American Indian/Alaska Native/Native Hawaiian Initiative

Fetal Alcohol Spectrum Disorders

Community Health and Unity: Collaboration

Strategies

American Indians, Alaska Natives, and Native Hawaiians may have

different cultures and histories, but they share many values related

to cooperation and the importance of family and community. They also

have some health-related problems in common. Some Native

communities have higher rates of alcoholism, tuberculosis, and diabetes

than the general population. Women in communities with higher rates

of alcoholism may also be at higher risk for exposing their babies to

fetal alcohol spectrum disorders (FASD).

What Is FASD?

“FASD” is a term that describes a range of lifelong effects that can occur

in someone whose mother drank alcohol during pregnancy. Children

whose mothers drank during pregnancy may need surgeries to fix

physical problems. They may also have brain damage that can make it

hard to remember things or solve problems. They may not be able to

follow simple instructions or form friendships. These challenges may

make it difficult to focus in school or follow everyday routines. Children

with an FASD may require ongoing medical attention and special

programs and schools. The impact of these additional services can strain

family and community resources. Every year, at least 40,000 babies are

born with an FASD.*

Facts To Remember and Share

The following are important facts to remember and share about FASD

and drinking alcohol during pregnancy:

❖ FASD is permanent. It cannot be cured.

❖ FASD is 100 percent preventable. If a woman doesn’t drink when

she’s pregnant, her baby will not have an FASD.

❖ There is no known safe time, safe amount, or safe type of alcohol to

drink while pregnant. Beer and wine are just as harmful as hard liquor.

❖ If a pregnant woman stops drinking as soon as possible, she can

improve her chances of having a healthy baby.
Who Can Help?

Community groups can help with FASD prevention and treatment by

using collaboration strategies to educate members of their community

and to provide treatment options for children and adults with an FASD.

Communities benefit when tribal and community leaders, educators,

health care providers, and others share information and resources.

Collaboration is particularly important to Native groups who may place

greater trust in information and care coming from a community source

rather than from the “outside.” Collaborations may include many types

of partners. Potential partners in addressing FASD include:

❖ Tribal and community leaders

❖ School systems

❖ Indian Health Service, tribal, and other clinics and medical providers

❖ Social service agencies

❖ Behavioral health providers and programs

❖ Alcohol and drug treatment centers

❖ Head Start and other early intervention programs

❖ Local churches and faith-based organizations

❖ Legal and law enforcement organizations

❖ Nutrition programs, such as the Special Supplemental Nutrition

Program for Women, Infants, and Children (WIC)

Ways To Collaborate

Begin by identifying individuals and agencies in your tribe or community

who can assist in planning, developing, and doing FASD outreach and

prevention activities and providing treatment. Develop alliances and

networks with community health providers, social service providers, legal

professionals, schools, and others to help with referrals and information

sharing. Find out what treatment, education, and prevention activities

are already being provided and which groups (e.g., school children, clinic

patients) are benefiting from them. Consider ways to reach more

people. Here are some collaboration strategies that can help get the

word out about FASD and strengthen your tribe or community:

❖ Designate a tribal or community FASD coordinator to coordinate and

develop community education and prevention activities. Provide the

coordinator with adequate resources, training, and support.

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❖ Provide a consistent, simple message about drinking during

pregnancy and FASD that community partners can use.

❖ Create a list of FASD resources that are available in the community.

Include health care and treatment options for children, adolescents,

and adults with an FASD.

❖ Ask medical providers, including traditional providers, to:

- Talk with their patients about drinking before and during pregnancy

- Provide information about FASD to women of childbearing age

- Screen for alcohol use during pregnancy

- Become proficient in using motivational interviewing and brief

interventions—two ways of working with women who drink that

help them stop drinking

- Help women get into treatment who continue to drink

while pregnant

- Address underlying factors that may lead to maternal

drinking (e.g., trauma, depression)

❖ Work with nutrition programs such as WIC to distribute information

on drinking and pregnancy to all Native women of childbearing age.

❖ Work with restaurants, bars, and other places that serve or sell

alcohol to reduce sales to pregnant women through signage and

training for bartenders and wait staff. (For information on organizing

a campaign using warning signs, see www.cspinet.org/booze/

alcwarn.html, the Web site for the Center for Science in the

Public Interest. Also visit the Substance Abuse and Mental Health

Services Administration FASD Center for Excellence Web site,

www.fasdcenter.samhsa.gov, for printable materials ready for

posting.)

❖ Work with treatment programs and facilities to get priority admission

for women who are drinking during pregnancy.

❖ Help to create safe and sober living opportunities for pregnant

women and women with children.

American Indian/Alaska Native/Native Hawaiian Initiative

Fetal Alcohol Spectrum Disorders

Community Health and Unity: Collaboration Strategies

(Ways To Collaborate Continued)

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❖ Make sure there is support and case management for women in

recovery who are pregnant.

Native Treatment and Prevention Strategies

Some Native groups have looked to their traditional ways to address

FASD, emphasizing cultural values such as wellness and healing. The

Wellbriety Movement, developed by an American Indian nonprofit

organization, is a recovery process that uses the healthy principles, laws,

and values of traditional American Indian culture. It assists participants

in their recovery from alcohol and drugs and encourages lives of

wellness and wholeness rooted both in their own tribal cultures and in

the mainstream world. Similarly, many Alaskan programs stress the

importance of families in the recovery process and include practices

such as the steam bath, the Alaska Native version of the sweat lodge.

In Hawaii, a treatment program teaches Native Hawaiian clients about

their ancestors, history, and culture to help them see that they are

connected to something larger than themselves. The name of the

program is Ho’o Mau Ke Ola, which is Hawaiian for “to perpetuate life

as it was meant to be.”

Native groups have always looked to nature for inspiration and

understanding. They have studied the cycles of life and nature—

watching how all of nature works together to create a perfect balance.

Like the balance of nature, educators, community leaders, health care

providers, and others can work together to achieve greater harmony and

better health in their tribes and communities by spreading the FASD

prevention message and providing systems of care to meet the needs of

individuals with an FASD.

* May, P.A., and Gossage, J.P. 2001. Estimating the prevalence of fetal alcohol

syndrome: A summary. Alcohol Research & Health 25(3):159-167.

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Pregnancy is Sacred

For more information, visit fasdcenter.samhsa.gov or call 866-STOPFAS.

www.stopalcoholabuse.gov

DHHS Publication No. (SMA) 07-4264

Printed 2007