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2nd in Series: First-ever FASD Prevention Plenary at the 7th International Conference on FASD: PART 1

“Evidence for multi-faceted, culturally relevant, community-led approaches” – Dr. James Fitzpatrick, Head, and Kaashifah Bruce, Program Manager of Telethon Kids Institute’s FASD Research; June Councillor, CEO of Wirraka Maya Aboriginal Health Services; Anne Russell, Russell Family Fetal Alcohol Disorders Association

Making FASD History newsletter

The “Make FASD History in the Pilbara” program in Western Australia is the result of community-led and culturally relevant efforts within Indigenous communities dealing with the effects of long-term colonization and FASD. It was developed in collaboration and partnership with communities in the Fitzroy Valley and provides strategies and programs to assess and diagnose FASD, as well as to provide health, educational, and management supports to mothers and children.

James Fitzpatrick described earlier successes that underpin this program – like the Lilliwan prevalence project, the PATCHES program to diagnose FASD, and the Marlu Strategy for prevention and intervention (See Video). Dr. Fitzpatrick was nominated in 2016 for the WA Australian of the Year award for his work on FASD.

June Councillor explained the role of the “’Warajanga Marnti Warrarnja” Project – translation Together We Walk This Country – in the strategy and its long-term approach. She featured a video of the project in her remarks. View the program launch Video here.

Kaashifah Bruce presented evaluation results of using this multi-pronged approach that show an increase in: 1) awareness of FASD and the harms caused by drinking in pregnancy; 2) intentions to NOT drink during future pregnancies; and, 3) intentions to help pregnant women not to drink. The encouraging results suggest that this community-led, multi-strategy approach can serve as a blueprint for success in other Aboriginal communities.

LtoR: June Councillor, Anne Russell, Kaashifah Bruce, and James Kirkpatrick

 

Finally, Anne Russell provided a lived-experience viewpoint with examples of how stigma and stereotyping impede prevention efforts. By describing her own as well as other women’s experiences, she underscored how important it is to avoid stereotypes about women and drinking, and to talk with women and communities about what they need and what is important to them.

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

Alcohol Think Again Campaign in Western Australia (June 19, 2012)

Films from the Lililwan Project: Tristan and Marulu (May 9, 2012)

FASD Campaign from Kimberley and Pilbara Regions of Western Australia (October 22, 2012)

FASD Prevention in Australia’s Ord Valley (October 13, 2011)

Targeting Health Professionals in Western Australia (February 9, 2011)

Getting Fathers Involved (January 4, 2011)

More Activism from Australia (October 19, 2011)

Yajilarra: the story of the women of Fitzroy Crossing (October 15, 2010)

FASD Initiatives in Western Australia (September 15, 2010)

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.

planning-for-change-picture

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:

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:

nursing for women's health

Earlier this year, Sherri Di Lallo wrote an article for the journal Nursing for Women’s Health called “Prenatal Care Through the Eyes of Canadian Aboriginal Women” (Vol 18, Issue 1, pp. 38-46).

The article provides an overview of the Aboriginal Prenatal Wellness Program (APWP) in central Alberta, Canada. The four Maskwacis First Nations of Hobbema border Wetaskiwin and Ponoka Counties in Central Alberta and have a total population of 13,784 people.

The Aboriginal Prenatal Wellness Program is a culturally safe program that provides client-centered prenatal care that is designed to empower women, families and communities.

The program was created in 2005 to serve Aboriginal women who weren’t accessing the traditional system for prenatal care. Between 2002 and 2007, 16.5 percent of all women in Central Alberta who delivered at Wetaskiwin Hospital and Care Centre had received little or no prenatal care prior to their delivery. Of those, 82 percent were from the Maskwacis area.

The article discusses aspects of providing culturally safe care, including the importance of assessing cultural biases, understanding the roots of health disparities in Aboriginal communities, and understanding cultural history and current practices. Central to cultural safety is self-reflection and building trustful and respectful relationships.

The article provides a summary of an evaluation of the program. Overall, between November 2005 and February 2009, 281 women participated in the program and the percentage of women having limited or no prenatal care dropped.

In terms of substance use, forty-four percent of women stated that they quit drinking and using drugs once they found out they were pregnant while 39 percent decreased their smoking and 16 percent quit smoking.

For more on cultural safety and FASD prevention, see earlier posts:

FPCFR

The First Peoples Child & Family Review is a Canadian journal dedicated to interdisciplinary research honouring the voices, perspectives and knowledges of First Peoples through research, critical analyses, stories, standpoints and media reviews.

The Fall 2013 issue focuses specifically on FASD. Dorothy Badry and Tara Hanson describe the importance of this focus in the introduction:

“This special edition of The First Peoples Child & Family Review explores the social issue of Fetal Alcohol Spectrum Disorder (FASD) from the perspectives, experiences and needs of Aboriginal peoples. It recognizes that the context of FASD in Aboriginal communities is unique, and cannot be properly acknowledged or addressed through generalized studies and services.

As the articles in this edition illustrate, the issue and experience of Aboriginal peoples and FASD must be understood within the context of colonization and its intergenerational impacts. Without this critical lens, research findings and service recommendations may be inappropriate to Aboriginal families or communities. Mainstream programs developed from a Euro-Western perspective may conflict with Aboriginal worldviews.

The articles in this edition portray the human experience of struggles with alcohol, the role of history and trauma in adverse life outcomes as well as the existence of socioeconomic disparities. Experiences with child welfare and legal systems are chronicled, disruptions, difficulties and repercussive impacts of secondary disabilities. Along with the adversities, however, are powerful themes of hope, healing, promising practices, capabilities, and strength found through caring relationships.” (p. 5)

Several articles focus on FASD prevention and tackle topics such as developing community programs for pregnant and early parenting women who use alcohol and other substances that operate from an Indigenous knowledge framework, FASD prevention with women who have FASD themselves, and insights from workers in a home visitation program for women with a history of alcohol and drug abuse.

Many people continue to mistakenly believe that FASD is primarily an Indigenous issue (this is definitely not the case – FASD is an issue wherever women drink alcohol during pregnancy). It is true, though, that many Indigenous communities have been working to address FASD and related social concerns for longer than many non-Indigenous communities – this special issue highlights some of the leadership and innovation that many communities have taken in the past few years.

View the table of contents and download free full-text for all the articles here.

 

New poster and brochure from Healthy Child Manitoba

Poster_art_lr

It is important for women to receive clear and supportive information about staying as healthy as possible during pregnancy. This includes receiving appropriate culturally sensitive information about the potential impact of alcohol on pregnancy and ways of preventing FASD.

Women accessing the North Point Douglas Women’s Centre in Winnipeg, Manitoba wanted to get this message out to their community. Working with nursing students on practicum, and with help from the Aboriginal Health and Wellness Centre and Mount Carmel Clinic, they designed the message they wanted women to hear and know: “You are not Alone. Support is available.” Download the poster as a PDF here.

Healthy Child Manitoba worked with the North Point Douglas Women’s Centre at the final design and production stages providing: (1) helpful suggestions about design qualities including the final placement of visuals on the posters and brochures, (2) accurate message and content information for the posters and brochures, and (3) the financial resources for the production of the posters, brochures and promotional items.

Learn more about other FASD prevention initiatives in Manitoba, including Project Choices and the InSight Mentoring Program, on the Healthy Child Manitoba website.

For more on alcohol and pregnancy awareness initiatives in indigenous communities, see earlier posts:

Handbook Cover

“The Handbook for Aboriginal Alcohol and Drug Work is a practical tool written for Aboriginal drug and alcohol workers, mental health workers and others working in this field. It offers a detailed look at alcohol and drug work from clinical, through to prevention, early intervention and harm reduction. This handbook is also likely to help people working to improve policy and those advocating for change.

The idea for it came from workers all over Australia. They told us that they needed an easy to use handbook that can help them respond to the range of alcohol and drug issues they face every day. They also told us that such a book needs to take into account the complex challenges facing workers when helping clients, their families and, sometimes, whole communities.”

This plain language, evidence-based guide was created in partnership between the University of Sydney and Aboriginal and non-Aboriginal agencies and health professionals. Four of the six editors are Aboriginal.

It covers alcohol and drug use as well as a whole range of other issues, including child protection notifications, legal issues, working with clients without housing, mental health and polydrug use, and community-wide approaches.

Chapter 2 focuses on alcohol and Chapter 16 focuses on Special situations, settings, and groups, including pregnancy, breastfeeding and early childhood. It discusses the use of brief intervention and counselling approaches in the context of alcohol and pregnancy. It also has sections covering Neonatal Abstinence Syndrome, Alcohol use in pregnancy and Foetal Alcohol Spectrum Disorders.

The handbook was first distributed to alcohol and drug professionals from around Australia at the National Indigenous Drug and Alcohol Conference in Western Australia in June 2012.

The project started in 2010 with a grant from the Foundation for Alcohol Research and Education (FARE) and continued with the support of the NSW Ministry of Health.

The handbook is available online.

This recent media campaign from Western Australia uses a peer-to-peer approach, “a call to action from women, to women” to raise awareness of people affected by FASD and the impact it has on their lives.

The campaign was developed by Goolari Media, a fully owned Indigenous company, and includes a TV ad which has been broadcast on Goolari’s digital service throughout Broome, a radio advertisement broadcast in the immediate Broome area and throughout regional and remote communities in the Pilbara and Kimberley regions, and the distribution of the ad on DVD to regional health professionals.

This is an example of a targeted public education campaign which focuses on indigenous women in a particular region of Western Australia. The ad is intended to be supportive and encouraging, with women speaking directly to other women.

The ad says:

“Drinking grog during pregnancy is very dangerous for your unborn baby. We all have responsibility to give the best possible start to a baby’s life. Even small amounts of alcohol can cause major health problems that can last a lifetime…..So, if you’re pregnant, you just don’t charge up. When it comes to pregnancy, let’s help each other and say no to grog.”

The press release (July 10, 2012) from the Foundation for Alcohol Research and Education describes the advertisement:

“The single fluid TV and radio advertisements incorporate the voices and images of 16 women against a neutral background. The different ages, skin colours, and array of Indigenous faces and voices reflect the diversity and vastness of the Kimberley and Pilbara regions of today.”

The project has been funded with a grant of $19,720 (AUS) from the Foundation for Alcohol Research and Education (FARE), and was one of 17 grants awarded to community organisations throughout Australia as part of the 2011 Community Education and Engagement Grant Funding Round.

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

There have been recent debates about lifting alcohol bans in Aboriginal communities in Queensland, Australia. The governments in Queensland and Northern Territories have proposed to lift “grog bans” based on the idea that Aborigines should have the same rights as all Australians, including the right to drink.

This news clip interviews indigenous academic, Marcia Langton, who says the evidence supports keeping restrictions in place. “The fact of the matter is is that all Australians are subject to alcohol restrictions in one form or another. We can’t go and buy alcohol at any time of the day or night. There are restrictions on hours. There are restrictions everywhere in Australia now on drinking in public places and specified places. So, it is not true that Aborigines are the only people who are subject to restrictions on alcohol.”

For more on the history of alcohol bans in Queensland, check out this news article Bans on alcohol spawn generation of lucky children (The Australian, October 13, 2012).

For more on local alcohol policies and FASD prevention, see earlier posts:

Overview: Four Levels of FASD Prevention

Information Sheet: What Men Can Do To Prevent FASD

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