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An Aboriginal Woman's Historical and Philosophical Enquiry to Identify the Outcomes of Prenatal Alcohol Exposure and Early

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An Aboriginal Woman's Historical and Philosophical Enquiry to Identify the Outcomes of Prenatal Alcohol Exposure and Early An Aboriginal woman’s historical and philosophical enquiry to identify the outcomes of prenatal alcohol exposure and early life trauma in Indigenous children who live in Aboriginal communities in Queensland. Lorian Hayes Bachelor of Applied Health Sciences (Indigenous Primary Health Care) Hons Master of Applied Epidemiology A thesis submitted for the degree of Doctor of Philosophy at The University of Queensland in 2018 Faculty of Medicine 1 Preface This thesis describes my research journey over the past 20 years as I have striven to understand the effects that alcohol use in pregnancy has on the health of Aboriginal women and their children and families. 2 Abstract This doctoral thesis results from the experiences, findings and interpretation of several research projects that I have embarked on throughout my personal, professional and academic life in the area of alcohol and pregnancy in conjunction with early life trauma. My journey to identify the outcomes of prenatal alcohol exposure and early life trauma in Indigenous children who live in Aboriginal communities in Queensland has spanned the last two decades. During this journey I have discovered an understanding of the links between alcohol and pregnancy and healthy babies. I have been through a series of academic awakenings as well as personal insights. As an Aboriginal woman and student in a vast educational institution, I have had difficulty in separating the academic discovery from the personal. My approach throughout this thesis consists of four different methods in data collection, I have used participatory action research, quantitative and qualitative methods along with a narrative style explication method that will transfer the lessons that I have learned to the audience or readers, in relation to academic knowledge that I have gained as well as the enormous depth of personal experience. The important process of interacting with the community, developing a two-way form of respect, being included in the community, understanding the value of narratives, the validity in reporting and other qualitative methods has been a valuable experience. As Van Bronkhorst (2012) points out: “Learning together has the potential to honour the perspective of local communities and different cultural perspectives, and to entail an exploration of the inherent diversity and structural equity issues. Learning together also has the potential to develop an informed community of adults who feel empowered to address the issues of health and well-being in their own lives and to confront a health care system that ignores their informational needs.” This consideration of their cultural needs is vital to their health and wellbeing. By contextualizing literacy within the health field it addresses the development of discrete literacy skills, and even advocacy for behavioural change which strengthens people’s capacity to think critically about information leading to a greater sense of power and 3 control in their lives. Consequently, this thesis allows for a working definition of Health Literacy: “A model to engage groups in the development of health materials, while at the same time increasing their literacy levels and critical thinking skills to encourage lifelong interest in gaining, sharing and acting upon, health knowledge.” This investigation explored Aboriginal women’s perceptions and experiences of maternal alcohol consumption and the effects on the child. The outcome of this study was the conclusion that alcohol use is linked to a lifecycle of behaviours, and that alcohol use within Aboriginal communities can best be understood in terms of a life- cycle model of drinking behaviours. 4 Declaration by author This thesis is composed of my original work, and contains no material previously published or written by another person except where due reference has been made in the text. I have clearly stated the contribution by others to jointly-authored works that I have included in my thesis. I have clearly stated the contribution of others to my thesis as a whole, including statistical assistance, survey design, data analysis, significant technical procedures, professional editorial advice, financial support and any other original research work used or reported in my thesis. The content of my thesis is the result of work I have carried out since the commencement of my higher degree by research candidature and does not include a substantial part of work that has been submitted to qualify for the award of any other degree or diploma in any university or other tertiary institution. I have clearly stated which parts of my thesis, if any, have been submitted to qualify for another award. I acknowledge that an electronic copy of my thesis must be lodged with the University Library and, subject to the policy and procedures of The University of Queensland, the thesis be made available for research and study in accordance with the Copyright Act 1968 unless a period of embargo has been approved by the Dean of the Graduate School. I acknowledge that copyright of all material contained in my thesis resides with the copyright holder(s) of that material. Where appropriate I have obtained copyright permission from the copyright holder to reproduce material in this thesis and have sought permission from co-authors for any jointly authored works included in the thesis. Lorian Hayes, Candidate 5 Publications included in this thesis No publications included. Submitted manuscripts included in this thesis No manuscripts submitted for publication. Other publications during candidature HAYES, L. 2001. Grog Babies: Where Do They Fit in This Alcohol Life Cycle? Aboriginal and Islander Health Worker Journal, 25, 14-17. BOWER, C., HAYES, L. & BANKIER, A. 2009. Fetal Alcohol Spectrum Disorders Australian Government. HAYES, L. G. 2012. Aboriginal women, alcohol and the road to fetal alcohol spectrum disorder. The Medical Journal of Australia, 197, 21-23. WATKINS, R. E., ELLIOTT, E. J., MUTCH, R. C., PAYNE, J. M., JONES, H. M., LATIMER, J., RUSSELL, E., FITZPATRICK, J. P., HAYES, L., BURNS, L., HALLIDAY, J., D'ANTOINE, H. A., WILKINS, A., PEADON, E., MIERS, S., CARTER, M., O'LEARY, C. M., MCKENZIE, A. & BOWER, C. 2012. Consensus diagnostic criteria for fetal alcohol spectrum disorders in Australia: a modified Delphi study. BMJ Open, 2, 9. WATKINS, R. E., ELLIOTT, E. J., MUTCH, R. C., LATIMER, J., WILKINS, A., PAYNE, J. M., JONES, H. M., MIERS, S., PEADON, E., MCKENZIE, A., D’ANTOINE, H. A., RUSSELL, E., FITZPATRICK, J., O’LEARY, C. M., HALLIDAY, J., HAYES, L., BURNS, L., CARTER, M. & BOWER, C. 2012. Health professionals’ perceptions about the adoption of existing guidelines for the diagnosis of fetal alcohol spectrum disorders in Australia. BMC Pediatrics, 12, 69. WATKINS, R. E., ELLIOTT, E. J., HALLIDAY, J., O’LEARY, C. M., D’ANTOINE, H., RUSSELL, E., HAYES, L., PEADON, E., WILKINS, A., JONES, H. M., MCKENZIE, 6 A., MIERS, S., BURNS, L., MUTCH, R. C., PAYNE, J. M., FITZPATRICK, J. P., CARTER, M., LATIMER, J. & BOWER, C. 2013. A modified Delphi study of screening for fetal alcohol spectrum disorders in Australia. BMC Pediatrics, 13, 156. JONES, H. M., MCKENZIE, A., MIERS, S., RUSSELL, E., WATKINS, R. E., PAYNE, J. M., HAYES, L., CARTER, M., D’ANTOINE, H., LATIMER, J., WILKINS, A., MUTCH, R. C., BURNS, L., FITZPATRICK, J. P., HALLIDAY, J., O’LEARY, C. M., PEADON, E., ELLIOTT, E. J. & BOWER, C. 2013. Involving consumers and the community in the development of a diagnostic instrument for fetal alcohol spectrum disorders in Australia. Health Research Policy and Systems, 11, 26. WATKINS, R., ELLIOTT, E., WILKINS, A., LATIMER, J., HALLIDAY, J., FITZPATRICK, J., MUTCH, R., O'LEARY, C., BURNS, L., MCKENZIE, A., JONES, H., PAYNE, J., D'ANTOINE, H., MIERS, S., RUSSELL, E., HAYES, L., CARTER, M. & BOWER, C. 2014. Fetal alcohol spectrum disorder: development of consensus referral criteria for specialist diagnostic assessment in Australia. BMC Pediatrics, 14, 178. Book Chapter HAYES, L., D’ANTOINE, H. & CARTER, M. 2014. Addressing Fetal Alcohol Spectrum Disorder. In: DUDGEON, P., MILROY, H., WALKER, R. & CALMA, T. (eds.) Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. West Perth, Western Australia: Kulunga Research Network. Reports FOUNDATION FOR ALCOHOL RESEARCH AND EDUCATION 2013. The Australian Fetal Alcohol Spectrum Disorders Action Plan Canberra: FARE. AUSTRALIAN FASD COLLABORATION 2012. The Development of a Diagnostic Instrument for Fetal Alcohol Spectrum Disorders in Australia: Final Report. Commonwealth Department of Health and Ageing Awards 7 HAYES, L. International Star Fish Award Foetal Alcohol Spectrum Disorder: Having the courage to make a difference, 2011, 4th International Conference on Foetal Alcohol Spectrum Disorder, Vancouver, British Columbia, Canada, HAYES, L., Award for the dedication and commitment in raising the awareness, training and education of Foetal Alcohol Spectrum Disorder in the Indigenous communities throughout Australia, Australian Labor Party Foetal Alcohol Spectrum Disorder: 2005, Brisbane, Queensland, Australia Conference Presentations Presentations: invited – this includes workshops/seminars/forums HAYES, L. Foetal Alcohol Spectrum Disorder, Australian Aboriginal Women in Prison. Foetal Alcohol Spectrum Disorder and the Law: A Conversation about Current Research and Practices, 2013 Vancouver, Canada. (Invited presenter). HAYES, L. Trans-generational Trauma in Foetal Alcohol Spectrum Disorder. 5th International Conference on Foetal Alcohol Spectrum Disorder,
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