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Volume 8/Issue 3/Summer 2022
Leveraging Community-University Partnerships to Develop a
Strength-Based and Individualized Approach to Humanizing
Housing Service Delivery for Individuals with Fetal Alcohol
Spectrum Disorder (FASD)
Jacqueline Pei, Cheryl Poth, Elizabeth Carlson, Vannesa Joly,
Danielle Mattson, Nicol Patricny, Dorothy Badry, Richard Mugford,
Tracy Mastrangelo, Audrey McFarlane
A is eld report summarizes and advances key learnings for leveraging
community–university partnerships addressing housing service gaps for high-risk,
marginalized populations with complex needs. We describe our navigation of existing
and forged intersections to develop a strength-based and individualized approach
to humanizing housing service delivery for individuals with fetal alcohol spectrum
disorder (FASD). Our account is framed by four questions: why community and
university partners came together to develop a responsive approach through the
CanFASD network; who became key stakeholders in the partnership; how our
humanizing housing approach is guiding the navigation of complexities inherent
in service delivery for individuals with FASD; and what insights about creating
intersections are we applying to our community-university partnerships.
KW housing service delivery, community-university partnerships,
marginalized population needs, housing, fetal alcohol spectrum disorder
Why: Housing as a Human Right for All Requires a Responsive Approach to
Service Delivery
Adequate housing has been described as essential to one’s sense of dignity, safety, inclusion,
and ability to contribute to the fabric of neighbourhoods and societies (Public Research
Initiative, 2005). Canada has recognized that adequate housing is a fundamental human
right by ratifying the International Covenant on Economic, Social, and Cultural Rights
(ICESCR) and has agreed to take appropriate steps toward realizing the rights set out in
it. Yet, many Canadians struggle to secure adequate housing, and housing service gaps are
especially pronounced for high-risk marginalized populations with complex needs, including
individuals with fetal alcohol spectrum disorder (FASD), whose needs are not well understood
in the homeless serving sector (Badry et al., 2018). FASD is a diagnostic term that refers to
a broad spectrum of needs caused by prenatal alcohol exposure and the resultant injury to
the developing brain (Cook et al., 2016). FASD is a life-long disability and roughly 4% of
Canadians are formally diagnosed with it (Brownstone, 2005; Canada Fetal Alcohol Spectrum
56 J. Pei, C. Poth, E. Carlson, V. Joly, D. Mattson, N. Patricny, D. Badry, R. Mugford, T. Mastrangelo, A. McFarlane
Engaged Scholar Journal: Community-Engaged Research, Teaching and Learning
Disorder Research Network [CanFASD], 2018). Because the disorder often goes undetected
and can look and present dierently between individuals, many lack the necessary supports to
thrive in the community. Families and communities suggest that housing supports that oer a
more personalized approach are more likely to support healthy outcomes for this population
with complex needs.
Community organizations, in collaboration with specialized university-based researchers,
have largely been leading the initiatives toward realizing the fundamental human rights set out
in the ICESR. e Canada Fetal Alcohol Spectrum Disorder Research Network (CanFASD)
has been a leader as the rst collaborative, interdisciplinary FASD research network in the
world, with partners across the nation. CanFASD engages researchers, families, graduate
students, practitioners, program leaders, frontline workers, and community members who
receive services to advance research and service delivery—including housing supports (Badry
et al., 2019). CanFASD worked with the university-based Alberta Clinical and Community
Evaluation Research Team (ACCERT) to successfully partner with community members who
provided the impetus to develop a responsive approach to explore the question: How might we
support housing service delivery for marginalized individuals who have complex needs?
Our community–university partnership was founded on our shared beliefs that knowledge
arises from multiple sources and that respecting this diversity must be a cornerstone of any
work conducted. For this reason, we began by acknowledging what has been done previously
in this realm, which involved reviewing existing research and listening to those with lived
experience to inform our work. In our reading of literature, we sought to understand the gaps
in housing services for complex populations. However, we were not limited to what might still
be possible. By listening to our community and research partners, we sought to understand
the gaps they perceived between research and practice for individuals with FASD. Together
we started to understand the vast complexities of both the individual needs in the FASD
community as well as the systematic and functional needs within the housing community.
We committed to building a community-grounded place to move forward in a responsive
manner. Although the description that follows is presented in a linear manner, it is important
to note the iterative nature of this process as we engaged in multiple community consultations
throughout this experience to harness the expertise of our community and university partners.
Who: Diversity Was Essential for Understanding the Complexities of Housing Needs
and Partnership Roles
With a decade-long track record of forging successful community–university partnerships,
ACCERT was well-positioned to draw from diverse and interdisciplinary expertise and
experiences to advance the innovative thinking and practice this project required. A key
mission for ACCERT is equipping graduate student researchers to address the complex issues
they would encounter in their lifetime. For this project, our interdisciplinary team involved
faculty members and students from psychology and measurement elds of study with members
having expertise in neurodevelopmental research and best practices in working with individuals
with FASD together with our evaluation and community-based expertise to support an
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Volume 8/Issue 3/Summer 2022
interdisciplinary framework. Team roles were diverse and, in many cases, intersected spheres
of inuence; for instance, Pei is both a faculty member and senior research lead for CanFASD.
She acts to bridge the policy, practice, and research roles and thus helped to set the stage for
this partnership to emerge.
Critically, this project and the community–university partnership were initiated by
and roles negotiated with local members of the FASD community who were speaking on
behalf of and with individuals with FASD. As adults, unhoused individuals are vulnerable to
traumatization on the street, and many struggle with a variety of mental illnesses and substance
abuse problems alongside a great deal of stress and limited social support (Hulchanski et al.,
2009). In addition to the complex diculties experienced by individuals who are unhoused,
those who also have FASD may present with decits that aect their mental health and adaptive
functioning, which in turn further complicates their access to and maintenance of housing
(Astley, 2004). e number of unhoused individuals who have diagnosed or undiagnosed
FASD is unknown; however, frontline experts report that a large proportion of the unhoused
individuals they encounter are suspected to have FASD.
Together, the core partnership team (the authors of this paper) identied key community
stakeholders who were well-positioned to provide insight for addressing the following questions:
• What are the current barriers to housing success for individuals with FASD?
• What factors are associated with housing success for individuals with
FASD?
• How might a knowledge of the unique cognitive functions of those with
FASD better inform housing practices?
• How might knowledge of the process of providing housing supports
enhance proactive responses with the FASD community?
• What has facilitated successful housing for individuals with FASD?
• How might the co-creation of solutions among experts in dierent elds
generate guiding practices for individuals with FASD on their housing
journey?
How: Our Humanizing Approach Is Guiding the Navigation of the Complexities
Inherent in Housing Supports for Individuals with FASD
Recognizing the complexities inherent to the interrelated systems of local, provincial, and
federal initiatives, we employed a systems framework to inform the process of developing
our humanizing approach. Five activities informed the development; embedded within
this approach was an iterative process incorporating emerging insights, renements, and
identifying next steps (see Figure 1).
58 J. Pei, C. Poth, E. Carlson, V. Joly, D. Mattson, N. Patricny, D. Badry, R. Mugford, T. Mastrangelo, A. McFarlane
Engaged Scholar Journal: Community-Engaged Research, Teaching and Learning
Building upon our best practices for guiding service for individuals with FASD we completed
an extensive literature review focused on guiding housing practices (Pei et al., 2021). From
our review of 128 peer-reviewed articles, compelling evidence emerged for housing programs,
particularly the Housing First model (Adair et al., 2017; Aubry et al., 2015; Stergiopolous et
al., 2016; Woodhall-Melnick & Dunn, 2016). We identied key challenges for individuals
with FASD with non-abstinence-based housing and lack of consistent and long-term support
described as emerging factors related to housing tenure (Collins et al., 2012; Kirsh et al.,
2011). e lack of empirically based housing research specic to or including individuals with
FASD was noteworthy. ere was much to learn and integrate with the knowledge created
alongside our community partners about the unique needs of individuals with FASD.
Subsequently we held collaborative, multiday meetings focused on networking and
synergizing that brought together relevant researchers, service providers, system planners,
individuals with FASD, and caregivers of individuals with FASD to guide the group in an
appropriate direction. Of particular importance was engaging individuals from two dierent
communities of expertise—those from the FASD community and those from the housing
community—to identify gaps and barriers in service delivery. e core partnership team
initially identied and made contact with 66 potential attendees across Canada, with 40
agreeing to participate.
To begin, ACCERT provided a brief presentation on the state of the current research
in the housing eld alongside impactful presentations from community members describing
the unique needs of individuals with FASD. en the core partnership team facilitated small
group discussions intentionally composed of individuals with diverse expertise and roles.
Within these groups, participants tackled challenges in the eld, considered strengths to be
Figure 1. Five activities informing the development of our
humanizing approach to housing supports.
• What are the current barriers to housing success for individuals
with FASD?
• What factors are associated with housing success for individuals
with FASD?
• How might a knowledge of the unique cognitive functions of those
with FASD better inform housing practices?
• How might knowledge of the process of providing housing
supports enhance proactive responses with the FASD community?
• What has facilitated successful housing for individuals with FASD?
• How might the co-creation of solutions among experts in different
fields generate guiding practices for individuals with FASD on
their housing journey?
How: Our Humanizing Approach Is Guiding the Navigation of the
Complexities Inherent in Housing Supports for Individuals With FASD
Recognizing the complexities inherent to the interrelated systems of local, provincial,
and federal initiatives, we employed a systems framework to inform the process of
developing our humanizing approach. Five activities informed the development;
embedded within this approach was an iterative process incorporating emerging
insights, refinements, and identifying next steps (see Figure 1).
FFiigguurree 11..
Five activities informing the development of our humanizing approach to housing supports.
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Volume 8/Issue 3/Summer 2022
leveraged, and were charged with producing strategies or solutions for moving forward. Finally,
the groups reconvened to share, identify key themes, and advance possible actions.
Approval for the research study embedded within the networking and synergizing activity
was gained from the University of Alberta’s Research Ethics Board and, subsequently, all
appropriate measures were followed to ensure informed consent, protect condentiality, and
lessen power issues. Data was collected using surveys, documentation from discussions, and
observations. e collaborative event and the chance to be part of the creative process appeared
to motivate our community members to engage in action. ey expressed their frustration
with the status quo and desire to move beyond dialogue to create something that could catalyze
practice shifts, stating: “Enough talking, let’s make change!”
Following the networking and synergizing meetings, ACCERT led the in-depth analysis
and created a summary that was shared within the core partnership team. A clear understanding
emerged that a new approach to housing support was needed and to do so it was necessary to
move toward a strength-based individualized approach in which attaining healthy outcomes
was paramount. From the community perspective, this entailed a shift from a focus on problems
to be solved, as they expressed that such a decit lens makes the issue of housing individuals
with FASD seem hopeless, toward identifying success experiences that might be replicated.
Hopefulness also emerged as a key perspective within these meetings. Fueled by hope, a
readiness for action was expressed: “It will take time and hard work, but it is possible.” While
acknowledging that “the problem is complex,” participants also asserted that “there is a will to
change things.” e meetings were viewed as a “great start to addressing the issue of housing
and FASD” in collaborative action toward a harmonizing framework—a “strong foundation on
which to build together.” Attendees appreciated that this meeting allowed two sectors to come
together, and they stated that “working on the operations level to develop a usable framework
for housing is the best way forward.”
As we shared our ndings with the extended partnership and beyond, the feedback we
heard was that community members wanted further opportunities to engage in collaborative
conversations and to expand them to include housing landlords and government ocials
responsible for housing policy and practices. It became apparent through our intentional/
strategic connections with leaders in the homeless serving sector that we had successfully
provided a safe space for the voices of community leaders to be heard on working with this
vulnerable, marginalized population. We heard that conversations were continuing within
communities of practice, generating ripples within the larger practice and policy communities,
and creating opportunities for continued discussion. Such opportunities included our meetings
with provincial health services to explore the synergies between the work occurring between
our projects. is synergistic collaboration led to us all visiting a permanent supportive housing
program, successfully supporting individuals with FASD. Meetings even extended to a team
who was creating a business case for housing individuals with FASD and a group considering
specic architectural housing needs for programs working with individuals with FASD. Since
this time, momentum for these meaningful conversations has been maintained through
conferences, service meetings, and funding applications to enact and study novel ideas.
60 J. Pei, C. Poth, E. Carlson, V. Joly, D. Mattson, N. Patricny, D. Badry, R. Mugford, T. Mastrangelo, A. McFarlane
Engaged Scholar Journal: Community-Engaged Research, Teaching and Learning
What: New Insights About Creating Intersections Guide a Responsive Approach to
Housing Service Delivery
Contributions to the community from this work continue and the work and the synergies
generated continue to inuence practice and establish conditions for forging relationships
that are bridges for innovation and community empowerment. We were also fortunate that
the project timing aligned with government initiatives in which housing initiatives had been
prioritized, thereby creating conditions for this work to align with policy and practice initiatives.
People Create Essential Intersections for Community and University Partnerships
Careful consideration in identifying and engaging key community and university stakeholders
as well as clarifying our philosophy of practice at the outset was essential. is consideration
allowed the partnership to engage with genuine curiosity and honour diverse perspectives
essential for solving challenges related to housing and FASD. e community stakeholders
were comprised of individuals from various backgrounds whose experiences and positions
provided them with unique abilities to support the intersection of ideas in dierent ways.
Four key partnership roles emerged, each with unique characteristics: brokers, visionaries,
innovators, and experts. Whereas the professional links of brokers within both the university
and community settings aorded unique synergy opportunities, the willingness of visionaries
to take risks while imagining dierent outcomes was integral in creating and upholding a
safe space for shared discovery. Similar to visionaries, the willingness of innovators to try new
things and think dierently about their work in pursuit of optimized outcomes helped nd
new approaches to long-existing challenges often experienced by those with experiences related
to housing instability and FASD. e valuing and recognition of those with lived experience as
experts alongside researcher expertise allowed the nal outcome to be relevant and applicable in
the real world. Together the brokers, visionaries, innovators, and experts created intersections
of ideas, experiences, and practicalities to imagine novel solutions based on existing knowledge
and practices without being hindered by those same things.
Intentionality Creates Processes Conducive to Intersections of Ideas
By integrating diverse stakeholders and generative methods we were able to create intersections
among ideas to advance our thinking; for example, combining the literature review with the
content obtained in meetings moved us beyond traditional research evidence. e complexity
of the presenting issue and lack of evidence to guide us required that we be innovative in our
thinking by seeking evidence that might be obtained through opportunities for generative and
integrative thinking. Systematic and ongoing data collection, in which all data was viewed as
equal and meaningful, allowed for ideas to emerge based on consensus or emphasis rather than
source. is approach contributed to credibility at all levels and reduced perceptions of valuing
based on educational level or social/professional position.
As co-creators of knowledge, we created a safe space where everyone was equal in their
learning, and it was safe to “not know.” In this setting, lling information gaps became the goal
rather than the exception. e ensuing respect was characterized by expressions of appreciation
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between all attendees—many of whom quickly advanced from strangers, in some instances
from two divided groups (i.e., housing and FASD, or families and support providers), into an
integrated team within which each voice was necessary, valued, and respected.
Operating from a well-dened guiding philosophy, we spoke to the shared valuing of lived
experiences, practical knowledge, and traditional research. We sought equity and balance during
meetings. Small, diverse groups aorded each participant a position of relative expertise that
fostered their willingness to contribute. We recorded all information provided and identied
emergent themes and core ideas, which were integrated into the report then distributed for
feedback. rough this process and with ongoing interactions with our stakeholders, we
employed a process of negotiation, proposing, and altering in response to feedback. We quickly
realized that we did not need to include every idea, but that we did need to include some. It
was necessary that we take a stand and produce content that allowed stakeholders to see their
voice and to suggest changes. We learned that co-creation requires some degree of structure
and support to leverage the wisdom of the larger communities in strategic ways.
Momentum Creates Ongoing Opportunities for Expanding Intersections
In taking our housing framework beyond the project, we faced the most daunting challenge:
distributing the materials in a meaningful way to facilitate uptake. Fortunately, we had
set the tone for partnership and engagement that are foundational to this element. In our
collaborative work, we were informed that a large document is rarely accessible to community
members. Even though team members might appreciate the content; turning it into actions
was another matter. us, we learned the importance of having component parts to our nal
project. Based on our process of co-creation, we generated stand-alone materials that allowed
for program users to best access the information they needed within their program. is
promoted tailoring of content and continued co-creation and engagement of the community
as stakeholders identied key elements. Additionally, recognizing the power of our stakeholder
group, we named all partners who participated in the document’s development and ensured
they received a copy of our ndings that they could share; thus, increasing the probability
that the contents would be more widely communicated. In essence, we shared ownership and
empowered stakeholders to become advocates to continue building the community of practice
that was catalyzed during this developmental process.
Conclusion: Successful Community–University Partnerships Require Readiness
e readiness of a community of partners, their willingness to engage in a collaborative process,
and their commitment to move forward created the necessary synergies for innovation and
impact around housing solutions for individuals with FASD. In particular, this partnership
beneted from the political landscape of 2019 wherein the Governor General signed into
law Bill C-97, which contained the National Housing Strategy Act and the federal right to
housing legislation. A key outcome is the legislation creating new accountability bodies that
will proactively monitor implementation of the right to housing and can investigate systemic
barriers to accessing housing.
62 J. Pei, C. Poth, E. Carlson, V. Joly, D. Mattson, N. Patricny, D. Badry, R. Mugford, T. Mastrangelo, A. McFarlane
Engaged Scholar Journal: Community-Engaged Research, Teaching and Learning
Relational approaches to housing demonstrate understanding of the complex interplay
of individual, relational, societal, cultural, and historical factors that have resulted in the
individuals’ experience of being unhoused and allows for a true connection to be made so
that person-centered work can occur. e interconnected nature of all that surrounds housing
needs was reected upon by community experts who not only called for systems-level change
but were willing to become agents of change themselves. Together we learned that we do
not always need to do more, we need to do it dierently and without truly listening to one
another we will persist down the wrong path. We understood the necessity of shifting from
conventional, depersonalized categorical approaches to housing service provision and evaluation
to instead oering a harmonizing, translational, relational, person-centered, process-oriented,
and systems-informed approach for practice.
About the Authors
Dorothy Badry is a professor in the Faculty of Social Work, University of Calgary with 16 years
in child welfare. Research focus includes FASD and child welfare issues, suicide prevention in
FASD, disability, FASD prevention, housing and homelessness, post-secondary education on
FASD and child advocacy.
Elizabeth Carlson is a school and clinical child psychology graduate student at the University
of Alberta. Elizabeth takes a collaborative, wholistic, and strengths-based approach to working
with youth with complex needs. She strives to learn ways of improving assessment practices to
best serve youth and their families.
Vannesa Joly is enrolled in the School and Clinical Child Psychology (SCCP) doctoral
program at the University of Alberta. She completed her Masters of Education in 2020 and a
Bachelor of Arts in Psychology in 2017, at the University of Alberta. Vannesa is enthusiastic
about community-based research and program evaluation.
Tracy Mastrangelo has focused her career in the social work and education elds. Her
work has focused primarily on supporting families and children/youth with complex needs
through relational approaches to support individual success. Tracy has a Master’s degree in
Interdisciplinary Studies with a focus on psychosocial interventions in school communities.
Danielle Mattson is a PhD student in the University of Alberta’s School and Clinical Child
Psychology program. She is also a member of the ACCERT research team and is particularly
interested in studying mental health and the factors that contribute to positive psychosocial
outcomes for youth with complex needs.
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Audrey McFarlane is the Executive Director for the Canada Fetal Alcohol Spectrum Disorder
Research Network. She was one of the founders of the Lakeland Centre for FASD and led
this organization for almost 20 years. As the Executive Director of the national research
network in FASD, she directs and encourages research in areas of FASD that is meaningful
to families, individuals with FASD, policy makers, service providers and to promote healthy
pregnancies.
Richard Mugford has spent his career developing and managing programs addressing
homelessness for youth, families, and individuals, as well as programs that support individuals
and families living with an FASD.
Nicol Patricny is a registered psychologist in Alberta who provides clinical services to individuals
experiencing occupational stress injuries. She graduated from the School and Clinical Child
Psychology doctoral program and Counselling Psychology Master’s program at the University
of Alberta. Her research has focused on protective factors in at-risk populations
Jacqueline Pei (corresponding author) is a Professor in the Department of Educational Psychology
at the University of Alberta, and co-founder of the Alberta Clinical and Community-Based
Evaluation Research Team. She is Senior Research Lead for the Canada FASD Research
Network which supports her interest in linking research, policy, and practice. Email: jpei@
ualberta.ca
Cheryl Poth is a professor in the Centre for Applied Measurement and Evaluation within the
Department of Educational Psychology, Faculty of Education, University of Alberta, and co-
founder of the Alberta Clinical and Community-Based Evaluation Research Team. Her research
interests include evaluation use with particular emphasis on developmental, participatory, and
collaborative evaluations.
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