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In Canada, people <jats:italic>diagnosed<\/jats:italic> with Fetal Alcohol Spectrum Disorder (FASD) represent a fraction people living with FASD. While social stigma may deter people from seeking an FASD diagnosis, other deterrents include the lack of screening and diagnostic referrals, cost of travelling to a clinic, and lack of clarity of how a diagnosis may improve supports and services. Preventing FASD and improving lifelong outcomes for people living with FASD requires a coordinated approach between prevention, diagnostic, intervention, and support efforts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the example of Newfoundland and Labrador, a province where 60% of the population lives in rural communities and benefits from being involved in national initiatives and partnerships, we discuss efforts underway in other Canadian provinces to address FASD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We make three recommendations that begin to address FASD\u2010specific needs in both rural and urban regions: a) a provincial FASD consultant position, b) an explicit partnership between provincial government and fasdNL, and c) increased access to FASD diagnostic teams.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While the recommendations are both modest and essential first steps, we also suggest that collaborations and resource\u2010sharing in FASD prevention and supports are more about doing things differently, rather than doing more.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.1378","type":"journal-article","created":{"date-parts":[[2018,9,10]],"date-time":"2018-09-10T10:13:37Z","timestamp":1536574417000},"page":"1215-1222","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The past, present, and future of fetal alcohol spectrum disorder work in Newfoundland and Labrador: A landscape paper for change"],"prefix":"10.1002","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6045-5558","authenticated-orcid":false,"given":"Katharine","family":"Dunbar Winsor","sequence":"first","affiliation":[{"name":"Department of Sociology Memorial University of Newfoundland  St. John's Newfoundland Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melody E.","family":"Morton Ninomiya","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health Institute for Mental Health Policy Research  Toronto Ontario Canada"},{"name":"Well Living House, St. Michael's Hospital  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,9,10]]},"reference":[{"issue":"3","key":"e_1_2_9_2_1","first-page":"e416","article-title":"Validation of the fetal alcohol spectrum disorder (FASD) 4\u2010digit diagnostic code","volume":"20","author":"Astley S. 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