Preventing Drift through Continued Co-Design with a First Nations Community: Refining the Prototype of a Tiered FASD Assessment

Luke Miller, Dianne C. Shanley, Marjad Page, Heidi Webster, Wei Liu, Natasha Reid, Doug Shelton, Karen West, Joan Marshall and Erinn Hawkins ()
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Luke Miller: Gold Coast Hospital and Health Service, Gold Coast 4215, Australia
Dianne C. Shanley: Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia
Marjad Page: Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia
Heidi Webster: Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia
Wei Liu: Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia
Natasha Reid: Child Health Research Centre, University of Queensland, Brisbane 4101, Australia
Doug Shelton: Gold Coast Hospital and Health Service, Gold Coast 4215, Australia
Karen West: Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia
Joan Marshall: Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia
Erinn Hawkins: Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia

IJERPH, 2022, vol. 19, issue 18, 1-13

Abstract: As part of the broader Yapatjarrathati project, 47 remote health providers and community members attended a two-day workshop presenting a prototype of a culturally-safe, tiered neurodevelopmental assessment that can identify fetal alcohol spectrum disorder (FASD) in primary healthcare. The workshop provided a forum for broad community feedback on the tiered assessment process, which was initially co-designed with a smaller number of key First Nations community stakeholders. Improvement in self-reported attendee knowledge, confidence, and perceived competence in the neurodevelopmental assessment process was found post-workshop, assessed through self-report questionnaires. Narrative analysis described attendee experiences and learnings (extracted from the workshop transcript), and workshop facilitator experiences and learnings (extracted from self-reflections). Narrative analysis of the workshop transcript highlighted a collective sense of compassion for those who use alcohol to cope with intergenerational trauma, but exhaustion at the cyclical nature of FASD. There was a strong desire for a shared responsibility for First Nations children and families and a more prominent role for Aboriginal Health Workers in the assessment process. Narrative analysis from workshop facilitator reflections highlighted learnings about community expertise, the inadvertent application of dominant cultural approaches throughout facilitation, and that greater emphasis on the First Nation’s worldview and connection to the community was important for the assessment process to be maintained long-term. This study emphasised the benefit of continued co-design to ensure health implementation strategies match the needs of the community.

Keywords: neurodevelopmental assessment; first nations peoples; co-design; fetal alcohol spectrum disorder; primary health care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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