NACCHO Aboriginal Health and Fetal Alcohol Spectrum Disorders #FASD : Community participation is a key principle in effective health promotion

yc

 ” Community participation is a key principle in effective health promotion. Gurriny have used a whole-of-community approach by involving the five above mentioned target groups when designing their FASD prevention activities.

Gurriny consulted with women of childbearing age to learn about their views and attitudes towards alcohol, and assed their current knowledge about the harms associated with drinking in pregnancy. It was also important for health professionals to understand what types of alcoholic drinks women of child bearing age were consuming and how much.

For further information about the FASD Prevention and Health Promotion Resources Project please contact Bridie Kenna on 0401 815 228 or bridie.kenna@naccho.org.au

Read 17 Articles about FASD

Menzies School of Health Research have partnered with the National Aboriginal Community Controlled Health Organisation (NACCHO) and the Telethon Kids Institute (TKI) to develop a package of resources to reduce the impacts of FASD on the Aboriginal population.

FASD is a diagnostic term used for a spectrum of conditions caused by fetal alcohol exposure. Each condition and its diagnosis is based on the presentation of characteristic features which are unique to the individual and may be physical, developmental and/or neurobehavioural.

The package of resources is based on the model developed by the Ord Valley Aboriginal Health Service (OVAHS). OVAHS is an Aboriginal Community Controlled Health Service located in the far north east region of the Kimberly in Western Australia. OVAHS services Aboriginal people in the remote town of Kununurra and surrounding regions.

The package incorporates FASD education modules targeting five key groups:

  • Pregnant women using New Directions: Mothers and Babies Services (NDMBS) antenatal services, and their partners and families;
  •  Aboriginal and Torres Strait Islander women of childbearing age;
  •  Aboriginal and Torres Strait Islander grandmothers;
  •  NDMBS staff who provide antenatal care
  •  Aboriginal and Torres Strait Islander men.

To complement the package of resources, two day capacity building workshops for the 85 New Directions: Mothers and Babies Services (NDMBS) were held in Darwin, Cairns, Melbourne (TAS, VIC and SA sites combined), Perth and Sydney. The aim of the training workshops was to enable NDMBS sites to develop, implement and evaluate community-driven strategies and solutions by:

i. Increasing awareness and understanding of alcohol use during pregnancy, and FASD;

ii. Increasing awareness and understanding of existing FASD health promotion resources;

iii. Increase understanding, skills and capacity to use existing FASD health promotion resources within NDMBS, in line with their capacity, readiness and community circumstances and needs.

Staff from Gurriny Yealamucka Health Service (Gurriny) participated in the Queensland FASD training workshop in April. Since then, Gurriny have thrived in the area of FASD prevention by implementing multiple strategies within their community.

A key component of the FASD training workshop was highlighting the importance of routine screening of women about alcohol use during pregnancy. Assessment of alcohol consumption, combined with education in a supportive environment can assist women to stop or significantly reduce their alcohol use during pregnancy. A number of screening tools were introduced at the workshop including AUDIT-C (Alcohol Use Disorders Identification Test – Consumption), which Gurriny have now incorporated into their own data recording system. This tool has three short questions that estimate alcohol consumption in a standard, meaningful and non-judgemental manner.

Gurriny now places great emphasis on providing routine screening of women about their alcohol use during all stages of pregnancy and recording results in clinical records at each visit. Health professionals at Gurriny often use brief intervention and motivational interviewing techniques to guide conversations about alcohol and pregnancy.

This is of particular significance when working with pregnant women, as there are multiple opportunities through routine antenatal care to provide support through the stages of change. There is sound evidence that motivational interviewing and brief interventions can decrease alcohol and other drug use in adults. Both practices are listed in the Royal Australian College of General Practice (RACGP) guidelines as an effective strategy for positive behaviour change.

It is estimated that over half of all pregnancies in Australia are unplanned and many Australian women are unknowingly consuming alcohol during pregnancy. Providing women of childbearing age with reliable information about the risks of alcohol consumption during pregnancy and the importance of contraception use if they are not planning a pregnancy are essential strategies in preventing FASD. Staff at Gurriny have pre-conception discussions about healthy pregnancies and FASD prevention with women who cease contraception use and may be planning a pregnancy. Women are provided with reliable information in a supportive environment to help them make informed decisions.

Knowledge transfer strategies are a key component to ensure new information is shared and retained within the service and community. Members from Gurriny’s Child and Maternal Health team have shared the package of resources and new skills gained at the workshop with a number of their colleagues, both clinical and administrative. They have also shared the new information with relevant health professionals from external organisations, including the local hospital. This assists in developing a more consistent approach to FASD prevention and maximises available resources in the community. Gurriny have made links with other health and community services within the Yarrabah community to develop a coordinated, strategic approach to FASD prevention.

Community participation is a key principle in effective health promotion. Gurriny have used a whole-of-community approach by involving the five abovementioned target groups when designing their FASD prevention activities.

Gurriny consulted with women of childbearing age to learn about their views and attitudes towards alcohol, and assed their current knowledge about the harms associated with drinking in pregnancy. It was also important for health professionals to understand what types of alcoholic drinks women of child bearing age were consuming and how much.

Based on the findings, laminated cards were developed which show the number of standard drinks in each serving according to the National Health and Medical Research Council (NHMRC) alcohol guidelines. These cards are used in both one-on-one and group based education sessions. There is no safe level of alcohol consumption at any stage of pregnancy; this message is emphasised at all opportunities with women of childbearing age.

Raising community awareness is a key strategy in successful health promotion. Gurriny have a strong presence in the Yarrabah community and often attend health and community events to raise awareness of the harms associated with drinking in pregnancy and FASD.

Health staff make use of any opportunity to raise awareness, share information and prompt people to think about making positive changes to their own drinking behaviour, or support others to do so.

Additional awareness raising strategies include showing FASD prevention DVD’s on iPad’s in clinic waiting rooms, demonstrating the concept of the invisible nature of FASD disability by using demonstration FASD dolls in education sessions, and having posters about healthy pregnancies and FASD prevention in clear view throughout the clinic.

Health promotion is most effective when multiple strategies are used which target not only the individual, but the community at large. It is evident Gurriny Yealamucka Health Service is using this approach in order to reach the best possible health outcomes for women, children and families.

For further information about the FASD Prevention and Health Promotion Resources Project please contact Bridie Kenna on 0401 815 228 or bridie.kenna@naccho.org.au

 

NACCHO welcomes feedback/comment:Leave a Reply

Please log in using one of these methods to post your comment:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s