatal care. Over half of mothers have been able to take their babies home with them from the hospital. Check out the infographic below for more.

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fasd prev entry The Encyclopedia on Early Childhood Development is produced by the Centre of Excellence for Early Childhood Development (CEECD) and the Strategic Knowledge Cluster on Early Child Development (SKC-ECD). This online Encyclopedia is intended for service providers, service planners, policy makers and parents and provides evidence-based information on 51 topics on early childhood development from conception to age 5. It includes easy-to-understand articles on FASD prevention and related topics. The encyclopedia is translated into French, Spanish, Portuguese and is expected to be translated into Russian. homepage Entries related to FASD include:

  • Early Intervention for Children with Fetal Alcohol Spectrum Disorders
  • Prevention of Fetal Alcohol Spectrum Disorders
  • Fetal Alcohol Spectrum Disorders and Nutrition
  • Supporting Parents of Children with Fetal Alcohol Spectrum Disorders and Young Children with Significant Prenatal Alcohol Exposure

The Encyclopedia includes two information sheets for parents on alcohol use during pregnancy (one for a general audience and one for Aboriginal parents) that are available in English, French, and Portuguese. parents - alc preg parents - alc preg abor french

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Elizabeth Elliott recently wrote a short article describing current FASD prevention efforts in Australia for the journal Public Health Research and Practice (available here).

Increasing awareness and understanding of FASD has resulted in a number of positive developments at a national level, including a federal parliamentary inquiry into FASD (2011), the development of an Australian Government action plan to prevent FASD (2013) and the announcement of government funding to progress the plan and appoint a National FASD Technical Network (June 2014).

Some of the earliest FASD prevention activities in Australia were led by indigenous communities. In 2007, a group of Aboriginal women from Fitzroy Crossing in remote northern Western Australia led a campaign to place a ban on the sale of full strength alcohol in their community.

This led to the Lililwan Project, the first ever prevalence study of FASD in Australia and a partnership between Nindilingarri Cultural Health Services, Marninwarntikura Woman’s Resource Centre, the George Institute for Global Health and the Discipline of Paediatrics and Child Health at The University of Sydney Medical School.

This ‘research in action’ project included diagnosis and development of individualised management plans to address the health issues of each child. Earlier this year, the researchers reported that one in eight (or 120 per 1000) children born in 2002 or 2003 in the Fitzroy Valley have FAS.

In 2009, the National Health and Medical Research Council revised the guidelines regarding alcohol use in pregnancy to state “For women who are pregnant or planning a pregnancy, not drinking is the safest option.”

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In 2014, the Women Want to Know project was launched. Developed by the Foundation for Alcohol Research and Education (FARE) in collaboration with leading health professional bodies across Australia and with support from the Australian Government Department of Health, the project encourages health professionals to routinely discuss alcohol and pregnancy with women in keeping with the revised guidelines.

FARE also launched the Pregnant Pause campaign in 2013 to encourage ‘dads-to-be’ and all Australians to support someone they care about through their pregnancy by taking a break from alcohol.

November 2013 also marked the first Australasian Fetal Alcohol Spectrum Disorders Conference  held in Brisbane.

Organizations such as the National Organisation for FASD Australia have taken a leadership role in education and advocacy related to FASD, including advocating for pregnancy warning labels on alcohol.

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Drinkwise, an alcohol industry-funded organization, has voluntarily developed ‘consumer information messages’ such as ‘It is safest not to drink while pregnant’ and ‘Kids and Alcohol Don’t Mix.’ However, an audit found that 26% of products carried a DrinkWise alcohol pregnancy warning label. (Visit Drink Tank for a discussion of alcohol industry led product labeling in Australia).

For more on FASD prevention in Australia, see earlier posts:

Overview: Four Levels of FASD Prevention

Information Sheet: What Men Can Do To Prevent FASD

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