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1.
Support Care Cancer ; 29(3): 1675-1681, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32772197

RESUMO

PURPOSE: To explore how Chinese Canadian patients with breast cancer make dietary choices and to understand their nutritional information needs in order to inform oncology healthcare providers about provision of optimal supportive care for this population. METHODS: Using interpretive description methodology, semi-structured interviews were conducted with first- and second-generation Chinese Canadian women aged 41-73 years living in Vancouver, Canada, who were diagnosed with breast cancer within the last 5 years. A follow-up focus group was held to validate emergent themes. RESULTS: Nineteen women were interviewed; 6 participated in the focus group. Their accounts of dietary experiences following diagnosis focused on three areas: dietary change (including desired and implemented changes that participants believed would benefit their health), facilitators and barriers to dietary change, and information and resource needs. Dietary changes reported included avoiding or consuming greater amounts of certain foods, and taking traditional Chinese medicine (TCM) and natural health products. Barriers to desired dietary change included the interplay between food preferences and family and social life, work-life balance, and cost and availability of specialty foods. Support from family members, however, facilitated participants' consumption of more whole and natural foods after their cancer diagnosis. Participants obtained food and nutrition information from a variety of sources but had difficulty determining the reliability and accuracy of information. They requested timely, credible, culturally-relevant, and easily accessible dietary information. CONCLUSIONS: Oncology healthcare providers would benefit from increased understanding of the dietary practices, including TCM, of Chinese women living with breast cancer. To facilitate communication and improve quality of care, healthcare professionals should provide credible and culturally relevant diet-related information in a variety of forms.


Assuntos
Neoplasias da Mama/dietoterapia , Preferências Alimentares/fisiologia , Adulto , Idoso , Povo Asiático , Canadá , Dieta , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
2.
Public Health Nutr ; 23(8): 1460-1471, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32157974

RESUMO

OBJECTIVE: To identify key school-level contexts and mechanisms associated with implementing a provincial school food and beverage policy. DESIGN: Realist evaluation. Data collection included semi-structured interviews (n 23), structured questionnaires (n 62), participant observation at public events (n 3) and scans of school, school district and health authority websites (n 67). The realist heuristic, context + mechanism → outcome configuration was used to conduct the analysis. SETTING: Public schools in five British Columbia (BC), Canada school districts. PARTICIPANTS: Provincial and regional health and education staff, private food vendors and school-level stakeholders. RESULTS: We identified four mechanisms influencing the implementation of BC's school food and beverage sales policy. First, the mandatory nature of the policy triggered some actors' implementation efforts, influenced by their normative acceptance of the educational governance system. Second, some expected implementers had an opposite response to the mandate where they ignored or 'skirted' the policy, influenced by values and beliefs about the role of government and school food. A third mechanism related to economics demonstrated ways vendors' responses to school demand for compliance with nutritional Guidelines were mediated by beliefs about food preferences of children, health and food. The last mechanism demonstrated how resource constraints and lack of capacity led otherwise motivated stakeholders to not implement the mandatory policy. CONCLUSION: Implementation of the food and beverage sales policy at the school level is shaped by interactions between administrators, staff, parent volunteers and vendors with contextual factors such as varied motivations, responsibilities and capacities.


Assuntos
Comércio , Serviços de Alimentação/economia , Política Nutricional , Instituições Acadêmicas , Bebidas/economia , Colúmbia Britânica , Criança , Alimentos/economia , Serviços de Alimentação/normas , Humanos , Entrevistas como Assunto , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Inquéritos e Questionários
3.
Public Health Nutr ; 19(10): 1842-51, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-26471409

RESUMO

OBJECTIVE: Undernutrition is prevalent among pregnant women in Cambodia. The provision of fortified dietary supplements is one strategy to help pregnant women meet their nutritional needs. Corn Soya Blend Plus (CSBP) is a widely used prenatal dietary supplement in areas with high rates of undernutrition and food insecurity. However, little is known about its acceptability during pregnancy. The present study aimed to identify factors that affected the acceptability and consumption of CSBP supplements among pregnant women. DESIGN: Women completed a structured interview designed to provide information on facilitators of and barriers to utilization. In addition, six focus groups were conducted with a subset of women (n 70) to further explore attitudes, perceptions and experiences related to CSBP use. SETTING: Two districts in Kampong Chhnang Province, Cambodia. SUBJECTS: Pregnant women (n 288) participating in a cluster-randomized trial of CSBP. RESULTS: The acceptability of CSBP was influenced by sensory attributes, family support, peer influences, and attitudes related to diet, nutritional status and weight gain in pregnancy. Attaining adequate nutrition was considered less important than other concerns during pregnancy, particularly anxiety related to the costs of delivery and postpartum care. Acceptance was lower among new mothers due to fears of weight gain. Health benefits were common reasons for continued use and minor side-effects, such as nausea, were not major barriers to consumption. CONCLUSIONS: CSBP was generally well accepted in this population. However, organoleptic factors and perceptions regarding nutrition and weight gain in pregnancy, particularly for first-time mothers, were barriers to increasing acceptance among Cambodian women.


Assuntos
Comportamento do Consumidor , Suplementos Nutricionais , Fenômenos Fisiológicos da Nutrição Materna , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Camboja , Dieta , Feminino , Grupos Focais , Humanos , Gravidez , População Rural , Glycine max , Zea mays
4.
Can J Diet Pract Res ; 77(3): 148-53, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27182726

RESUMO

This study examined student-reported participation in school food and nutrition activities in Vancouver, British Columbia (BC), and whether engagement differed by gender and between elementary and secondary school students. A cross-sectional survey of grade 6-8 public school students (n = 937) from 20 elementary and 6 secondary schools assessed student-reported participation in a range of food and nutrition activities. Statistical analyses included descriptive statistics and multilevel logistic regression to examine associations between participation with gender and school type. Overall, <50% of students reported engaging in most of the food and nutrition activities examined in the 2011-2012 school year, including: food preparation (36%), choosing/tasting healthy foods (27%), learning about Canada's Food Guide (CFG) (45%), learning about foods grown in BC (35%), gardening (21%), composting (32%), and recycling (51%). Females were more likely to report recycling and learning about CFG and BC-grown foods (P < 0.05). Secondary students were more likely to report activities focused on working with or learning about food/nutrition (P < 0.05). Despite local and provincial efforts to engage students in food and nutrition experiences, participation in most activities remains relatively low, with few students exposed to multiple activities. Continued advocacy is needed from the dietetics community to improve student engagement in food and nutrition activities.


Assuntos
Alimentos , Conhecimentos, Atitudes e Prática em Saúde , Fenômenos Fisiológicos da Nutrição , Serviços de Saúde Escolar , Instituições Acadêmicas , Adolescente , Colúmbia Britânica , Criança , Estudos Transversais , Dieta , Feminino , Jardinagem , Humanos , Masculino , Política Nutricional , Plantas Comestíveis/crescimento & desenvolvimento , Fatores Sexuais
5.
Public Health Nutr ; 18(5): 764-73, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25098190

RESUMO

OBJECTIVE: To examine associations between students' socio-economic status (SES) and school-day dietary intake, and the roles of parents and peers in shaping these associations. DESIGN: A cross-sectional survey measured school-day intake of vegetables, whole grains, low-fat milk, packaged snack foods and sugar-sweetened beverages. Logistic regression models examined associations between SES (parental education and food insecurity status) and dietary outcomes during or en route to or from school, and examined whether peer modelling or parental norms potentially mediated the associations between SES and dietary outcomes. SETTING: Twenty-six public schools in Vancouver, Canada in 2012. SUBJECTS: Nine hundred and fifty students in grades 5-8. RESULTS: Students whose parents completed some college, compared with those completing high school or less, were significantly more likely to consume vegetables daily (unadjusted OR = 1.85; 95 % CI 1.06, 3.22) and students whose parents completed college or university were significantly less likely to consume sugar-sweetened beverages daily (unadjusted OR = 0.67; 95 % CI 0.47, 0.94). Food secure students were also significantly less likely to consume sugar-sweetened beverages daily compared with food insecure students (unadjusted OR = 0.52; 95 % CI 0.29, 0.92). Parental norms, but not peer modelling, emerged as a potential mediator of the association between SES and vegetable intake. SES was not significantly associated with the remaining dietary outcomes. CONCLUSIONS: Higher SES was significantly associated with two of five school-day dietary outcomes and predicted higher likelihood of daily nutritious food choices at school. The present study suggests that there is room for improvement in school-day dietary quality for students from all SES backgrounds in Vancouver.


Assuntos
Fenômenos Fisiológicos da Nutrição do Adolescente , Fenômenos Fisiológicos da Nutrição Infantil , Dieta/efeitos adversos , Política Nutricional , Relações Pais-Filho , Cooperação do Paciente , Influência dos Pares , Adolescente , Colúmbia Britânica , Criança , Estudos Transversais , Dieta/economia , Escolaridade , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Pais/educação , Instituições Acadêmicas , Fatores Socioeconômicos , Meios de Transporte , Saúde da População Urbana
6.
Public Health Nutr ; 18(13): 2379-91, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25771940

RESUMO

OBJECTIVE: To describe the development and application of the School Food Environment Assessment Tools and a novel scoring system to assess the integration of healthy and environmentally sustainable food initiatives in elementary and secondary schools. DESIGN: The cross-sectional study included direct observations of physical food environments and interviews with key school personnel regarding food-related programmes and policies. A five-point scoring system was then developed to assess actions across six domains: (i) food gardens; (ii) composting systems; (iii) food preparation activities; (iv) food-related teaching and learning activities; and availability of (v) healthy food; and (vi) environmentally sustainable food. SETTING: Vancouver, Canada. SUBJECTS: A purposive sample of public schools (n 33) from all six sectors of the Vancouver Board of Education. RESULTS: Schools scored highest in the areas of food garden and compost system development and use. Regular integration of food-related teaching and learning activities and hands-on food preparation experiences were also commonly reported. Most schools demonstrated rudimentary efforts to make healthy and environmentally sustainable food choices available, but in general scored lowest on these two domains. Moreover, no schools reported widespread initiatives fully supporting availability or integration of healthy or environmentally sustainable foods across campus. CONCLUSIONS: More work is needed in all areas to fully integrate programmes and policies that support healthy, environmentally sustainable food systems in Vancouver schools. The assessment tools and proposed indicators offer a practical approach for researchers, policy makers and school stakeholders to assess school food system environments, identify priority areas for intervention and track relevant changes over time.


Assuntos
Conservação dos Recursos Naturais , Ecologia/educação , Política Ambiental , Serviços de Alimentação , Abastecimento de Alimentos , Política Nutricional , Ciências da Nutrição/educação , Adolescente , Colúmbia Britânica , Criança , Culinária , Estudos Transversais , Dieta/efeitos adversos , Jardinagem/educação , Fidelidade a Diretrizes , Implementação de Plano de Saúde , Humanos , Substâncias Húmicas , Avaliação de Programas e Projetos de Saúde , Instituições Acadêmicas
7.
Matern Child Nutr ; 11(2): 253-9, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23061469

RESUMO

To prevent rickets, the Health Canada and the American Academy of Pediatrics recommend that breastfed infants receive a daily vitamin D supplement of 10 µg d(-1) . Compliance with this recommendation is variable and its effect on infant vitamin D status is unclear. We measured serum 25-hydroxyvitamin D (25OHD) in Asian immigrant (n=28) and White (n=37) mothers and their infants aged 2-4 months living in Vancouver (49°N). Mothers completed health and demographic questionnaires. All subjects were term infants who were primarily breastfed. Analysis of variance, χ(2) , multiple regression and logistic regression analysis were performed as appropriate. Mean 25OHD of the infants was 31 (95% confidence interval 28-34) ng mL(-1) . Only two infants had a 25OHD concentration indicative of deficiency, <10 ng mL(-1) . Of the infants, 14% (n=9) and 49% (n=32) were vitamin D insufficient based on two commonly used cut-offs of 20 and 30 ng mL(-1) , respectively. Fifty-eight (89%) infants had been given a vitamin D supplement. Mean 25OHD was 9.4 ng mL(-1) higher in infants consuming ≥10 µg d(-1) of vitamin D from supplements vs. those consuming less (P=0.003). Mother's 25OHD, season, skin colour or ethnicity (Asian vs. White) did not influence infant 25OHD. The infants in our study, most of whom received vitamin D supplements, were generally protected against low 25OHD. The study was limited by sample size and the nature of the cross-sectional study design.


Assuntos
Suplementos Nutricionais , Fenômenos Fisiológicos da Nutrição do Lactente , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/administração & dosagem , Vitamina D/sangue , Povo Asiático , Aleitamento Materno , Canadá , Estudos Transversais , Humanos , Lactente , Análise Multivariada , Estações do Ano , Pigmentação da Pele , Fatores Socioeconômicos , Inquéritos e Questionários , População Branca
8.
Can J Public Health ; 114(4): 659-670, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37040043

RESUMO

OBJECTIVES: Social scientists have demonstrated that family health work is interlinked with heteronormative gender inequities. Yet family-based public health interventions rarely incorporate a gender transformative approach or address heteronormativity as a potential health barrier in North America. Instead, attention to gender surfaces primarily in family health interventions conducted in low- to middle-income countries with majority Black and racialized populations. The objective of this article is to establish the importance of designing health interventions that account for heteronormative relations in Ontarian families by drawing on empirical data from the Guelph Family Health Study (GFHS). METHODS: We draw on data (February-October 2019) from (1) semi-structured interviews with 20 families and with 4 health educators facilitating the GFHS home visits and (2) observational data of 11 GFHS home visits and 1 health educator training day. Informed by gender transformation theory, data were analyzed and coded to understand the impact of gender, sexuality, and place in family health interventions. RESULTS: Pre-existing heteronormative parenting relations were reinforced through GFHS participation: the GFHS was mother-led, increasing some mothers' stress levels. Fathers tended to consider paid work a justification for disengaging from the GFHS, and their detachment sometimes obstructed mothers' intervention efforts. Health educators (all women) were caught in these relations, feeling like because of their gender, they were viewed by parents as confidants and marriage counsellors. CONCLUSION: Findings emphasize the need for expanding the epistemic and methodological approaches to family-based health interventions, changing the demographic and geographic emphasis within the field, and designing interventions that focus on societal-level changes. Heterosexuality has not been analyzed as a risk factor within the public health field, but our findings indicate the need for further study.


RéSUMé: OBJECTIFS: Les spécialistes des sciences sociales ont démontré que le travail en santé familiale est indissociable des inégalités hétéronormatives entre les sexes. Il est pourtant rare que les interventions sanitaires axées sur la famille intègrent une approche transformatrice du genre ou abordent l'hétéronormativité en tant qu'obstacle possible à la santé en Amérique du Nord. Au lieu de cela, l'attention au genre fait principalement surface dans les interventions en santé familiale menées dans des pays à faible revenu et à revenu intermédiaire dont les populations sont majoritairement noires et racisées. Notre article vise à souligner l'importance de concevoir des interventions sanitaires qui tiennent compte des relations hétéronormatives dans les familles ontariennes en puisant dans les données empiriques de l'étude Guelph Family Health Study (GFHS). MéTHODE: Nous avons fait appel aux données (février­octobre 2019) : 1) d'entretiens semi-directifs avec 20 familles et avec 4 éducatrices sanitaires ayant facilité des visites à domicile dans le cadre de la GFHS; et 2) d'observation de 11 visites à domicile menées dans le cadre de la GFHS et d'une journée de formation des éducatrices sanitaires. Éclairées par la théorie de la transformation de genre, les données ont été analysées et codées pour nous aider à comprendre les effets du sexe, de la sexualité et du lieu dans les interventions en santé familiale. RéSULTATS: Les relations parentales hétéronormatives préexistantes ont été renforcées par la participation à l'étude GFHS : ce sont surtout des mères qui y ont participé, ce qui a accru les niveaux de stress chez certaines. Les pères ont eu tendance à considérer leur travail rémunéré comme une raison de se retirer de l'étude, et leur détachement a parfois fait obstacle aux efforts d'intervention des mères. Les éducatrices sanitaires (toutes des femmes) ont été prises en étau dans ces relations et ont senti qu'en raison de leur sexe, elles étaient vues par les parents comme des confidentes et des conseillères conjugales. CONCLUSION: Nos constatations soulignent le besoin d'élargir les approches épistémiques et méthodologiques des interventions en santé familiale, de changer l'accent sur les données démographiques et géographiques dans le domaine et de concevoir des interventions axées sur les changements sociétaux. L'hétérosexualité n'est pas analysée en tant que facteur de risque dans le domaine de la santé publique, mais nos constatations indiquent le besoin de pousser la recherche en ce sens.


Assuntos
Mães , Pais , Humanos , Feminino , Ontário , Poder Familiar , Promoção da Saúde
9.
Ethn Health ; 17(5): 513-29, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22348428

RESUMO

OBJECTIVE: Most research on food, ethnicity and health in Canada is focused on the dietary acculturation of first of second generation migrants. 'Failure' to adopt nutritional guidelines for healthy eating is generally understood as lack of education or persistence of cultural barriers. In this study we explore the meanings of food, health, and well-being embedded in the food practices of African Nova Scotians, a population with a 400-year history in Canada. DESIGN: Qualitative interviews were conducted with 2 or 3 members of each of 13 families who identified as African Nova Scotian. Interviews asked about eating patterns; the influence of food preferences, health concerns, cost, and culture; perceptions of healthy eating and good eating; how food decisions were made; and changes over time. In addition, research assistants observed a 'typical' grocery shopping trip and one family meal. RESULTS: Participants readily identified what they perceived to be distinctively 'Black ways of eating.' Beyond mainstream nutrition discourses about reduction of chronic disease risk, participants identified three ways of thinking about food, health, and well-being: physical well-being, emphasizing stamina, energy and strength; family and community well-being; and cultural or racial well-being, emphasizing cultural identity maintenance, but also resistance to racism. CONCLUSION: While culturally traditional eating patterns are often understood as costly in terms of health, it is equally important to understand that adopting healthy eating has costs in terms of family, community, and cultural identity. Dietary change unavoidably entails cultural loss, thus resisting healthy eating guidelines may signify resistance to racism or cultural dominance. Several suggestions are offered regarding how community strengths and beliefs, as well as cultural meanings of food and health, might inform effective healthy eating interventions.


Assuntos
População Negra/etnologia , Comportamento Alimentar/etnologia , Preferências Alimentares/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Adolescente , Adulto , Idoso , Cultura , Família , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Nova Escócia/epidemiologia , Características de Residência , Adulto Jovem
10.
J Homosex ; : 1-29, 2022 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-36480036

RESUMO

In this article we describe and analyze five videos created through an arts-informed research project, Precarious Inclusion: Studying Ontarian 2SLGBTQI+ parents' experiences childrearing in a post-legal parity framework. Precarious Inclusion used interviews and digital storytelling to investigate Ontario 2SLGBTQI+ parents' current experiences of inclusion and exclusion when navigating institutional and social interactions in everyday life in a post-legal parity context. The study centrally explored how intersecting identities with regards to sexuality, gender, geography, disability, class, race, Indigeneity, and ethnicity intersect with structural forces to influence 2SLGBTQI+ parents' inclusion and exclusion experiences. We examine research creation activities that supported 2SLGBTQI+ parents in making short videos about their experiences of parenting. Our analysis of the five videos created by Indigenous, racialized, trans, nonbinary, Two-Spirit, and disabled parents show how consistent experiences of exclusion mark 2SLGBTQI+ parents' everyday lives. We deepen theorizations of the material and psychological impacts of exclusion for 2SLGBTQI+ families through foregrounding three themes: 1) the operations of racism, white supremacy, and colonialism in makers' lives; 2) misrecognition and its psychic effects of bifurcation and disjuncture; and 3) love, joy, and multi-species kinship as powerful sites of healing and belonging. We further demonstrate how parents used their videos as self-advocacy for resisting precarious inclusion.

11.
Appetite ; 55(3): 398-406, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20670667

RESUMO

Research indicating that certain diets can lower prostate-specific antigen levels suggests that diet change might be a beneficial treatment adjunct for low-grade prostate cancer. However, few men with prostate cancer adopt significant diet change, indicating a need to better understand how and why they make food choices. This qualitative study explored men's perceptions of their diets following a prostate cancer diagnosis, and the rationales underpinning diet changes (or lack thereof). Individual semi-structured interviews were conducted with 14 men ages 48-78 years who had been diagnosed with prostate cancer within the previous 5 years. Findings show that participants exhibited varied dietary patterns, which we labeled 'eating as usual', 'intensifying efforts', 'adding-on', and 'overhauling diets'. Four main domains informed rationales for diet changes or lack thereof: perception of pre-prostate cancer diet, diet and health understandings, orientation towards prostate cancer, and the need for "doing something." Dietary ideals framed as masculine, important, action-oriented and autonomous endeavors contributed to participants' food choice behaviors, suggesting that their alignment to masculine dietary ideals influenced if and how they engaged in diet change. A better understanding of how masculine food ideals shape food choice might be useful in expanding food choice models and in developing effective nutrition education interventions for this group.


Assuntos
Dieta/psicologia , Comportamento Alimentar/psicologia , Identidade de Gênero , Conhecimentos, Atitudes e Prática em Saúde , Neoplasias da Próstata/dietoterapia , Idoso , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Antígeno Prostático Específico/metabolismo , Neoplasias da Próstata/psicologia
12.
Can J Public Health ; 101(3): 246-50, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20737819

RESUMO

OBJECTIVES: Health Canada recommends vitamin D supplements (10 microg/d) for Canadians aged > or = 50 years, but no data are available on adoption of this recommendation. Accordingly, this study was conducted to determine the current use of vitamin D supplements among British Columbian adults 50 years and over, and to explore relationships among vitamin D supplement use, socio-demographic variables, and knowledge, attitudes and beliefs about vitamin supplementation. METHODS: A population-representative stratified sample, recruited by random-digit dialling, completed a telephone-administered survey in late fall of 2008. Respondents provided details on supplements used in the past month (dosage, frequency, etc.) and demographic data, and responded to statements reflecting health beliefs about supplements, from which a Supplement Health Belief score was calculated. Eligible non-respondents indicated their age, sex, and whether they had used a supplement within the past month. RESULTS: Similar proportions of participants (n = 969) and non-respondents (n = 1,027) reported any supplement use in the past month. Among participants, 60% had used a vitamin D supplement (median intake among supplement users was 10 microg/d) and 3% exceeded the Tolerable Upper Intake Level of 50 microg/d. In multivariate analysis, vitamin D supplementation was significantly associated with female sex, not smoking, higher educational attainment, having a health care professional recommend supplement use, and a higher Supplement Health Belief score. CONCLUSION: Although most older adults used a vitamin D supplement, further dissemination of this recommendation is needed.


Assuntos
Suplementos Nutricionais/estatística & dados numéricos , Vitamina D/administração & dosagem , Idoso , Atitude Frente a Saúde , Colúmbia Britânica/epidemiologia , Escolaridade , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fumar/epidemiologia , Inquéritos e Questionários
13.
Health Promot Int ; 25(2): 166-73, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20197359

RESUMO

Aboriginal people in Canada suffer ill-health at much higher rates compared with the rest of the population. A key challenge is the disjuncture between the dominant biomedical approach to health in Canada and the holistic and integrative understandings of and approaches to health in many Aboriginal cultures. More fundamentally, colonization is at the root of the health challenges faced by this population. Thus, effective approaches to health promotion with Aboriginal people will require decolonizing practices. In this paper, we look at one case study of a health promotion project, the Urban Aboriginal Community Kitchen Garden Project in Vancouver, Canada, which, guided by the teachings of the Medicine Wheel, aims to provide culturally appropriate health promotion. By drawing on Aboriginal approaches to healing, acknowledging the legacy of colonization and providing a context for cultural celebration, we suggest that the project can be seen as an example of what decolonizing health promotion could look like. Further, we suggest that a decolonizing approach to health promotion has the potential to address immediate needs while simultaneously beginning to address underlying causes of Aboriginal health inequities.


Assuntos
Promoção da Saúde/organização & administração , Grupos Populacionais , População Urbana , Colúmbia Britânica , Canadá , Comportamento Cooperativo , Humanos , Entrevistas como Assunto , Medicina Tradicional , Estudos de Casos Organizacionais , Desenvolvimento de Programas
14.
Can J Diet Pract Res ; 71(1): e12-7, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20205974

RESUMO

PURPOSE: In this study, we sought insight into the clinical practice experiences of dietitians working independently (i.e., as the only dietitian in a facility) in long-term care (LTC). We hoped to learn about their work roles and identify specific factors that facilitate their success. METHODS: Grounded theory methods were used. Data were collected through 11 semi-structured interviews. Verbatim transcripts were analyzed using a constant comparative method, which included coding, memo writing, and ongoing discussion between the two researchers. RESULTS: When speaking about their roles, participants identified both specific tasks they had to complete and broader roles they fulfilled. Many of these roles focused on relationships with co-workers and building effective multidisciplinary teams. Effective teamwork was linked with dietitians' personal feelings of success in providing resident-focused nutritional care in the LTC setting. CONCLUSIONS: The LTC dietitians' various roles were generally self-appointed, and they focused more on the purpose of their work than on tasks. A primary focus of these roles was the multidisciplinary team and the promotion of effective teamwork, especially, but not exclusively, as it applies to the provision of nutritional care. Successful teamwork was linked to dietitians' reports of personal success in their work.


Assuntos
Serviços de Dietética/organização & administração , Dietética/organização & administração , Dietética/normas , Assistência de Longa Duração/métodos , Atitude Frente a Saúde , Colúmbia Britânica , Bases de Dados Factuais , Humanos , Entrevistas como Assunto , Equipe de Assistência ao Paciente , Papel Profissional , Relações Profissional-Paciente , Estatística como Assunto/métodos
15.
Can J Diet Pract Res ; 70(1): 13-8, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19261202

RESUMO

PURPOSE: The number of visually impaired and blind Canadians will rise dramatically as our population ages, and yet little is known about the impact of blindness on the experience of food and eating. In this qualitative study, the food experiences and eating patterns of visually impaired and blind people were examined. Influencing factors were also explored. METHODS: In 2000, nine blind or severely visually impaired subjects were recruited through blindness-related organizations in British Columbia. Participants completed individual semi-structured, in-depth interviews. These were transcribed verbatim, coded, and analyzed to explicate participants' experiences. RESULTS: Participants experienced blindness-related obstacles when shopping for food, preparing food, and eating in restaurants. Inaccessible materials and environments left participants with a diet lacking in variety and limited access to physical activity. Seven participants were overweight or obese, a finding that may be related to limited physical activity and higher-than-average restaurant use. CONCLUSIONS: This is the first study in which the experience of food and eating is described from the perspective of visually impaired Canadians. Nutrition and blindness professionals must work together to reduce the food-related obstacles faced by visually impaired and blind people. Professionals must address both individual skill development and social and structural inequities.


Assuntos
Cegueira/fisiopatologia , Ingestão de Alimentos , Comportamento Alimentar , Pessoas com Deficiência Visual/psicologia , Adulto , Cegueira/psicologia , Colúmbia Britânica , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/etiologia , Restaurantes
16.
Can J Public Health ; 110(1): 21-30, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30536207

RESUMO

INTERVENTION: British Columbia's (BC) provincial school food and beverage sales policy. RESEARCH QUESTION: What are the processes associated with district-level implementation of BC's school food and beverage sales policy? METHODS: We adopted a realist approach and a qualitative, multiple case study design that included three urban and two rural BC school districts. Data collection involved semi-structured interviews and questionnaires with health, education, and industry stakeholders, observations, document analysis and website scans. Analysis identified: (i) mechanisms influencing if and how stakeholders engage in implementation activities at the district level and (ii) specific dimensions of context influencing these mechanisms. RESULTS: We identified three mechanisms driving implementation processes at the school district level associated with BC's school food and beverage sales policy. These mechanisms are influenced by various dimensions of context that lead to a range of implementation outcomes. The 'mandatory mechanism' refers to the mandatory nature of the policy effectively triggering implementation efforts, influenced by a normative acceptance of the education system hierarchy. The 'money mechanism' refers to how this district demand leads vendors to create a compliant supply; it is influenced by beliefs about children's food preferences, health and food, and the existence of competition. Finally, the 'monitoring mechanism' refers to how systems of informal monitoring are used to promote compliance in the context of a competitive sales environment. CONCLUSION: The outcomes of these three policy mechanisms are influenced by complex dimensions of context. Identifying context-mechanism interactions can help inform public health policymakers interested in interventions for improving school food environments.


Assuntos
Comércio , Serviços de Alimentação/economia , Promoção da Saúde/métodos , Política Pública , Instituições Acadêmicas , Bebidas/economia , Colúmbia Britânica , Criança , Alimentos/economia , Humanos , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , População Rural , Inquéritos e Questionários , População Urbana
17.
Can J Diet Pract Res ; 69(2): 66-70, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18538059

RESUMO

PURPOSE: To gain insight into the decision-making processes used by women when selecting dairy and dairy alternative foods, including examination of the role of bone health concerns. METHODS: Semi-structured, point-of-purchase interviews were conducted with a convenience sample of 30 female grocery shoppers. Constant comparative data analysis was used to generate themes on shoppers' decision-making processes. RESULTS: Women considered multiple issues in their dairy and dairy alternative food choice strategies: taste was most often associated with the fat and sugar content of foods; health concerns were centred on achieving an acceptable body weight and preventing osteoporosis and cardiovascular disease, and women chose foods to satisfy other family members' needs and preferences and to obtain "good food value." Women prioritized their food choices by weighing the value of each issue, which led to a strategic process for "maximizing the value" of their food choices. The availability of a wide range of dairy and dairy alternative foods meant that in most instances, it was unnecessary for women to "trade off" one area of concern for another. CONCLUSIONS: Dietitians and nutrition educators can help women make dietary changes by helping them identify foods that they perceive as meeting a variety of needs.


Assuntos
Laticínios/análise , Laticínios/economia , Tomada de Decisões , Osteoporose/prevenção & controle , Saúde da Mulher , Adulto , Idoso , Cálcio da Dieta , Custos e Análise de Custo , Gorduras na Dieta/administração & dosagem , Feminino , Alimentos Orgânicos , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Paladar/fisiologia
18.
Eval Program Plann ; 70: 73-82, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29866404

RESUMO

School food environments are the target of nutrition interventions and evaluations across the globe. Yet little work to-date has articulated the importance of developing a theory of change upon which to base evaluation of both implementation and outcomes. This paper undertakes an interpretive approach to develop a retrospective theory of change for an implementation evaluation of British Columbia's school food and beverage sales Guidelines. This study contributes broadly to a nuanced conceptualization of this type of public health intervention and provides a methodological contribution on how to develop a retrospective theory of change with implications for effective evaluation. Data collection strategies included document analysis, semi-structured interviews with key stakeholders, and participant observation. Developing the logic model revealed that, despite the broad population health aims of the intervention, the main focus of implementation is to change behaviors of adults who create school food environments. Derived from the analysis and interpretation of the data, the emergent program theory focuses on the assumption that if adults are responsibilized through information and education campaigns and provided implementation tools, they will be 'convinced' to implement changes to school food environments to foster broader public health goals. These findings highlight the importance of assessing individual-level implementation indicators as well as the more often evaluated measures of food and beverage availability.


Assuntos
Bebidas , Serviços de Alimentação , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Instituições Acadêmicas , Adulto , Colúmbia Britânica , Comércio , Comportamento Cooperativo , Tomada de Decisões Gerenciais , Guias como Assunto , Humanos , Entrevistas como Assunto , Lógica , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos
19.
Qual Health Res ; 17(7): 902-7, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17724102

RESUMO

Despite repeated efforts to encourage health professionals to conduct practice-based research, including qualitative research, few practitioners have become active researchers. Mentoring, networking, and hands-on experience have been identified as potential approaches for changing this situation. In this article, the authors describe how they implemented a research mentoring/training component in a national study exploring Canadian dietitians' attitudes and practices with regard to obesity and weight management. They discuss the successes and challenges experienced by mentors and trainees, and provide recommendations for future initiatives to enhance capacity for qualitative, practice-based research among health care practitioners.


Assuntos
Atitude do Pessoal de Saúde , Dietética/organização & administração , Obesidade/psicologia , Obesidade/terapia , Pesquisa Qualitativa , Redução de Peso , Canadá , Comportamento Cooperativo , Medicina Baseada em Evidências , Humanos , Disseminação de Informação , Mentores , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde
20.
Can J Diet Pract Res ; 68(2): 67-72, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17553191

RESUMO

PURPOSE: How Canadian dietitians define and use non-dieting and size acceptance approaches (SAAs) in the context of weight management was explored. METHODS: Fifteen focus groups with 104 dietitians were conducted in seven Canadian cities. Questions were designed to explore participants' understanding and use of non-dieting and SAAs, including counselling goals, techniques, and outcome measures. Sessions were tape-recorded, transcribed verbatim, coded, and analyzed using qualitative methods. RESULTS: Participants generally agreed that non-dieting involves promoting healthy lifestyles and avoiding restrictive diets. Participants also agreed that size acceptance means accepting all body shapes and sizes and promoting comfort with one's body. Many dietitians said they use size acceptance only with appropriate clients, most often with those who are lighter or without other health risks. Others said that size acceptance, by definition, is appropriate for everyone. Opinions varied about the appropriateness of teaching portion sizes or using meal plans, and whether weight loss could be a goal of non-dieting and SAAs. CONCLUSIONS: Views on the usefulness of non-dieting and size acceptance strategies in weight management counselling were related, at least partially, to the different understanding that dietitians had of these approaches. Terminology needs to be clarified when we speak about non-dieting and SAAs. The varied understanding about these concepts should help dietitians reflect on their own perspectives and practice.


Assuntos
Dietética/métodos , Promoção da Saúde/métodos , Estilo de Vida , Obesidade/psicologia , Obesidade/terapia , Adulto , Imagem Corporal , Canadá , Aconselhamento , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Autoimagem
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