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Stubbs T, Cannon L, Carter E, Naanai H, Okurame JC, Martiniuk ALC, Davies J, Thomas S, Bedford M, Elliott EJ, Rice LJ. Fetal alcohol spectrum disorder resources for health professionals: a scoping review. BMJ Open 2024; 14:e086999. [PMID: 39002966 PMCID: PMC11253770 DOI: 10.1136/bmjopen-2024-086999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/12/2024] [Indexed: 07/15/2024] Open
Abstract
OBJECTIVES This scoping review aimed to identify and critically appraise resources for health professionals to identify, diagnose, refer, and support individuals with fetal alcohol spectrum disorder (FASD)-including the extent to which the resources are appropriate for use in communities with First Nations Peoples. METHOD Seven peer-reviewed databases (April 2022) and 14 grey literature websites (August 2022) were searched. The reference lists of all sources that underwent full-text review were handsearched, and FASD experts were consulted for additional sources. Resources were assessed using the Appraisal of Guidelines for REsearch and Evaluation II instrument and an adapted version of the National Health and Medical Research Council FORM Framework and iCAHE Guideline Quality Checklist. RESULTS A total of 41 resources underwent data extraction and critical appraisal, as screening and/or diagnosis guidelines were excluded because they are covered in other reviews. Most were recently published or updated (n=24), developed in the USA (n=15, 36.6%) or Australia (n=12, 29.3%) and assisted with FASD patient referral or support (n=40). Most management guidelines scored 76%-100% on overall quality assessment (n=5/9) and were recommended for use in the Australian context with modifications (n=7/9). Most of the guides (n=15/22) and factsheets (n=7/10) received a 'good' overall score. Few (n=3/41) resources were explicitly designed for or with input from First Nations Australians. CONCLUSION High-quality resources are available to support health professionals providing referrals and support to individuals with FASD, including language guides. Resources should be codesigned with people living with FASD to capture and integrate their knowledge and preferences.
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Affiliation(s)
- Thomas Stubbs
- Speciality of Child and Adolescent Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Lisa Cannon
- Speciality of Child and Adolescent Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Emily Carter
- Marulu Unit, Marninwarntikura Women’s Resource Centre, Fitzroy Crossing, Western Australia, Australia
| | - Habiba Naanai
- Speciality of Child and Adolescent Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Josephine Chidinma Okurame
- Speciality of Child and Adolescent Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Alexandra L C Martiniuk
- School of Public Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Office of the Chief Scientist, The George Institute for Global Health, Sydney, New South Wales, Australia
- Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
| | - Jadnah Davies
- Marulu Unit, Marninwarntikura Women’s Resource Centre, Fitzroy Crossing, Western Australia, Australia
| | - Sue Thomas
- Marulu Unit, Marninwarntikura Women’s Resource Centre, Fitzroy Crossing, Western Australia, Australia
| | - Mudge Bedford
- Marulu Unit, Marninwarntikura Women’s Resource Centre, Fitzroy Crossing, Western Australia, Australia
- NDIS Remote Community Connector Team, Marra Worra Worra Aboriginal Cooporation, Fitzroy Crossing, Western Australia, Australia
| | - Elizabeth J Elliott
- Speciality of Child and Adolescent Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Sydney Children's Hospital Network and Kid's Research, Westmead, Sydney, New South Wales, Australia
| | - Lauren J Rice
- Speciality of Child and Adolescent Health, University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
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Saunders P. Fulfilling cultural safety expectations in specialist medical education and training: considerations for colleges to advance recognition and quality. Med J Aust 2024; 221:8-12. [PMID: 38946654 DOI: 10.5694/mja2.52317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/18/2024] [Indexed: 07/02/2024]
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Williams R, Hayton S, Campbell A, Kemp H, Badry D. Strong Born-A First of Its Kind National FASD Prevention Campaign in Australia Led by the National Aboriginal Community Controlled Health Organisation (NACCHO) in Collaboration with the Aboriginal Community Controlled Health Organisations (ACCHOs). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:85. [PMID: 38248547 PMCID: PMC10815402 DOI: 10.3390/ijerph21010085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/21/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024]
Abstract
The Strong Born Campaign (2022-2025) was launched by the National Aboriginal Community Controlled Health Organisation (NACCHO) in 2023. Strong Born is the first of its kind national Aboriginal and Torres Strait Islander health promotion campaign to address Fetal Alcohol Spectrum Disorder (FASD) within Australia. Strong Born was developed to address a longstanding, significant gap in health promotion and sector knowledge on FASD, a lifelong disability that can result from alcohol use during pregnancy. Utilizing a strengths-based and culturally sound approach, NACCHO worked closely with the Aboriginal Community Controlled Health Organisations (ACCHOs) to develop the campaign through co-design, as described in this paper. Since its inception, the ACCHOs have continually invested in driving change towards improvements in Aboriginal health determinants and health promotion. The Strong Born Campaign developed culturally safe health promotion tool kits designed for the community and health sector staff and also offered communities the opportunity to apply for FASD Communications and Engagement Grants to engage in local campaign promotion. The tool kits have been disseminated to 92 ACCHOs across Australia. This paper describes the development of the Strong Born Campaign and activities following its launch in February 2023 from an Indigenous context within Australia, as described by NACCHO.
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Affiliation(s)
- Robyn Williams
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Bentley 6102, Australia
| | - Sarah Hayton
- National Aboriginal Community Controlled Health Organisation (NACCHO), Canberra 2601, Australia; (A.C.); (H.K.)
| | - Annabel Campbell
- National Aboriginal Community Controlled Health Organisation (NACCHO), Canberra 2601, Australia; (A.C.); (H.K.)
| | - Holly Kemp
- National Aboriginal Community Controlled Health Organisation (NACCHO), Canberra 2601, Australia; (A.C.); (H.K.)
| | - Dorothy Badry
- Faculty of Social Work, University of Calgary, Calgary, AB T2N 1N4, Canada;
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Kent N, Hayes N, Young S, Vanderpeet C, Shanley D, Harris K, Pestell C, Elliott E, Reid N. Exploring resource implications and models of care for assessment and diagnosis of fetal alcohol spectrum disorder: A scoping review. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:2022-2032. [PMID: 38226761 DOI: 10.1111/acer.15198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/11/2023] [Accepted: 09/16/2023] [Indexed: 01/17/2024]
Abstract
Previous reviews have examined annual mean costs of care for individuals with fetal alcohol spectrum disorder (FASD), costs of the health burden, costs to the justice system, productivity losses for caregivers, and both the monetary and nonmonetary costs of reduced quality of life. However, because there have been no published reviews focused on understanding the resource implications and specific service features for the assessment and diagnostic process for FASD, the current scoping review investigated the available evidence on these topics. Eligible studies were identified through a systematic search of six databases and included if they contained information on the potential costs or models of care associated with undertaking an assessment for FASD. Data were charted, underwent content analysis, and were reported according to the PRISMA extension for scoping reviews. Eleven studies were included in the final qualitative synthesis. The primary patient costs were attributed to the lengthy time required for diagnosis (up to 47 h). The primary service costs were attributed to costs of clinicians and support personnel and the involvement of multidisciplinary teams in the assessment process. Estimates of the specific dollar values of diagnostic costs were limited and varied between studies. Several models of care were explored, primarily in Canadian clinics, which aimed to capitalize on available services to improve accessibility and patient care and reduce service costs. This study provides important preliminary insights into the resource implications and models of care involved in the diagnostic assessment of FASD. However, the low number of available studies and variability in available data highlight the need for formal costing studies and detailed information gathering on available models of care to inform future clinical practice and policy development.
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Affiliation(s)
- Nykola Kent
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
| | - Nicole Hayes
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- Australian Research Council Centre of Excellence for the Digital Child, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Sophia Young
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
| | - Chelsea Vanderpeet
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
| | - Dianne Shanley
- School of Applied Psychology, Griffith University, Gold Coast, Queensland, Australia
- Menzies Health Institute of Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Katrina Harris
- Victorian Fetal Alcohol Service, Monash Children's Hospital, Clayton, Victoria, Australia
- Australian Childhood Foundation, Abbotsford, Victoria, Australia
| | - Carmela Pestell
- Australian Childhood Foundation, Abbotsford, Victoria, Australia
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Elizabeth Elliott
- Faculty of Medicine and Health, Specialty of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Children's Hospital Network, Westmead, Sydney, New South Wales, Australia
| | - Natasha Reid
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
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Reid N, Kent N, Hewlett N, Bagley K, Tsang TW, Goldsbury S, Williams R, Akison L, Holland L, Vanderpeet C, Doyle M, Boaden N, Hayes N. Factors to be considered as part of a holistic assessment for fetal alcohol spectrum disorder: A scoping review. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:2007-2021. [PMID: 38226745 DOI: 10.1111/acer.15191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/16/2023] [Accepted: 09/04/2023] [Indexed: 01/17/2024]
Abstract
We undertook a scoping review to identify the factors outside of current fetal alcohol spectrum disorder (FASD) diagnostic criteria to be considered as part of a holistic assessment process. This included physical, social, cultural, mental health and wellbeing factors to inform targeted recommendations and supports to improve outcomes for individuals with FASD. Evidence from this review will be used to inform the revision of the Australian Guide to the Diagnosis of FASD. Six electronic databases were searched. Studies were eligible if they included factors outside of the diagnostic criteria that cover dysmorphology, growth restriction, neurodevelopmental impairments. Data charting and content analysis were performed to synthesize the results. One hundred twenty-one studies were included that spanned 12 key areas These included physical health, sleep, adverse postnatal experiences, substance use/other risk-taking behaviors, contact with the criminal justice system, mental health, First Nations cultural considerations, transition to adult roles, involvement with the out-of-home care system, feeding and eating, strengths/interests/external resources and incontinence. Areas to be considered as part of a holistic assessment and diagnostic process spanned individual, family, and system level factors. Results provide guidance for clinicians on the wide range of factors that could influence long-term health, development, and wellbeing for individuals with prenatal alcohol exposure and FASD. In practice, this guidance can be used to inform an individualized assessment process to facilitate tailored recommendations and supports to best meet the complex needs of individuals living with FASD and their families.
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Affiliation(s)
- Natasha Reid
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
| | - Nykola Kent
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- School of Biomedical Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Nicole Hewlett
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- The First Nations Cancer & Wellbeing Research Team, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Kerryn Bagley
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Tracey W Tsang
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Kids Research, Westmead, New South Wales, Australia
| | - Sarah Goldsbury
- Māori/Indigenous Health Innovation, University of Otago Christchurch, Christchurch, New Zealand
| | - Robyn Williams
- Curtin Medical School, Curtin University, Bentin, Western Australia, Australia
| | - Lisa Akison
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- School of Biomedical Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Lorelle Holland
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, Queensland, Australia
| | - Chelsea Vanderpeet
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
| | - Michael Doyle
- Central Clinical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Nirosha Boaden
- School of Social Work, The University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole Hayes
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- Australian Research Council Centre of Excellence for the Digital Child, Queensland University of Technology, Brisbane, Queensland, Australia
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Lyall V, Egert S, Reid N, Moritz K, Askew D. "Our Mothers Have Handed That to Us. Her Mother Has Handed That to Her": Urban Aboriginal and Torres Strait Islander Yarning about Community Wellbeing, Healthy Pregnancies, and the Prevention of Fetal Alcohol Spectrum Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095614. [PMID: 37174134 PMCID: PMC10178754 DOI: 10.3390/ijerph20095614] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023]
Abstract
In Australia, fetal alcohol spectrum disorder (FASD) is a largely hidden disability that is currently under-recognized, under-resourced, and under- or misdiagnosed. Unsurprisingly, efforts to prevent FASD in urban Aboriginal and Torres Strait Islander communities are lacking. Further, mainstream approaches are not compatible with diverse and distinct Aboriginal and Torres Strait Islander ways of approaching family, pregnancy, and parenting life. To support the creation of culturally appropriate urban Aboriginal and Torres Strait Islander FASD prevention strategies, we sought to understand local perspectives, experiences, and priorities for supporting healthy and alcohol-free pregnancies. Using a narrative methodology, we undertook research yarns with eight female and two male community participants. Data were analyzed using a narrative, thematic analysis and guided by an Indigenist research practice of reflexive listening. Participant yarns provided important insights into local urban Aboriginal and Torres Strait Islander cultural, social, and structural determinants that support family and child health, alcohol-free pregnancies, and the prevention of FASD. The results provide critical guidance for Indigenizing and decolonizing FASD prevention strategies to support culturally safe, relevant, and strengths-based services. This approach has critical implications for all health and social professionals and can contribute to Aboriginal and Torres Strait Islander peoples' justice, recovery, and healing from colonization.
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Affiliation(s)
- Vivian Lyall
- Medical School, General Practice Clinical Unit, Level 8 Health Sciences Building, Royal Brisbane & Women's Hospital, The University of Queensland, Herston, QLD 4029, Australia
| | - Sonya Egert
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, P.O. Box 52, Inala, QLD 4077, Australia
| | - Natasha Reid
- Child Health Research Centre, University of Queensland, Brisbane, QLD 4101, Australia
| | - Karen Moritz
- Child Health Research Centre, University of Queensland, Brisbane, QLD 4101, Australia
| | - Deborah Askew
- Medical School, General Practice Clinical Unit, Level 8 Health Sciences Building, Royal Brisbane & Women's Hospital, The University of Queensland, Herston, QLD 4029, Australia
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