Introduction: Current literature about interventions for adults with fetal alcohol spectrum disorder (FASD) is limited, which is a concern, due to the high prevalence of FASD. FASD creates lifelong physical, mental, cognitive and behavioral deficits, which impacts many aspects of daily living. Community-based interventions are necessary to better support adults with FASD and provide them with the opportunity to achieve success in their daily lives and social participation. This scoping review aimed to identify elements for developing successful community-based interventions for these individuals. Method: A search was conducted in the MEDLINE, PsycINFO, CINAHL, and EMBASE databases and supplementary gray literature was resourced. Articles were selected based on inclusion-exclusion criteria, and a thematic analysis was completed to identify and present relevant findings. Results: Seven articles met selection criteria and were included in this review. Six emerging themes were identified: inclusion of a functional context, individualized support, education for service providers, structure and routine, utilizing a strengths-based approach, and environmental adaptations. These themes were used to present the findings related to the elements necessary for developing interventions for adults with FASD. Conclusion: The results indicate that the identified elements may be necessary to develop successful interventions, especially community-based interventions, for adults with FASD.

The Oregon Health Study was a groundbreaking experiment in which uninsured participants were randomized to either apply for Medicaid or stay with their current care. The study showed that Medicaid produced numerous important socioeconomic and health benefits but had no statistically significant impact on hypertension, hypercholesterolemia, or diabetes. Medicaid opponents interpreted the findings to mean that Medicaid is not a worthwhile investment. Medicaid proponents viewed the experiment as statistically underpowered and, irrespective of the laboratory values, suggestive that Medicaid is a good investment. We tested these competing claims and, using a sensitive joint test and statistical power analysis, confirmed that the Oregon Health Study did not improve laboratory values. However, we also found that Medicaid is a good value, with a cost of just $62 000 per quality-adjusted life-years gained.