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Burton TCJ, Crooks N, Pezley L, Hemphill NO, Li Y, Sawatpanich A, Farrow V, Erbe K, Kessee N, Reed L, Tussing-Humphreys L, Koenig MD. Food Choice and Dietary Perspectives of Young, Urban, Black Pregnant Women: A Focus Group Study. Nutrients 2024; 16:781. [PMID: 38542692 PMCID: PMC10974382 DOI: 10.3390/nu16060781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/27/2024] [Accepted: 03/06/2024] [Indexed: 04/01/2024] Open
Abstract
Black pregnant women in Chicago are disproportionately affected by maternal morbidity and mortality and are more likely to reside in neighborhoods that experience greater economic hardships and food apartheid than any other race/ethnicity. Addressing social determinants of health such as structural inequities, economic environment, and food apartheid issues may provide insights into eliminating Black maternal morbidity and mortality disparities. This study explores food choice determinants and dietary perspectives of young, urban, Black pregnant women. Two audio-recorded focus groups were conducted in Chicago, IL between March 2019 and June 2019 to discuss pregnancy experiences and factors affecting maternal nutrition. Thematic analysis was used to identify the codes, themes, and subthemes of the data. Data analysis was guided by the Social Ecological Model (SEM) as a theoretical framework. Eleven, young, Black women were recruited. Three major themes were discussed across the SEM levels that influenced food choice including food access, stress and family influences on eating, and the need for nutritional education during pregnancy. These choices were primarily rooted in the detrimental effects of food apartheid experienced within the participants' neighborhoods. Therefore, acknowledging, understanding, and addressing food apartheid and its impact on Black maternal health disparities is needed in clinical practice, research, and policy change.
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Affiliation(s)
| | - Natasha Crooks
- Department of Human Development Nursing Science, University of Illinois Chicago, 845 S. Damen Ave., Chicago, IL 60612, USA; (N.C.); (Y.L.); (A.S.); (V.F.); (M.D.K.)
| | - Lacey Pezley
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 W. Taylor St., Chicago, IL 60612, USA; (L.P.); (N.O.H.); (N.K.); (L.T.-H.)
| | - Nefertiti OjiNjideka Hemphill
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 W. Taylor St., Chicago, IL 60612, USA; (L.P.); (N.O.H.); (N.K.); (L.T.-H.)
| | - Yanqiao Li
- Department of Human Development Nursing Science, University of Illinois Chicago, 845 S. Damen Ave., Chicago, IL 60612, USA; (N.C.); (Y.L.); (A.S.); (V.F.); (M.D.K.)
| | - Arissara Sawatpanich
- Department of Human Development Nursing Science, University of Illinois Chicago, 845 S. Damen Ave., Chicago, IL 60612, USA; (N.C.); (Y.L.); (A.S.); (V.F.); (M.D.K.)
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd., Ratchathewi, Bangkok 10400, Thailand
| | - Vanessa Farrow
- Department of Human Development Nursing Science, University of Illinois Chicago, 845 S. Damen Ave., Chicago, IL 60612, USA; (N.C.); (Y.L.); (A.S.); (V.F.); (M.D.K.)
| | - Katherine Erbe
- Yvonne L. Munn Center for Nursing Research, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA;
| | - Nicollette Kessee
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 W. Taylor St., Chicago, IL 60612, USA; (L.P.); (N.O.H.); (N.K.); (L.T.-H.)
| | - Luecendia Reed
- New Moms, 5317 W. Chicago Ave., Chicago, IL 606051, USA;
| | - Lisa Tussing-Humphreys
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 W. Taylor St., Chicago, IL 60612, USA; (L.P.); (N.O.H.); (N.K.); (L.T.-H.)
| | - Mary Dawn Koenig
- Department of Human Development Nursing Science, University of Illinois Chicago, 845 S. Damen Ave., Chicago, IL 60612, USA; (N.C.); (Y.L.); (A.S.); (V.F.); (M.D.K.)
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Moore KR, Stotz SA, Terry MA, Seely EW, Gonzales K, Marshall G, Nadeau KJ, Akers A, Garcia-Reyes Y, Charron-Prochownik D. Respecting tribal voices in the development of a gestational diabetes risk reduction preconception counseling program for American Indian/Alaska Native adolescent females: a qualitative study. BMC Pregnancy Childbirth 2023; 23:552. [PMID: 37528363 PMCID: PMC10392008 DOI: 10.1186/s12884-023-05850-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/12/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND American Indians and Alaska Natives (AI/AN) are disproportionately affected by adolescent obesity, adolescent pregnancy and gestational diabetes mellitus (GDM). GDM is associated with increased risk for perinatal death, obesity, and subsequent type 2 diabetes (T2D) for the offspring. Moreover, mothers with GDM are also at increased risk for T2D post-partum. Yet few lifestyle interventions exist to reduce GDM risk prior to pregnancy. We describe the process of adapting an existing validated preconception counseling intervention for AI/AN adolescent girls at-risk for GDM and their mothers. Perspectives and recommendations were gathered from a diverse array of stakeholders to assure the new program called Stopping GDM was culturally responsive and developed with tribal voices and perspectives represented. METHODS We conducted focus groups and individual interviews with multiple AI/AN stakeholders (n = 55). Focus groups and interviews were digitally recorded, transcribed verbatim, and analyzed using a thematic content approach to construct cross-cutting themes across the focus groups and interviews. RESULTS Four key themes emerged reflecting issues important to planning a reproductive health intervention: 1) Limited awareness, knowledge, and health education resources about GDM; 2) The importance of acknowledging traditional AI/AN values and the diversity of traditions and culture among AI/AN tribes; 3) The need to cultivate healthy decision-making skills and empower girls to make safe and healthy choices; and 4) Lack of communication about reproductive health between AI/AN mothers and daughters and between AI/AN women and health care professionals. CONCLUSION Findings have been used to inform the cultural tailoring and adaptation of an existing preconception counseling program, originally designed for non-AI/AN adolescent girls with diabetes, for AI/AN adolescents at-risk for GDM in future pregnancies.
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Affiliation(s)
- Kelly R Moore
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sarah A Stotz
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Martha Ann Terry
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ellen W Seely
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kelly Gonzales
- School of Public Health, Oregon Health & Science University - Portland State University, Portland, OR, USA
| | | | - Kristen J Nadeau
- Children's Hospital Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | | | | | - Denise Charron-Prochownik
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
- Department of Health Promotion and Development, Professor Nursing and School of Public Health, School of Nursing, University of Pittsburgh, 440 Victoria Bldg, Pittsburgh, USA.
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Wedekind LE, Mitchell CM, Andersen CC, Knowler WC, Hanson RL. Epidemiology of Type 2 Diabetes in Indigenous Communities in the United States. Curr Diab Rep 2021; 21:47. [PMID: 34807308 PMCID: PMC8665733 DOI: 10.1007/s11892-021-01406-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW The present review focuses on the epidemiology of type 2 diabetes (T2D) in Indigenous communities in the continental United States (U.S.)-including disease prevention and management-and discusses special considerations in conducting research with Indigenous communities. RECENT FINDINGS Previous studies have reported the disparately high prevalence of diabetes, especially T2D, among Indigenous peoples in the U.S. The high prevalence and incidence of early-onset T2D in Indigenous youth relative to that of all youth in the U.S. population pose challenges to the prevention of complications of diabetes. Behavioral, dietary, lifestyle, and genetic factors associated with T2D in Indigenous communities are often investigated. More limited is the discussion of the historical and ongoing consequences of colonization and displacement that impact the aforementioned risk factors. Future research is necessary to assess community-specific needs with respect to diabetes prevention and management across the diversity of Indigenous communities in the U.S.
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Affiliation(s)
- Lauren E Wedekind
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 1550 East Indian School Road, Phoenix, AZ, 85014, USA
- Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Cassie M Mitchell
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 1550 East Indian School Road, Phoenix, AZ, 85014, USA
| | - Coley C Andersen
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 1550 East Indian School Road, Phoenix, AZ, 85014, USA
| | - William C Knowler
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 1550 East Indian School Road, Phoenix, AZ, 85014, USA
| | - Robert L Hanson
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 1550 East Indian School Road, Phoenix, AZ, 85014, USA.
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