SpEx: a German-language dataset of speech and executive function performance.

This work presents data from 148 German native speakers (20-55 years of age), who completed several speaking tasks, ranging from formal tests such as word production tests to more ecologically valid spontaneous tasks that were designed to mimic natural speech. This speech data is supplemented by performance measures on several standardised, computer-based executive functioning (EF) tests covering domains of working-memory, cognitive flexibility, inhibition, and attention. The speech and EF data are further complemented by a rich collection of demographic data that documents education level, family status, and physical and psychological well-being. Additionally, the dataset includes information of the participants' hormone levels (cortisol, progesterone, oestradiol, and testosterone) at the time of testing. This dataset is thus a carefully curated, expansive collection of data that spans over different EF domains and includes both formal speaking tests as well as spontaneous speaking tasks, supplemented by valuable phenotypical information. This will thus provide the unique opportunity to perform a variety of analyses in the context of speech, EF, and inter-individual differences, and to our knowledge is the first of its kind in the German language. We refer to this dataset as SpEx since it combines speech and executive functioning data. Researchers interested in conducting exploratory or hypothesis-driven analyses in the field of individual differences in language and executive functioning, are encouraged to request access to this resource. Applicants will then be provided with an encrypted version of the data which can be downloaded.

Climate change, biodiversity loss, and Indigenous Peoples' health and wellbeing: A systematic umbrella review.

Indigenous Peoples worldwide are experiencing a cascade of impacts on their health and wellbeing as a result of climate change and biodiversity loss. Existing literature at the interface of climate change, biodiversity loss, and Indigenous health tells us that Indigenous Peoples are among those most disproportionately and acutely affected by these impacts. Yet, a gap exists with respect to comprehensively and critically synthesizing the impacts reported across this literature and identifying Indigenous-led responses. Guided by an Indigenous advisory group, we employed a systematic umbrella review methodology, following PRISMA guidelines, to characterize the global secondary literature (PROSPERO registration #: CRD42023417060). In so doing, we identified the proximal, intermediate, distal, and gendered impacts of climate change and biodiversity loss on Indigenous health and wellbeing as well as Indigenous-led responses. Five databases were searched for published reviews, along with a grey literature search that focused on underrepresented geographic regions in the academic literature. Two independent reviewers conducted two-stage screening, data extraction, and quality assessment of retrieved records. Basic descriptive statistics were calculated. Qualitative data were analyzed thematically, using a constant comparative approach. A total of 38 review articles met the eligibility criteria and 37 grey literature records were retrieved and included in the review. Reviews were published between 2010-2023 and geographically clustered in the Circumpolar North. Intersecting proximal, intermediate, and distal impacts were characterized as place-based and specific, and linked to colonialism as an antecedent to and driver of these impacts. Gendered impacts were underexplored within reviews. Reviewed literature underscored the value of engaging diverse knowledge systems; platforming localized, community-led adaptation to climate change and biodiversity loss, while addressing sociopolitical constraints to these efforts; and applying a broader conceptualization of health that aligns with Indigenous frameworks. Going forward, we must foreground equity- and rights-based considerations within integrated responses to climate and biodiversity crises.

Climate change, biodiversity loss, and Indigenous Peoples' health and wellbeing: a systematic umbrella review protocol.

BACKGROUND: Research that examines the intersections of Indigenous Peoples' health and wellbeing with climate change and biodiversity loss is abundant in the global scholarship. A synthesis of this evidence base is crucial in order to map current pathways of impact, as well as to identify responses across the global literature that advance Indigenous health and wellbeing, all while centering Indigenous voices and perspectives. This protocol details our proposed methodology to systematically conduct an umbrella review (or review of reviews) of the synthesized literature on climate change, biodiversity loss, and the health and wellbeing of Indigenous Peoples globally. METHODS: A multidisciplinary team of Indigenous and non-Indigenous scholars will conduct the review, guided by an engagement process with an Indigenous Experts group. A search hedge will be used to search PubMed®, Scopus®, Web of Science™, CINAHL (via EBSCOHost®), and Campbell Collaboration databases and adapted for use in grey literature sources. Two independent reviewers will conduct level one (title/abstract) and level two (full-text) eligibility screening using inclusion/exclusion criteria. Data will be extracted from included records and analyzed using quantitative (e.g., basic descriptive statistics) and qualitative methods (e.g., thematic analysis, using a constant comparative method). DISCUSSION: This protocol outlines our approach to systematically and transparently review synthesized literature that examines the intersections of climate change, biodiversity loss, and Indigenous Peoples' health and wellbeing globally. SYSTEMATIC REVIEW REGISTRATION: This protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on April 24, 2023 (registration number: CRD42023417060).

Children's Oral Health Initiative: workers' perspectives on its impact in First Nations communities. / Initiative en santé buccodentaire des enfants : le point de vue des intervenants quant à ses effets dans les communautés des Premières Nations.

INTRODUCTION: Since 2004, the Children's Oral Health Initiative (COHI) has been working in many First Nations and Inuit communities in Canada to address oral health disparities, specifically early childhood caries (ECC). The COHI community-based approach improves early childhood oral health (ECOH) by balancing prevention with minimally invasive dentistry. The goal is to reduce the burden of oral disease, mainly by minimizing the need for surgery. We investigated program success in First Nations communities in the province of Manitoba, from the perspective of COHI staff. METHODS: First Nations community-based dental therapists and dental worker aides participated in three focus groups and an in-depth semistructured interview. The collected data were thematically analyzed. RESULTS: Data from 22 participants yielded converging and practitioner-specific themes. Participants reported that dental therapists and dental worker aides provide access to basic oral care in their communities including oral health assessments, teeth cleaning, fluoride varnish applications and sealants. The participants agreed that education, information sharing and culturally appropriate parental engagement are crucial for continuous support and capacity building in the community programs. Low enrolment, difficulty accessing homes and getting consent, limited human resources as well as lack of educational opportunities for dental worker aides were identified challenges. CONCLUSION: Overall, the participants reported that the COHI program positively contributes to ECOH in First Nations communities. However, increased community-based training for dental workers, community awareness about the program, and engagement of parents to facilitate culturally appropriate programming and consent processes are critical to improving program outcomes.

Caring in crisis: The experiences of local religious leaders meeting community food needs in the Philippines during the COVID-19 pandemic.

To respond to the unintended consequences of prevention measures to reduce COVID-19 transmission, individuals and groups, including religious leaders, have collaborated to provide care to those negatively impacted by these measures. Amid these various efforts and interventions, there is a need to deepen our understanding of diverse expressions of care across various geographical and social contexts. To address this need, the objective of this study was to investigate how religious leaders in the Philippines practiced care for their communities by meeting emergency food needs amid the COVID-19 pandemic. Guided by an ethics of care theoretical orientation, we conducted 25 remote semi-structured interviews with Filipino religious leaders who partnered with a Philippines-based non-governmental organization (NGO) to mobilize essential food aid to their local communities. Through defining the efforts and activities of these religious leaders as care work, we found that religious leader experiences revolved around navigating care responsibilities, caring alongside others, and engaging holistically with the care work. Additionally, we observed how contextual factors such as the humanitarian settings where religious leaders worked, the partnership with an NGO, and the positionality of local religious leaders within their communities, fundamentally shaped the care work. This study expands our understanding of how care is practiced and experienced and also brings greater visibility to the experiences and efforts of local religious leaders in responding to humanitarian emergencies.

"Where Creator Has My Feet, There I Will Be Responsible": Place-Making in Urban Environments through Indigenous Food Sovereignty Initiatives.

There is a growing emergence of Indigenous Food Sovereignty (IFS) initiatives across urban centers within many regions of Canada. Urban Indigenous communities are leading these efforts to revitalize Indigenous foods and agricultural practices while promoting food security and increasing Land-based connections within cities. However, the socio-ecological environments within these urban contexts affect IFS initiatives in unique ways which have not been previously explored. This study addresses these gaps by drawing on qualitative interviews with seven urban Indigenous people leading IFS initiatives within Grand River Territory (situated within southern Ontario, Canada). Applying community-based participatory methods, this research explored how place impacts IFS initiatives within urban environments. Thematic analysis generated two overarching thematic categories: Land access, and place-making practices, revealing a bi-directional, dynamic interaction between place and urban IFS initiatives. Relationships with landowners, control of land, and external factors determined how Land was accessed in urban environments. Place-making practices involved fostering relationships with Land, upholding responsibilities, and cultivating Land-based knowledges. Therefore, IFS initiatives are impacted by Land access, but also facilitate place-making for urban Indigenous Peoples. These findings demonstrate pathways towards Indigenous self-determination and IFS within urban contexts, which can be applicable to other urban Indigenous communities.

Indigenous maternal health and health services within Canada: a scoping review.

BACKGROUND: Globally, there are disparities in access to maternal health care services and equity in maternal health outcomes between Indigenous and non-Indigenous populations. While the literature is growing, it has not been systematically synthesized. This review addresses this gap by synthesizing the existing literature on the organizational structure of maternity care, accessibility and delivery of services, and clinical disparities impacting Indigenous maternal health within Canada. It also identifies current knowledge gaps in research on these topics. METHODS: A scoping review was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines and the extension for scoping reviews. The search for relevant papers was performed in PubMed, CINAHL, and SCOPUS electronic databases and included any empirical literature written in English and published during 2006 - 2021. The research team inductively coded 5 articles to develop a coding scheme, which was then applied to the remaining articles. RESULTS: A total of 89 articles were included in the review, of which 32 were qualitative papers, 40 quantitative, 8 were mixed-methods publications, and 9 were review papers. The analysis of the articles resulted in identifying a range of overarching themes pertaining to the maternal health of Indigenous women within Canada including provision of services, clinical issues, education, health disparities, organization, spatial context, and impact of informal support. The results suggest that physical, psychological, organizational, and systemic barriers inhibit the quality-of-care pregnant Indigenous women receive, and that maternal health services are not consistently provided in a culturally safe manner. Results also suggest that, compared to non-Indigenous pregnant women, Indigenous women are more likely to develop clinical complications during pregnancy, reflecting the structural impacts of colonization that continue to negatively influence Indigenous maternal health and well-being. CONCLUSIONS: There are many complex barriers that prevent Indigenous women from receiving high quality and culturally appropriate maternal care. Possible areas that could address the service gaps illuminated through this review include the implementation of cultural considerations across health care jurisdictions within Canada.

"We Need to Live off the Land": An Exploration and Conceptualization of Community-Based Indigenous Food Sovereignty Experiences and Practices.

Although Indigenous food systems are sustainable in nature, many of these systems have been forcibly altered among Indigenous communities within Canada, as a consequence of colonization. Indigenous Food Sovereignty (IFS) movements work to counteract the dismantling of Indigenous food systems as well as the negative health impacts of environmental dispossession experienced by Indigenous communities. Through community-based participatory research methodologies and the utilization of Etuaptmumk, or two-eyed seeing, this research project explored community perspectives of IFS in Western Canada. Reflexive thematic analysis of qualitative data collected during a sharing circle held with community members identified the influence of Indigenous Knowledge and community support on three main aspects of Indigenous food sovereignty, including (1) environmental concerns, (2) sustainable practices and (3) a strong relationship with the land and waters. Through the sharing of stories and memories related to traditional foods and current sovereignty projects, community members identified concerns for their local ecosystem as well as a desire to preserve its natural state for generations to come. The strengthening of IFS movements is critical to the overall wellbeing of Indigenous communities within Canada. Support is needed for movements that honour relationships with traditional foods and recognize traditional lands and waters as necessary for healing and sustaining the health of Indigenous communities.

Maternal health literacy and health numeracy conceptualizations in public health: A scoping review.

Despite unprecedented advancement in educational opportunities and access to information, maternal health literacy (MHL) and health numeracy (HN) skills remain low in North America. By enhancing MHL, the educated civic public-those who have the capacity, skills, and knowledge to apply prose and numerical health information-engages more proactively in public health practice. The purpose of this scoping review was to map the existing empirical evidence on MHL to work toward a better understanding of the practical implications for public health. We explored MHL and HN through the following research question: "How are maternal health literacy and health numeracy conceptualised in public health planning, implementation, and evaluation?" First, we employed a five-stage methodological framework for scoping reviews and used PRISMA-P to systematically identify eligible articles. Then, we used thematic analysis and an inductive approach guided by the research aims to identify themes related to how MHL and HN are conceptualised in empirical studies and developed an evidence table. Finally, two different reviewers coded articles using an inductive approach into six themes. We identified 1733 articles through a systematic search of five databases. After screening all the articles, 52 articles were included for thematic analysis. The final themes were: (i) sociocultural demographics; (ii) self-efficacy; (iii) communication; (iv) information seeking and operationalisation; (v) health status; and (vi) reasoning. The research evidence demonstrated limitations concerning the impact of sociocultural background on a mother's recognition of health problems and the extent of which patient-centred care is culturally and linguistically appropriate. The research evidence revealed an opportunity to address the sociocultural linguistic experience of mothers within public health practice. Our research team supports moving away from the biomedical model of evidence-based medicine and adopting evidence-based practice ensures healthcare providers develop a holistic understanding of the maternal health needs of socioculturally diverse mothers.

Exploring the environmental determinants of food choice among Haudenosaunee female youth.

BACKGROUND: Research on Indigenous food literacy within Canada has been focused on northern and remote communities despite the fact there are considerable and unique barriers to food access, availability, and utilization in southern Indigenous communities. Food insecurity is also a prevalent issue among Indigenous Peoples living in these more populous regions. Study objectives included investigating the determinants of food choice among youth, along with perceived opportunities that would improve food environments individually and at the community level. METHODS: This community-based study used Photovoice to explore the perceptions and experiences of traditional foods and the determinants of food choice among youth in the community of Six Nations of the Grand River. Participants took photos of their local food environments, including where foods were acquired, consumed, prepared, or shared, and participated in semi-structured interviews to share the stories behind these images. Thematic analysis was used to identify patterns in participants' photos and interview content. RESULTS: Environmental factors were found to influence participants' traditional and everyday food choices. Built, social, economic and ecological environments were described by the youth as distinct yet inter-related determinants that converge to influence individual food choice. Built environments had a notable impact on food choice, most notably at home and in school settings. Home and family were found to be facilitators of meal consistency and healthy food choices across participants. The social environment including participants' relationships with their peers and community friends was often a barrier to healthy food choices. Eating at fast food outlets was a common social activity. The economic environment included cost deterrents associated with food choices and regular meals. The ecological environment was less of an influence and impacted the seasonal consumption of traditional and other locally harvested foods. CONCLUSIONS: Overall, the study findings have generated important knowledge regarding food environments and literacy and serves as a unique example of how to explore the traditional and everyday food experiences of Indigenous youth. Recommendations will inform the development of new as well as existing initiatives and resources to enhance the holistic wellbeing of youth and the broader community.

Relationality, Responsibility and Reciprocity: Cultivating Indigenous Food Sovereignty within Urban Environments.

There are collective movements of Indigenous food sovereignty (IFS) initiatives taking up place and space within urban environments across the Grand River Territory, within southern Ontario, Canada. Indigenous Peoples living within urban centres are often displaced from their home territories and are seeking opportunities to reconnect with culture and identity through Land and food. This research was guided by Indigenous research methodologies and applied community-based participatory research to highlight experiences from seven Indigenous community members engaged in IFS programming and practice. Thematic analysis revealed four inter-related themes illustrated by a conceptual model: Land-based knowledge and relationships; Land and food-based practices; relational principles; and place. Participants engaged in five Land and food-based practices (seed saving; growing and gathering food; hunting and fishing; processing and preserving food; and sharing and distributing), guided by three relational principles (responsibility, relationality, and reciprocity), framed by the social and physical environments of the place. Key findings revealed that employing self-determined processes to grow, harvest, and share food among the Indigenous community provide pathways towards IFS. This study is the first to explore urban IFS initiatives within this region, offering a novel understanding of how these initiatives are taking shape within urban environments.

Implementing Indigenous Gender-Based Analysis in Research: Principles, Practices and Lessons Learned.

Numerous tools for addressing gender inequality in governmental policies, programs, and research have emerged across the globe. Unfortunately, such tools have largely failed to account for the impacts of colonialism on Indigenous Peoples' lives and lands. In Canada, Indigenous organizations have advanced gender-based analysis frameworks that are culturally-grounded and situate the understanding of gender identities, roles, and responsibilities within and across diverse Indigenous contexts. However, there is limited guidance on how to integrate Indigenous gender-based frameworks in the context of research. The authors of this paper are participants of a multi-site research program investigating intersectoral spaces of Indigenous-led renewable energy development within Canada. Through introspective methods, we reflected on the implementation of gender considerations into our research team's governance and research activities. We found three critical lessons: (1) embracing Two-Eyed Seeing or Etuaptmumk while making space for Indigenous leadership; (2) trusting the expertise that stems from the lived experiences and relationships of researchers and team members; and (3) shifting the emphasis from 'gender-based analysis' to 'gender-based relationality' in the implementation of gender-related research considerations. Our research findings provide a novel empirical example of the day-to-day principles and practices that may arise when implementing Indigenous gender-based analysis frameworks in the context of research.

Sharing Indigenous Foods Through Stories and Recipes.

Participants at the second National Gathering of the Aboriginal Nutrition Network (ANN) were encouraged to submit their favourite traditional recipes. Approximately 40 were received, and a volunteer working group contacted contributors to assist in the creation of a recipe resource with a selection of 12 recipes that included traditional ingredients to promote Indigenous foodways. All contributors were interviewed to share stories about their recipes. Each recipe was then tested, photographed, and developed into a resource handout that was disseminated to a variety of stakeholders. Afterwards, a brief survey was conducted with ANN recipients of the recipes (n = 23) to evaluate the recipe collection. When asked, "Prior to learning about this resource, was a collection of recipes using traditional foods something that you or the communities you work with were interested in?" all respondents answered yes. Nearly all found the recipes easy to follow (91%), and that they were applicable to the interests or needs of the communities they work with (83%). Preserving recipes and building opportunities for dietitians and other health professionals to contribute to traditional food recipe collections facilitates increased knowledge transfer, enhanced cross-cultural understanding, and is generally a useful tool for those working with Indigenous Peoples in Canada.

First Nations Food Environments: Exploring the Role of Place, Income, and Social Connection.

BACKGROUND: In Canada, few studies have examined how place shapes Indigenous food environments, particularly among Indigenous people living in southern regions of Ontario. OBJECTIVE: This paper examines and compares circumstances of food insecurity that impact food access and dietary quality between reserve-based and urban-based Indigenous peoples in southwestern Ontario. METHODS: This study used a community-based survey containing a culturally adapted food-frequency questionnaire and cross-sectional study design to measure food insecurity, food access, and dietary quality among Indigenous respondents living in urban (n = 130) and reserve-based (n = 99) contexts in southwestern Ontario. RESULTS: Rates of food insecurity are high in both geographies (55% and 35% among urban- and reserve-based respondents, respectively). Urban-based participants were 6 times more likely than those living on-reserve to report 3 different measures of food insecurity. Urban respondents reported income to be a significant barrier to food access, while for reserve-based respondents, time was the most pressing barrier. Compared with recommendations from Canada's Food Guide, our data revealed overwhelming trends of insufficient consumption in 3 food categories among all respondents. Close to half (54% and 52%) of the urban- and reserve-based samples reported that they eat traditional foods at least once a week, and respondents from both groups (76% of urban- and 52% of reserve-based respondents) expressed interest in consuming traditional foods more often. CONCLUSIONS: Indigenous Food Sovereignty and community-led research are key pathways to acknowledge and remedy Indigenous food insecurity. Policies, social movements, and research agendas that aim to improve Indigenous food security must be governed and defined by Indigenous people themselves. Indigenous food environments constitute political, social, and cultural dimensions that are infinitely place based.

A mixed-methods investigation of women's experiences seeking pregnancy-related online nutrition information.

BACKGROUND: The objective of this study was to describe women's processes for finding pregnancy-related nutrition information, their experiences seeking this information online and their ideas for improving internet sources of this information. METHODS: In total, 97 pregnant women completed an online quantitative questionnaire and 10 primiparous pregnant women completed semi-structured telephone interviews. Questionnaires and interviews asked participants to describe sources of pregnancy-related nutrition information; time of seeking; processes of searching online; experiences searching online; ideas for improving information found online. Survey data were analyzed using descriptive statistics and Chi square tests; interview data were analyzed using thematic analysis. RESULTS: Nearly all (96%) survey participants sought nutrition information online. Information was most commonly sought during the first trimester of pregnancy. Motivators for using the internet included convenience and lack of support from health care providers. Barriers to using online information included lack of trust, difficulty finding information and worry. Women adapted the information they found online to meet their needs and reported making positive changes to their diets. CONCLUSIONS: The internet is a key source of prenatal nutrition information that women report using to make positive dietary changes. Women would benefit from improved access to trustworthy internet sources, increased availability of information on different diets and health conditions, and increased support from health care providers.

Exploring the Perceptions of and Experiences with Traditional Foods among First Nations Female Youth: A Participatory Photovoice Study.

Traditional foods contribute to the health and well-being of Indigenous Peoples. Many Indigenous Peoples within Canada have expressed a desire to consume more traditional foods; however, there are a number of barriers to doing so. Southern and urban communities face unique challenges associated with traditional food consumption. To address these concerns and build on community interests in a Haudenosaunee community in Southern Ontario, a participatory research project was initiated. This community-based study utilized Photovoice methodology to explore the perceptions of and experiences with traditional foods among local youth. Participants ranging in age from 15-22 (n = 5) took photos of their local food environments, including locations where foods were acquired, consumed, prepared, or shared during two seasons of the year. Semi-structured interviews were conducted to collect participants' stories behind 8-10 self-selected images. A thematic analysis was subsequently utilized to identify patterns and themes illustrated by the photos and interview content. The youth conveyed contextual understandings of traditional foods and a preference for these items, despite their limited consumption, preparation or harvesting of these foods. The youth also identified the important influence of families and communities on their individual perceptions and experiences with traditional foods. Recommendations to reduce barriers to traditional food choices among youth are made.

Exploring First Nation Elder Women's Relationships with Food from Social, Ecological, and Historical Perspectives.

BACKGROUND: The ongoing negative health effects of colonization have disproportionately affected Indigenous women, who are disproportionately affected by diabetes, food insecurity, and undernutrition. Indigenous women also perceive their health less positively than men do. This article draws theoretically from the socio-ecological model to explore health inequalities experienced by Indigenous women associated with the intergenerational effects of the residential school legacy, specifically related to food practices. OBJECTIVES: Study objectives were to describe and compare the historical context of present-day urban and rural food environments, and explore the hypothesis that food insecurity may be associated with cultural loss resulting from the intergenerational trauma of residential schools in this region of southwestern Ontario, Canada. METHODS: Framed by a larger community-based participatory study, life history interviews took place with 18 Elder women living on- and off-reserve in southwestern Ontario, Canada. RESULTS: Women discussed painful circumstances of displacement from the land and social disconnection from families and communities. The 10 participants who were residential school survivors conveyed the intergenerational effects of loss, responsibility, lack of support, and an altered sense of identity as narratives of survival. Six women had moved away from their home communities, which created challenges to fully engage in local food procurement and sharing practices. These altered geographies present practical limitations, along with apparent mechanisms of social and cultural exclusion. CONCLUSIONS: Research on Indigenous Peoples' food systems requires further analysis of the root causes of disparities in the context of societal and gender relations. Food sovereignty has been the domain of women, who have led movements aimed at both social and environmental justice. Unraveling the historical, social, and environmental determinants of Indigenous food knowledge will support and guide community and policy recommendations, highlighting the ongoing effects of residential schooling and other indirect examples of environmental dispossession that have disproportionately affected Indigenous women.

Patient and caregiver perspectives of health provision practices for First Nations and Métis women with gestational diabetes mellitus accessing care in Winnipeg, Manitoba.

BACKGROUND: More North American Indigenous women are diagnosed with gestational diabetes mellitus (GDM) than the general population. Despite the number of health problems associated with GDM, few studies have been conducted that explore Indigenous women's understandings of GDM in an effort to develop appropriate and effective health strategies. METHODS: A qualitative investigation was conducted to describe the experiences of First Nations and Métis women with GDM. Unstructured interviews and focus groups initially took place with 25 advisors such as maternal care providers and community representatives. Semi-structured explanatory model interviews were subsequently carried out with 29 First Nations and Métis women in Winnipeg, Manitoba, Canada. RESULTS: Divisions in health services, communication and cultural barriers exist, and limit prenatal care access as well as the consistent interpretation of diabetes education messages. CONCLUSIONS: Collectively the results suggest living with GDM can be overwhelming and underscore the need for health care providers to encourage self-efficacy towards effective management practices in the context of cultural safety.

Food perceptions and concerns of aboriginal women coping with gestational diabetes in Winnipeg, Manitoba.

OBJECTIVE: To describe how Aboriginal women in an urban setting perceive dietary treatment recommendations associated with gestational diabetes mellitus (GDM). DESIGN: Semi-structured explanatory model interviews explored Aboriginal women's illness experiences with GDM. SETTING AND PARTICIPANTS: Twenty-nine self-declared Aboriginal women who had received a diagnosis of GDM within the last 5 years in Winnipeg, Manitoba. MAIN OUTCOME MEASURES: Factors influencing Aboriginal women's prenatal food perceptions with GDM. ANALYSIS: Thematic analysis was used through coding linkages and matrix queries to assist in identifying and categorizing patterns or relationships. RESULTS: Participants associated fear, anxiety, and frustration with GDM. Emotional reactions appeared alongside negative relationships with food and other prescribed lifestyle treatments. Collectively, these results suggested that the experience of living with GDM can be overwhelming, as suggested by some of the complex factors influencing women's perceptions and reported behaviors. Discussions indicated many felt socially isolated and had a poor self-image and sense of failure resulting from ineffective GDM management practices. CONCLUSIONS AND IMPLICATIONS: Future efforts should focus on self-efficacy and security in Aboriginal women's own interpretation of GDM, providing them with the understanding that there is potential for prevention and change.