Preventing Drift through Continued Co-Design with a First Nations Community: Refining the Prototype of a Tiered FASD Assessment
Abstract
:1. Introduction
1.1. The Yapatjarrathati Project
1.2. Content of the Workshop and Study Objectives
2. Materials and Methods
2.1. Research Design
2.2. Participants
2.3. Materials and Methods
2.4. Procedure
2.5. Statistical Analysis
3. Results
3.1. Attendee Knowledge, Confidence and Perceived Confidence in the Assessment Prototype
3.2. Narrative Analysis of Attendee Contributions
A lot of our mob give up and we talk about why warriors lie down and die. Well, it’s all the stress, trauma, and those things that impact on our mob’s everyday life.
It [racism] impacts on our mob and us as workers. It is a separate entity. It is the most challenging barrier to get into any space. To get our mob to be able to talk.
No one should be working with our Aboriginal kids or our Aboriginal health unless you have taken into account the history, our history. Our dispossession of land, our loss of culture, and how that still affects a lot of our Elders and how that is passed down. The new word is inter-generational trauma and it’s still there.
And when you look at our mob today, with all that is going on in our lives and everything that impacts on them, the only way they can find any salvation or any hope [is] through alcohol usage. Unfortunately, that has impacted on our children, their children so we talk about the four generations of alcohol abuse and the impact on our mob.
The other day I saw a young girl who was going (sic) dealing with sorry business and she said to me ‘I’ve cut down drinking, but because I can’t heal the spiritual and emotional trauma, I want to drink’.
Our mob are starting to drink at 12. So, when you got that kid with FASD consuming alcohol themselves. We are really faced with the ugliest demon out there.
We need to not only be together in this room, but to be together outside this bloody door. Because the minute we walk out this door. Everybody is in their own little silo. In their own little predicament. No one wants to share, and we are all here to help. But it is not seen outside these doors. We can sit in here and talk, but out there you become your individual organisations, which is shit, because we are working for the same people and the same journey and for this to be successful and to work we need each other.
We shouldn’t be working in little pockets. We should be out helping one another…We shouldn’t be saying that’s not our problem. That’s what we have been getting for the last 20 years…That’s the only way we are going to make a difference, is everyone working together.
Until that kid or that family trusts you enough, they won’t do any of this here. For anyone working with our mob. That relationship—don’t give up. If you are there for the right reason and our mob know that, our mob will be a bit more open to let them into their space.
The [Aboriginal] health workers today keep on emphasising how important that connection is.
[Aboriginal] health workers being a crucial component in this journey. But as a health worker we are always fighting the system because there is always that conflict, the health workers are always judged, rather than us being the expert, because we live in this community, we know our mob, we know how to communicate with our mob. We need to be recognised for the expertise that we have…
3.3. Narrative Analysis of Workshop Facilitator Reflections
My background led me to focus on presenting the details and demonstrations of the assessment, provide the reasoning and logic behind decision-making and present case stories showing the process.
The first day would have more about community yarning, sharing of the impacts of history and culture and broader determinants of health, more time and space for participant feedback.
I quickly realised that I don’t have all the answers, that I’m not an expert in their community, and don’t have the grassroots knowledge of all the barriers/factors that impact.
I walked away from this workshop truly acknowledging that I didn’t know how to deliver FASD services in this community. I realised that this was okay, because the community knew—we just needed to listen.
I would also be more focused on the Dreamtime story at more moments, showing everyone how the Dreamtime story brings everything we are talking about to life.
We have corrected this in our online training modules. The Dreamtime story comes first. Aboriginal health workers are also much more central to the training. Aboriginal health workers are part of the presentation/training team and encouraged to take on a larger role.
Our focus shifted from ‘assessing children’ to helping children and their families connect, and through that connection their health outcomes would improve, because when families feel connected, they start to thrive, from attending more appointments—to spending more quality time with the people who care about them.
The implementation needs to be in parallel with the community, going on the journey together and not in segregation.
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Frequency (%) | |
---|---|
Identified as First Nations | |
Aboriginal or Torres Strait Islander | 19 (40.4) |
Prefer not to answer | 1 (2.1) |
Gender | |
Female | 41 (87.2) |
Male | 6 (12.8) |
Occupation | |
Aboriginal health practitioner/worker | 7 (14.9) |
Allied health | 18 (38.3) |
Education professional | 3 (6.4) |
Child Health Nurse | 5 (10.6) |
Child Safety Officer | 4 (8.5) |
Student | 1 (2.1) |
Other | 9 (19.1) |
Sector | |
Aboriginal Controlled Health Service | 11 (23.4) |
Non-government/not-for-profit | 11 (23.4) |
Queensland Health | 11 (23.4) |
Primary Health Networks | 2 (4.3) |
Department of Child Safety, Youth and Women | 4 (8.5) |
Education Queensland | 1 (2.1) |
Catholic/Private Education | 4 (8.5) |
Other | 3 (6.4) |
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Miller, L.; Shanley, D.C.; Page, M.; Webster, H.; Liu, W.; Reid, N.; Shelton, D.; West, K.; Marshall, J.; Hawkins, E. Preventing Drift through Continued Co-Design with a First Nations Community: Refining the Prototype of a Tiered FASD Assessment. Int. J. Environ. Res. Public Health 2022, 19, 11226. https://doi.org/10.3390/ijerph191811226
Miller L, Shanley DC, Page M, Webster H, Liu W, Reid N, Shelton D, West K, Marshall J, Hawkins E. Preventing Drift through Continued Co-Design with a First Nations Community: Refining the Prototype of a Tiered FASD Assessment. International Journal of Environmental Research and Public Health. 2022; 19(18):11226. https://doi.org/10.3390/ijerph191811226
Chicago/Turabian StyleMiller, Luke, Dianne C. Shanley, Marjad Page, Heidi Webster, Wei Liu, Natasha Reid, Doug Shelton, Karen West, Joan Marshall, and Erinn Hawkins. 2022. "Preventing Drift through Continued Co-Design with a First Nations Community: Refining the Prototype of a Tiered FASD Assessment" International Journal of Environmental Research and Public Health 19, no. 18: 11226. https://doi.org/10.3390/ijerph191811226
APA StyleMiller, L., Shanley, D. C., Page, M., Webster, H., Liu, W., Reid, N., Shelton, D., West, K., Marshall, J., & Hawkins, E. (2022). Preventing Drift through Continued Co-Design with a First Nations Community: Refining the Prototype of a Tiered FASD Assessment. International Journal of Environmental Research and Public Health, 19(18), 11226. https://doi.org/10.3390/ijerph191811226