An evaluation of a program supporting Indigenous youth through their FASD assessment

This dissertation was a program evaluation of a three-year program focusing on the intersection of health, justice and child welfare in relation to FASD where holistic, culturally-informed support services are provided to justice-involved Indigenous youth before, during, and after FASD assessments. Fetal alcohol spectrum disorder (FASD) is a diagnostic term used to describe the resulting neurodevelopmental impacts of prenatal alcohol exposure. Not only is FASD a health concern, but FASD is also a concern within justice and child welfare. There are several areas where an individual living with FASD may experience difficulties navigating the justice system and advocating for themselves. Children living with FASD are also more likely to be wards of child welfare agencies. At the heart of this Program, the focus is on exploring, revitalizing, and nurturing cultural connections and Indigenous identity. The scope of this evaluation focused on a formative and process evaluation which aimed to garner information for program improvement. A total of six Program staff and management and three Program advisory committee members participated in evaluation interviews developed by the evaluator, and 65 Program stakeholders participated in a program needs assessment survey. Evaluation data collection tools were developed in a participatory manner with the Program manager and staff. Qualitative data were hand-coded using thematic analyses. Findings from the evaluation showed the strengths of Indigenous youth living with FASD are plenty, yet also underscored the many challenges they face in accessing services and being supported. Several needs emerged from the evaluation, including needs around brain-based services, public awareness and education, culturally-informed services and professionals, holistic support, and access and exposure to culture and identity. Evaluation findings showed that the Program is reaching the right youth and the holistic design was perceived to be effective. While the Program rolled out differently than designed, adaptations were necessary to address the needs of those being served. Findings also highlighted that the Program is contributing to community level changes in stigma, and increases in cultural connections and identity among youth. Findings from this evaluation are informative for the Program in moving forward as several recommendations for program improvement were developed.