{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:35:15Z","timestamp":1789724115374,"version":"4.0.1"},"reference-count":48,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T00:00:00Z","timestamp":1557187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000155","name":"Social Sciences and Humanities Research Council of Canada","doi-asserted-by":"publisher","award":["612 2018-0187"],"award-info":[{"award-number":["612 2018-0187"]}],"id":[{"id":"10.13039\/501100000155","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Canadian Institute for Health Research","award":["150430"],"award-info":[{"award-number":["150430"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The association between fetal alcohol spectrum disorder (FASD), residential schools and subsequent assimilatory policies in Canada is of such significance that it was included in the groundbreaking Truth and Reconciliation Commission of Canada\u2019s Final Report through Call to Action #33, which focuses on collaboratively developing FASD prevention programs in Indigenous communities. A consensus statement with eight tenets for enacting Call to Action #33 was co-developed in May 2017 using a Two-Eyed Seeing approach during and after a meeting on Indigenous approaches to FASD prevention held in Canada. The consensus statement provides guidance for creating community-based, culture-led FASD prevention programs in Indigenous communities. The eight tenets reflect the diverse perspectives of Indigenous and non-Indigenous participants, are grounded in available research evidence, and align with Indigenous worldviews and wellness models. This paper uses the consensus statement and eight exemplary FASD prevention programs from Indigenous communities and organizations across Canada to highlight identity, culture, and relationships as central elements of FASD prevention in Indigenous communities. The consensus statement provides guidance for developing community- and culture-led FASD prevention programs and highlights the importance of Indigenous knowledge systems in developing and researching FASD prevention in, and with, Indigenous communities.<\/jats:p>","DOI":"10.3390\/ijerph16091589","type":"journal-article","created":{"date-parts":[[2019,5,9]],"date-time":"2019-05-09T08:19:59Z","timestamp":1557389999000},"page":"1589","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Collaborative Action on Fetal Alcohol Spectrum Disorder Prevention: Principles for Enacting the Truth and Reconciliation Commission Call to Action #33"],"prefix":"10.3390","volume":"16","author":[{"given":"Lindsay","family":"Wolfson","sequence":"first","affiliation":[{"name":"Centre of Excellence for Women\u2019s Health, Vancouver, BC V6H 3N1 Canada"},{"name":"Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC V5R 0A4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Poole","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Women\u2019s Health, Vancouver, BC V6H 3N1 Canada"},{"name":"Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC V5R 0A4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0196-3410","authenticated-orcid":false,"given":"Melody","family":"Morton Ninomiya","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health, London, ON N6G 4X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Rutman","sequence":"additional","affiliation":[{"name":"Nota Bene Consulting Group, Victoria, BC V8R 1P8, Canada"},{"name":"School of Social Work, University of Victoria, Victoria, BC V8P 5C2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry","family":"Letendre","sequence":"additional","affiliation":[{"name":"Alexis Nakota Sioux Nation, Glenevis, AB T0E 0X0, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toni","family":"Winterhoff","sequence":"additional","affiliation":[{"name":"St\u00f3:l\u014d Service Agency, Chilliwack, BC V2R 4G5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Finney","sequence":"additional","affiliation":[{"name":"St\u00f3:l\u014d Service Agency, Chilliwack, BC V2R 4G5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Carlson","sequence":"additional","affiliation":[{"name":"Department of Educational Psychology, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Prouty","sequence":"additional","affiliation":[{"name":"Skidegate Health Centre, Skidegate, BC V0T 1S1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"McFarlane","sequence":"additional","affiliation":[{"name":"Lakeland Centre for Fetal Alcohol Spectrum Disorder, Cold Lake, AB T9M 1P1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lia","family":"Ruttan","sequence":"additional","affiliation":[{"name":"Independent Scholar, Edmonton, AB T6J 0V5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Murphy","sequence":"additional","affiliation":[{"name":"Lakeland Centre for Fetal Alcohol Spectrum Disorder, Cold Lake, AB T9M 1P1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Stewart","sequence":"additional","affiliation":[{"name":"Kermode Friendship Society, Terrace, BC V8G 2N7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Lawley","sequence":"additional","affiliation":[{"name":"Kermode Friendship Society, Terrace, BC V8G 2N7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy","family":"Rowan","sequence":"additional","affiliation":[{"name":"Mount Carmel Clinic, Winnipeg, MB R2W 5L4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,5,7]]},"reference":[{"key":"ref_1","unstructured":"National Collaborating Centre for Aboriginal Health (2014). Strong Women, Strong Nations: Aboriginal Maternal Health in British Columbia, National Collaborating Centre for Aboriginal Health."},{"key":"ref_2","first-page":"28","article-title":"Aboriginal midwifery: A model for change","volume":"6","author":"Skye","year":"2010","journal-title":"J. Aborig. Health"},{"key":"ref_3","unstructured":"Tait, C.L. (2003). Fetal Alcohol Syndrome among Aboriginal People in Canada: Review and Analysis of the Intergenerational Links to Residential Schools, The Aboriginal Healing Foundation."},{"key":"ref_4","unstructured":"First Nations Child and Family Caring Society, and Pauktuutit Inuit Women of Canada (2006). FASD Training Study: Final Report, First Nations Child and Caring Society of Canada."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1177\/1043659612452006","article-title":"Northern British Columbia Aboriginal mothers: Raising adolescents with Fetal Alcohol Spectrum Disorder","volume":"24","author":"Johnston","year":"2013","journal-title":"J. Transcult. Nurs."},{"key":"ref_6","unstructured":"Poole, N., Gelb, K., and Trainor, J. (2009). Preventing FASD through Providing Addictions Treatment and Related Supports for First Nations and Inuit Women in Canada\u2014Summary, British Columbia Centre of Excellence for Women\u2019s Health."},{"key":"ref_7","unstructured":"Aguiar, W., and Halseth, R. (2015). Aboriginal Peoples and Historic Trauma: The Processes of Intergenerational Transmission, National Collaborating Centre for Aboriginal Health Canada."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1017\/cls.2014.8","article-title":"The truth and reconciliation commission of Canada: Genesis and design","volume":"29","author":"Nagy","year":"2014","journal-title":"Can. J. Law Soc."},{"key":"ref_9","unstructured":"Truth and Reconciliation Commission of Canada (2015). Honouring the Truth, Reconciling for the Future: Summary of the Final Report of the Truth and Reconciliation Commission of Canada, TRC."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1177\/0886260507312290","article-title":"Historical trauma in American Indian\/Native Alaska communities: A multilevel framework for exploring impacts on individuals, families, and communities","volume":"23","year":"2008","journal-title":"J. Interpers. Violence"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Gonzales, K.L., Jacob, M.M., Mercier, A., Heater, H., Nall Goes Behind, L., Joseph, J., and Keurshner, S. (2018). An indigenous framework of the cycle of fetal alcohol spectrum disorder risk and prevention across the generations: Historical trauma, harm and healing. Ethn. Health.","DOI":"10.1080\/13557858.2018.1495320"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"66","DOI":"10.7202\/1071794ar","article-title":"Contemporary practice of traditional Aboriginal child rearing: A review","volume":"9","author":"Muir","year":"2014","journal-title":"First Peoples Child Fam. Rev."},{"key":"ref_13","unstructured":"Pacey, M. (2010). Fetal Alcohol Syndrome & Fetal Alcohol Spectrum Disorder among Aboriginal Canadians: Knowledge Gaps, National Collaborating Centre for Aboriginal Health."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.ejmg.2016.09.010","article-title":"Prevalence of alcohol consumption during pregnancy and Fetal Alcohol Spectrum Disorders among the general and Aboriginal populations in Canada and the United States","volume":"60","author":"Popova","year":"2017","journal-title":"Eur. J. Med Genet."},{"key":"ref_15","unstructured":"Institute for Integrative Science and Health (2007). Integrative science: Enabling concepts within a journey guided by trees holding hands and two-eyed seeing. Two-Eyed Seeing Knowledge Sharing Series, Cape Breton University."},{"key":"ref_16","first-page":"179","article-title":"Ethical spaces and places: Indigenous cultural safety in British Columbia health care","volume":"13","author":"Greenwood","year":"2017","journal-title":"Altern. Int. J. Indig. Peoples"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/1747-597X-9-34","article-title":"Cultural interventions to treat addictions in Indigenous populations: Findings from a scoping study","volume":"9","author":"Rowan","year":"2014","journal-title":"Subst. Abuse Treat. Prev. Policy"},{"key":"ref_18","unstructured":"Nathoo, T., and Poole, N. (2017). Indigenous Approaches to FASD Preven on: Indigenous Mothering, Centre of Excellence for Women\u2019s Health."},{"key":"ref_19","unstructured":"Canada FASD Research Network, Thunderbird Partnership Foundation, and Centre of Excellence for Women\u2019s Health (2017). Consensus Statement: Eight Tenets for Enacting the Truth and Reconciliation Commission\u2019s Call to Action #33, Thunderbird Partnership Foundation."},{"key":"ref_20","unstructured":"Health Canada, and Assembly of First Nations (2015). First Nations Mental Wellness Continuum Framework, Health Canada."},{"key":"ref_21","unstructured":"First Nations Addictions Advisory Panel (2011). Honouring Our Strengths: A Renewed Framework to Address Substance Use Issues among First Nations People in Canada."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"89","DOI":"10.7870\/cjcmh-2015-014","article-title":"First Nations mental wellness: Mobilizing change through partnership and collaboration","volume":"34","author":"Restoule","year":"2015","journal-title":"Can. J. Community Ment. Health"},{"key":"ref_23","unstructured":"National Native Addictions Partnership Foundation Inc (2015). Indigenous Wellness Framework and Outcomes, National Native Addictions Partnership Foundation Inc."},{"key":"ref_24","first-page":"135","article-title":"Making a place of respect: Lessons learned in carrying out consent protocol with First Nations Elders","volume":"7","author":"Baydala","year":"2013","journal-title":"Prog. Community Health Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"87","DOI":"10.17953\/AICRJ.41.1.RUTTAN","article-title":"Wicubami: Honouring Alexis Nakota Sioux Ish?awimin (Elders) though kinship, language, spirit and research","volume":"41","author":"Ruttan","year":"2017","journal-title":"Am. Indian Cult. Res. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1177\/1049732316657812","article-title":"Understanding the life histories of pregnant-involved young Aboriginal women with substance use experiences in three Canadian cities","volume":"27","author":"Shahram","year":"2017","journal-title":"Qual. Health Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1007\/s40429-016-0116-9","article-title":"Understanding addictions among Indigenous people through social determinants of health frameworks and strengths-based approaches: A review of the research literature from 2013 to 2016","volume":"3","author":"McKenzie","year":"2016","journal-title":"Curr. Addict. Rep."},{"key":"ref_28","unstructured":"Loppie, S., Reading, C., and de Leeuw, S. (2014). Aboriginal Experiences with Racism and Its Impacts, National Collaborating Centre for Aboriginal Health."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1081\/ADA-200056813","article-title":"Preventing Alcohol and Drug Exposed Births in Washington State: Intervention Findings from Three Parent-Child Assistance Program Sites","volume":"31","author":"Grant","year":"2005","journal-title":"Am. J. Drug Alcohol Abus."},{"key":"ref_30","first-page":"94","article-title":"Voices from the community: Developing effective community programs to support pregnant and early parenting women who use alcohol and other substances","volume":"8","author":"Nathoo","year":"2013","journal-title":"First Peoples Child Fam. Rev."},{"key":"ref_31","first-page":"e22","article-title":"Breaking the cycle: Measures of progress 1995\u20132005","volume":"4","author":"Motz","year":"2006","journal-title":"J. Fas. Int."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1038\/sj.jp.7200357","article-title":"The effect of integrating substance abuse treatment with prenatal care on birth outcome","volume":"20","author":"Sweeney","year":"2000","journal-title":"J. Perinatol."},{"key":"ref_33","unstructured":"Innu Roundtable Secretariat (2017). A Guide to the Innu Care Approach, Innu Roundtable Secretariat."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1177\/000841740807500107","article-title":"\u201cCircle of caring\u201d: A First Nations worldview of child rearing","volume":"75","author":"Gerlach","year":"2008","journal-title":"Can. J. Occup. Ther."},{"key":"ref_35","unstructured":"Advisory Panel for the Review of Federal Support for Fundamental Science (2017). Investing in Canada\u2019s Furture: Strengthening the Foundations of Canadian Research, Canada\u2019s Fundamental Science Review."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Badry, D., and Felske, A.W. (2013). An examination of the social determinants of health as factors related to health, healing and prevention of foetal alcohol spectrum disorder in a northern context\u2014The brightening our home fires project, Northwest Territories, Canada. Int. J. Circumpolar Health, 72.","DOI":"10.3402\/ijch.v72i0.21140"},{"key":"ref_37","unstructured":"Best Start Resource Centre (2012). The Sacred Journal from Preconception to Parenting, Best Start Resource Centre."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1007\/s10995-013-1242-9","article-title":"Integrating the Life Course into MCH Service Delivery: From Theory to Practice","volume":"18","author":"Brady","year":"2014","journal-title":"Matern. Child Health J."},{"key":"ref_39","unstructured":"Little Bear, L. (2000). Jagged Worldviews Colliding, UTP Distribution."},{"key":"ref_40","unstructured":"Tait, C. (2012). Transformative change: Can a community-based ethical framework improve FASD prevention and interventions in Indigenous health?. Proceedings of Fetal Alcohol Canadian Expertise (FACE) Research Roundtable, Department of Psychiatry, University of Saskatchewan."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"21","DOI":"10.3138\/cjpe.28.002","article-title":"To Case Study or Not to Case Study: Our Experience with the Canadian Government\u2019s Evaluation Practices and the Use of Case Studies as an Evaluation Methodology for First Nations Programs","volume":"28","author":"Johnston","year":"2013","journal-title":"Can. J. Program Eval."},{"key":"ref_42","unstructured":"Johnston, A. (2010). The Waawiyeyaa Evaluation Tool, Johnston Research."},{"key":"ref_43","unstructured":"Nota Bene Consulting Group, and British Columbia Centre of Excellence for Women\u2019s Health (2013). Community\/System Outcomes: Culturally Relevant Reporting and Accountability. Evaluation of FASD Prevention and FASD Support Programs, British Columbia Centre of Excellence for Women\u2019s Health."},{"key":"ref_44","unstructured":"Pei, J., Tremblay, M., Carlson, E., and Poth, C. (2017). PCAP in Alberta First Nation Communities: Evaluation Report, Policy Wise for Children & Families in collaboration with the University of Alberta."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Pei, J., Carlson, E., Tremblay, M., and Poth, C. (2019). Exploring the contributions and suitability of relational and community-centered fetal alcohol spectrum disorder (FASD) prevention work in First Nation communities. Birth Defects Res.","DOI":"10.1002\/bdr2.1480"},{"key":"ref_46","first-page":"29","article-title":"Ethical programming: Towards a community-centred approach to mental health and addiction programming in Aboriginal communities","volume":"6","author":"Tait","year":"2008","journal-title":"Pimatisiwin"},{"key":"ref_47","first-page":"167","article-title":"Preconception care: Clinical and policy implications of the preconception agenda","volume":"17","author":"Curtis","year":"2010","journal-title":"J. Clin. Outcomes Manag."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Symons, M., Pedruzzi, R.A., Bruce, K., and Milne, E. (2018). A systematic review of prevention interventions to reduce prenatal alcohol exposure and fetal alcohol spectrum disorder in indigenous communities. 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