Maternal and Child Health Journal

, Volume 11, Issue 4, pp 385–393 | Cite as

Fetal Alcohol Spectrum Disorder Prevention Approaches among Canadian Physicians by Proportion of Native/Aboriginal Patients: Practices during the Preconception and Prenatal Periods

  • Suzanne Tough
  • Margaret Clarke
  • Jocelynn Cook
Original Paper


Objective: To examine if physician knowledge and practices related to fetal alcohol spectrum disorders (FASD) and its prevention vary based on the proportion of Native/Aboriginal patients served. Methods: A questionnaire was mailed to a national random sample of Canadian physicians between October 2001 and May 2002. The main outcome measure was responses regarding knowledge about and prevention of FASD. Bivariate analysis was used to compare practice patterns and knowledge between those who cared for a higher proportion (≥10%) and a lower proportion (<10%) of Native/Aboriginal patients. Results: The overall response rate was 39.4% (1,700/4,313), and 21.4% of physicians reported that ≥10% of their clinical practice was comprised of Native/Aboriginal patients. Those caring for a greater proportion of Native/Aboriginal patients were significantly (p<0.05) more likely to discuss sexual and emotional abuse (approximately 20% vs. 10%) and a history of addictions (52% vs. 44%) with women of childbearing age. In prenatal interviews, they were also significantly (p<0.05) more likely to routinely include a history of addictions treatment (70% vs. 62%) and drinking prior to pregnancy awareness (91% vs. 85%), as well as more likely to ask about evidence of alcohol related defects in other children (50% vs. 37%), and discuss the drinking pattern of the patient–s partner (25% vs. 18%). Conclusions: Physicians who had a higher proportion of Native/Aboriginal patients appeared to be more attuned to the issues of FASD and to assess risk in a more comprehensive manner. However, support for improved identification of women at risk and referral opportunities is warranted.


Preconception care Prenatal care Fetal alcohol spectrum disorders Physician practice patterns Native/Aboriginal women 



We would like to acknowledge the financial contribution of Health Canada to this survey as well as the support of the Calgary Health Region. We thank Health Canada and the FAS National Advisory Committee for their support on survey development and the professional organisations for their support and assistance. Also, we would like to recognise the assistance of Lysanne Delogne, Elaine Foulkes, Monica Jack, Janelle Jubb, Christine Loock, Laura Schorn, and Jonathan Snider.


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Suzanne Tough
    • 1
    • 2
    • 3
    • 5
  • Margaret Clarke
    • 1
  • Jocelynn Cook
    • 4
  1. 1.Department of PaediatricsUniversity of CalgaryCalgaryCanada
  2. 2.Department of Community Health SciencesUniversity of CalgaryCalgaryCanada
  3. 3.Decision Support Research TeamCalgary Health RegionCalgaryCanada
  4. 4.First Nations and Inuit Health BranchHealth CanadaCalgaryCanada
  5. 5.Alberta Children–s Hospitalc/o Decision Support Research TeamCalgaryCanada

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