strategies for community mobilization around fetal alcohol spectrum disorder an experience from...
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Strategies for Community Mobilization around Fetal Alcohol
Spectrum Disorder
An Experience from Rural Ontario
Marilyn Lemon R.N. BSc.N. PHN Grey Bruce Health Unit&
Jennifer Sells Program Manager CAPC/CPNPBruce Grey Children’s Services
Introduction Over the past four years there have been a number of
community capacity building strategies focusing on FASD in our rural area of Grey and Bruce Counties.
Mainly rural 1 urban center with 20,000 Similar size as PEI
Background
1999 FAS-World launched an international FAS campaign focusing on prevention with the theme month being September- the date of the campaign launch - Sept.9th ,1999
“The 9th month, 9th day and 9th hour to be the moment of reflection when people all over the world show support for women not to drink alcohol through their entire 9
months of pregnancy” (FAS-
World, 1999)
Starting Point - Partnership
All FASD strategies have occurred through interagency partnerships
There have been 2 lead agencies and an interagency committee that have been responsible for coordinating and initiating all FASD activities
Lead agencies , BGCS Brighter Futures (CAPC/ CPNP), and Public Health
Interagency Reproductive Health Committee members include First Nations, Child Protection, Social Services, etc.
Inter-collaboration
When agency partnership exists it enables the community to lend itself to inter-collaboration
Awareness alone requires a multiple of interested people willing to give time and financial support
Partners need to see the benefits of participating and the strength in partnership
Proposals for funding are done in partnership Strengthens community capacity to respond to issues Set’s strategic direction
Plan with Partnership
Health Canada offered funding in 2001 through “CPNP Dollars”
A joint proposal was developed by Bruce Grey Brighter Futures and Public Health
This was a key strategy because the initiative began with a partner focus and seed funding
Both agencies have a large number of contacts and high profile in the community
The proposal requested funding to support FASD awareness & education session
The Benefits of a Framework
Using a framework as a tool or guide for action focuses on a coordinated effort to address the complexities of FASD and provide communities with opportunities for:
-Education -Support -Treatment (Health Canada, FASD, A Framework For Action,
2003)
FASD A Framework for Action
Five Goals: Increase Public & Professional Awareness &
Understanding of FASD & the Impact of Alcohol use during Pregnancy
Develop & Increase Capacity Create Effective National Screening Diagnostic &
Data Reporting Tools & Approaches Expand the Knowledge Base & Facilitate Information
Exchange Increase Commitment & Support for Action on FASD
(Health Canada, FASD, A Framework for Action, 2003)
Increase Public & Professional Awareness & Understanding
In our community the first step involved raising awareness and education for the community to learn more about FASD and develop responsibility that FASD is a community based issue. “Increase Public and Professional awareness and understanding of FASD and the impact of Alcohol use during pregnancy” 1st of 5 goals (Health Canada FASD, A Framework
for Action, 2003)
All FASD strategies and initiatives support Goal 5 “Increase Commitment & Support for Action” (Health Canada, FASD, A Framework for Action, 2003)
Increasing Awareness & EducationPoints to be addressed
Points addressed at the training session: What is it that I am here to learn about? (Define the
question and the focus) How is this affecting our community?(Key points, local
issues, and statistics) Why should I be interested?(Personalize it) What can I do? (How to take action) What will be the benefits/outcomes for our community?
(Impact on community)
Awareness & Education Invite Key Stakeholders
Utilize existing mailing lists to invite: Key Health and Social Service Providers Parents (birth, adoptive and foster) Physicians Board of Education (teachers, principals, etc) Police and Correctional Services Substance Abuse Prevention Programs First Nations in local area and other significant cultural
group(s) Local Politicians Faith Communities
Awareness & Education Survey the Participants
Initially: Sept. 2002 Offered “free” breakfast & seminar about FASD Survey participants about their: -Interest in FASD -Knowledge on the topic -Further involvement -Contact information Survey results indicated next steps would include
connecting with interested individuals to discuss FASD community needs
Survey repeated at subsequent meetings received feedback from participants about their needs/interests
Continued...Public & Professional Awareness
March, 2002 Interagency Reproductive Health Committee hosted a
2nd. FASD education workshop featuring Donna Debolt,- Lethbridge, Alberta (Health Can. funding supported this)
Workshop educated community professionals & nonprofessionals about FASD primary & secondary disabilities, guidelines & interventions for families, & case management
Over 130 people attended FASD educational workshop
Continued… Public & Professional Awareness
Survey & evaluation feedback suggested the community wanted involvement with strategies around FASD support, education, and further awareness
An example of the high energy and commitment came from a participant at the workshop on the evaluation….
“It was worth driving through a snowstorm to be
here” (Participant at FASD Workshop)
Education leads to Commitment & Support
Since 2002 there have been 4 Education/Training Events
Donna Debolt (Sept. 02) spoke to community professionals/nonprofessional and Board of Education Staff
Allan Mountford (Oct. 03) teaches children in the school system with violent behaviour and specializes in the behaviour of the child with FASD and interventions
Marilyn Debassige (Feb. 04)- FASD through the Eyes of a Child- an Aboriginal approach to children with FASD
Allan Mountford (Aug. 04) focus- educators working with children with FASD in school setting
Awareness
Awareness Campaigns included posters, pens, fact cards
Provincial Campaign -May 2004 posters, pamphlets, tent cards, trans-ads etc. (Provincially funded)
Target groups faith communities, health/social service providers, protection services, educators, families & caregivers for children with FASD
Restaurant Sticker Campaign (2002) in partnership, targeting licensed establishments with a no alcohol during pregnancy sticker to put in their menu in alcohol section
Develop & Increase Capacity
September, 2002:Developed: FASD Community Mobilization Committee: Joint Initiative
(Brighter Futures-CPNP/CAPC & Public Health) Invited:
- All past workshop participants who indicated interest in becoming involved - Key service providers (child protection, police, social services, etc.) - Chris Margetson -Executive Director FASAT Guelph, Ont. - District Health Council
Develop & Increase Capacity
Community Mobilization:Meeting agenda: District Health Council - Chaired Guest from FASAT- Shared her expertise Brainstormed community needs around FASD focused
on 3 areas (Community, Family, Child/Youth) Narrowed our focus to 2 attainable objectives for the
community 1. FASD Support Group Development 2. FASD Resource Lending Library **see handouts in package**
FASD Support & Resources
FASD Support Group: Native Friendship Centre - hosted the Support Group Evening meetings - once a month Public Health - houses the mailing list
FASD Resources: Lending Library - partnered - Ontario Early Years Centre
library -accessible, day & evening hours Proposal - funding for resources - through FOCUS
Substance Abuse Prevention Program and CPNP funding
*These initiatives expanded knowledge & facilitated information exchange (Goal 4, Health Canada, FASD, A Framework for Action, 2003)
Create Effective Screening Diagnostic &Data Reporting Tools & Approaches
Strategies to Improve Community Capacity for Screening & Diagnosis of FASD
Physician Training using a standard tool to diagnose FASD
Facilitated by Dr. Gideon Koren Executive Director-Motherisk-Hospital for Sick Children, Toronto, Ont.
10 Physicians, 12 Psychologists received training Physicians received 3 MAIN PRO C Medical credits upon
completion of the training Hosted by Interagency Reproductive Health Committee Medical Officer of Health as the lead
Continued…Tools and Approaches
Meconium Testing for In-Utero Exposure to Alcohol:Grey-Bruce Study: Conducted by Masters of Toxicology
Student, University of Toronto
A sample of a minimum of 1 gram of meconium is collected in a clean container, kept refrigerated and within 48 hrs. transported to The Hospital for Sick Children in Toronto Motherisk Lab for Drug Exposure. If it will take more than 48hr. to transport sample it can be frozen and transported on dry ice
The lab extracts the alcohol esters (fatty acid ethyl esters) from the meconium and analyzed using a gas chromatographic method
Meconium Study
Meconium starts to form in 2nd trimester therefore the test provides information about alcohol use during 2nd & 3rd trimester
Significant correlation to # of drinks during pregnancy & FAEE in meconium
FASD meconium study provides evidenced-based research to determine prevalence of alcohol consumption by pregnant women in Grey-Bruce
Data-base will provide current results for our community that link directly to FASD strategies
Keys to Success Obtain seed funding Recruit motivational speakers Link with other areas with expertise and resources Increase awareness and resources through information
campaigns Provide training for local physicians to assist with
diagnosis Survey participants at educational events Know mandates local agencies have so you partner
appropriately Create committee to develop community capacity
Indicators of Success
Sustainable Activities: -Community Mobilization Committee -Support Group -Lending Library Interagency Involvement: -Interagency Committee - Local Agencies committed to FASD sustainable activities ie. hosting Support Group, housing and marketing resources, providing education and training opportunities locally
Thank you
All the best to you in your Communities
as you develop capacity building &
mobilization strategies targeting FASD.
Contact Information
Marilyn Lemon, Grey Bruce Health Unit, 920 1st Ave West, Owen Sound, Ontario N4K 4K5
[email protected] 1-519-376-9420
Jennifer Sells, Bruce Grey Children’s Services, 845 2nd Ave East
Owen Sound, Ontario N4K 2H2 [email protected] 1-519-371-4773