Fetal alcohol spectrum disorder diagnostic clinics in Canada: "It wouldn't happen if nobody wanted it to happen".

Background: We address the question: If you wanted to start a fetal alcohol spectrum disorder (FASD) diagnostic clinic, what would you need to do, think about, and plan for, from a policy perspective? Our aims were to understand how clinics are developed and established and the key factors that facilitate their success.

Method: Within a pragmatist epistemology, we conducted a basic qualitative study using semistructured interviews. Interviews were conducted with 12 key informants from 10 diagnostic clinics. Data were analysed using iterative thematic analysis.

Results: We derived five themes pertaining to our objectives: (i) listening and responding to your community; (ii) community buy-in and practical steps; (iii) multidisciplinary team trust, respect, and collaboration; (iv) the clinic coordinator; and (v) promoting uniqueness and learning from each other.

Conclusions: Our findings demonstrated the importance of local, community-based planning, team cohesion, and opportunities for mentorship in the development of new FASD clinical services.