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      Reflections of experts by experience and research team members on research and development about a sensitive issue that attracts stigma

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          Abstract

          To reduce the number of alcohol-exposed pregnancies in antenatal care in the UK, the CHAMPION study objective was to design appropriate training and resources to develop the midwifery skills and confidence required to have an effective conversation about alcohol with pregnant women. Women with lived experience of drinking during pregnancy and ‘birth mums’ of a child with fetal alcohol spectrum disorders (FASD) were central to the co-creation process of the CHAMPION study. Some remarkable unintended positive outcomes resulted from this collaboration process for the women involved. They include increased confidence levels from newfound friendships with other mothers of children with FASD, and an acceptance that societal influences had a significant role to play in their personal situations. Reflecting on this authentic co-creation process has elicited important learning outcomes to inform future research design. The significance of excellent communication channels, robust support networks and genuinely valuing and respecting experts by experience as equal partners should not be underestimated.

          Most cited references3

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          A Survey of Health Care Professionals’ Knowledge and Experience of Foetal Alcohol Spectrum Disorder and Alcohol Use in Pregnancy

          Background: Foetal alcohol spectrum disorders (FASDs) are one of the most common preventable forms of developmental disability and congenital abnormalities globally, particularly in countries where alcohol is considered socially acceptable. Screening for alcohol use early in pregnancy can facilitate the detection of alcohol-exposed pregnancies and identify women who require further assessment. However, only a small percentage of children with FASD are identified in the United Kingdom. This may be partly attributed to a lack of awareness of the condition by National Health Service (NHS) health professionals. Methods: We developed an online survey to determine health care professionals’ (midwives, health visitors, obstetricians, paediatricians, and general practitioners) perceived knowledge, attitudes, and clinical practices relating to alcohol in pregnancy and FASD. Results: There were a total of 250 responses to the surveys (78 midwives, 60 health visitors, 55 obstetricians, 31 paediatricians, and 26 general practitioners). About 58.1% of paediatricians had diagnosed a patient with foetal alcohol syndrome (FAS) or FASD and 36.7% worried about stigmatisation with diagnosis. Paediatricians reported the highest levels of FASD training (54.8%), with much lower levels in midwives (21.3%). This was reflected in perceived knowledge levels; overall, only 19.8% of respondents knew the estimated UK prevalence of FASD for example. Conclusions: We identified a need for training in alcohol screening in pregnancy and FASD to improve awareness and recognition by UK professionals. This could improve patient care from the antenatal period and throughout childhood.
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            Multi-service prevention programs for pregnant and parenting women with substance use and multiple vulnerabilities: Program structure and clients’ perspectives on wraparound programming

            Background In Canada, several community-based, multi-service programs aimed at reaching vulnerable pregnant or parenting women with substance use and complex issues have emerged. These programs offer basic needs and social supports along with perinatal, primary, and mental health care, as well as substance use services. Evaluations of these ‘one-stop’ programs have demonstrated positive outcomes; nevertheless, few published studies have focused on how these programs are structured, on their cross-sectoral partnerships, and on clients’ perceptions of their services. Methods The Co-Creating Evidence (CCE) project was a three-year evaluation of eight multi-service programs located in six Canadian jurisdictions. The study used a mixed-methods design involving semi-structured interviews, questionnaires, output data, and de-identified client data. This article focuses on qualitative interviews undertaken with 125 clients during the first round of site visits, supplemented by interview data with program staff and service partners. Results Each of the programs in the CCE study employs a multi-service model that both reflects a wrap-around approach to care and is intentionally geared to removing barriers to accessing services. The programs are either operated by a health authority (n = 4) or by a community-based agency (n = 4). The programs’ focus on the social determinants of health, and their provision of primary, prenatal, perinatal and mental health care services is essential; similarly, on-site substance use and trauma/violence related services is pivotal. Further, programs’ support in relation to women’s child welfare issues promotes collaboration, common understanding of expectations, and helps to prevent child/infant removals. Conclusions The programs involved in the Co-Creating Evidence study have impressively blended social and primary care and prenatal care. Their success in respectfully and flexibly responding to women’s diverse needs, interests and readiness, within a community-based, wraparound service delivery model paves the way for others offering pre- and postnatal programming.
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              Alcohol Guidelines for Pregnant Women: Barriers and enablers for midwives to deliver advice

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                Author and article information

                Journal
                rfa
                Research for All
                UCL Press (UK )
                2399-8121
                16 February 2023
                : 7
                : 1
                : 02
                Affiliations
                [1 ]Department of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
                [2 ]FASD Network, Newtown Community Resource Centre, Stockton-on-Tees, UK
                [3 ]Institute for Clinical and Applied Health Research, Faculty of Health Sciences, University of Hull, Hull, UK
                [4 ]School of Health Sciences, Birmingham City University, Birmingham, UK
                Author notes

                **Co-author is anonymised and uses a pseudonym to protect their identity throughout this article. All anonymised co-authors are recognised as individual authors to the article and can be contacted by the corresponding author at time of publication, meeting the journal’s expectations of integrity and transparency required for publication.

                Author information
                https://orcid.org/0000-0002-5557-8358
                https://orcid.org/0000-0001-8551-442X
                https://orcid.org/0000-0002-0928-0438
                https://orcid.org/0000-0002-6418-0317
                Article
                10.14324/RFA.07.1.02
                dda2d3aa-3d30-4ae9-9ecd-3687e9328d4d
                Copyright 2023, Helen Howlett, Maria Catterick, Charlotte, Karen, Cheyenne, Franklin Onukwugha, Helen Roberts, Judith Dyson and Lesley Smith

                This is an open-access article distributed under the terms of the Creative Commons Attribution Licence (CC BY) 4.0 https://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

                History
                : 11 February 2022
                : 31 October 2022
                Page count
                References: 3, Pages: 8
                Funding
                Funded by: the NIHR RfPB programme
                Award ID: NIHR201128
                The CHAMPION (alCohol HArM PreventIOn iN pregnancy) study was funded by the NIHR RfPB programme (Grant Number: NIHR201128).
                Categories
                Practice case study

                Assessment, Evaluation & Research methods,Education & Public policy,Educational research & Statistics
                stigma,alcohol,pregnancy,FASD,co-production

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