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Bhawra J, Buchan MC, Green B, Skinner K, Katapally TR. A guiding framework for needs assessment evaluations to embed digital platforms in partnership with Indigenous communities. PLoS One 2022; 17:e0279282. [PMID: 36548382 PMCID: PMC10045546 DOI: 10.1371/journal.pone.0279282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION In community-based research projects, needs assessments are one of the first steps to identify community priorities. Access-related issues often pose significant barriers to participation in research and evaluation for rural and remote communities, particularly Indigenous communities, which also have a complex relationship with academia due to a history of exploitation. To bridge this gap, work with Indigenous communities requires consistent and meaningful engagement. The prominence of digital devices (i.e., smartphones) offers an unparalleled opportunity for ethical and equitable engagement between researchers and communities across jurisdictions, particularly in remote communities. METHODS This paper presents a framework to guide needs assessments which embed digital platforms in partnership with Indigenous communities. Guided by this framework, a qualitative needs assessment was conducted with a subarctic Métis community in Saskatchewan, Canada. This project is governed by an Advisory Council comprised of Knowledge Keepers, Elders, and youth in the community. An environmental scan of relevant programs, three key informant interviews, and two focus groups (n = 4 in each) were conducted to systematically identify community priorities. RESULTS Through discussions with the community, four priorities were identified: (1) the Coronavirus pandemic, (2) climate change impacts on the environment, (3) mental health and wellbeing, and (4) food security and sovereignty. Given the timing of the needs assessment, the community identified the Coronavirus pandemic as a key priority requiring digital initiatives. CONCLUSION Recommendations for community-based needs assessments to conceptualize and implement digital infrastructure are put forward, with an emphasis on self-governance and data sovereignty.
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Affiliation(s)
- Jasmin Bhawra
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, ON, Canada
| | - M. Claire Buchan
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Brenda Green
- Île-à-la-Crosse School Division, The Northern Village of Île-à-la-Crosse, Île-à-la-Crosse, SK, Canada
| | - Kelly Skinner
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Tarun Reddy Katapally
- DEPtH Lab, Faculty of Health Sciences, Western University, London, ON, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Lawson Health Research Institute, London, Ontario, Canada
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Development and testing of the Sustainable Nutrition Environment Measures Survey for retail stores in Ontario. Public Health Nutr 2021; 24:1962-1971. [PMID: 33517938 DOI: 10.1017/s1368980021000446] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To develop and test a tool to assess the price and availability of low-carbon footprint and nutritionally balanced dietary patterns in retail food environments in Ontario, Canada. DESIGN Availability and price of selected food from discount and regular grocery stores (n 23) in urban/rural areas of northern/southern Ontario were assessed with the Sustainable Nutrition Environment Measures Survey in 2017. SETTING Ontario, Canada. RESULTS Inter-rater reliability was high for price (intra-class correlation coefficients = 0·819) and for availability (Cohen's κ = 0·993). The tool showed 78 % of the selected food items were available in all stores. Overall, price differences were small between urban and rural locations, and northern and southern Ontario. The greatest price difference was between discount and regular stores. CONCLUSIONS The tool showed excellent inter-rater agreement. Researchers and public health dietitians can use this tool for research, practice and policy to link consumer-level health outcomes to the retail environment.
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Drivers and health implications of the dietary transition among Inuit in the Canadian Arctic: a scoping review. Public Health Nutr 2020; 24:2650-2668. [PMID: 32914743 DOI: 10.1017/s1368980020002402] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The current study undertook a systematic scoping review on the drivers and implications of dietary changes among Inuit in the Canadian Arctic. DESIGN A keyword search of peer-reviewed articles was performed using PubMed, Web of Science, CINAHL, Academic Search Premier, Circumpolar Health Bibliographic Database and High North Research Documents. Eligibility criteria included all full-text articles of any design reporting on research on food consumption, nutrient intake, dietary adequacy, dietary change, food security, nutrition-related chronic diseases or traditional food harvesting and consumption among Inuit populations residing in Canada. Articles reporting on in vivo and in vitro experiments or on health impacts of environmental contaminants were excluded. RESULTS A total of 162 studies were included. Studies indicated declining country food (CF) consumption in favour of market food (MF). Drivers of this transition include colonial processes, poverty and socio-economic factors, changing food preferences and knowledge, and climate change. Health implications of the dietary transition are complex. Micro-nutrient deficiencies and dietary inadequacy are serious concerns and likely exacerbated by increased consumption of non-nutrient dense MF. Food insecurity, overweight, obesity and related cardiometabolic health outcomes are growing public health concerns. Meanwhile, declining CF consumption is entangled with shifting culture and traditional knowledge, with potential implications for psychological, spiritual, social and cultural health and well-being. CONCLUSIONS By exploring and synthesising published literature, this review provides insight into the complex factors influencing Inuit diet and health. Findings may be informative for future research, decision-making and intersectoral actions around risk assessment, food policy and innovative community programmes.
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Luongo G, Skinner K, Phillipps B, Yu Z, Martin D, Mah CL. The Retail Food Environment, Store Foods, and Diet and Health among Indigenous Populations: a Scoping Review. Curr Obes Rep 2020; 9:288-306. [PMID: 32780322 DOI: 10.1007/s13679-020-00399-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE OF THE REVIEW Describe the state of knowledge on how the retail food environment contributes to diet-related health and obesity among Indigenous populations, and assess how the literature incorporates Indigenous perspectives, methodologies and engagement throughout the research process. Outcomes included dietary behaviour (purchasing, intakes and diet quality) and diet-related health outcomes (weight-related outcomes, non-communicable diseases and holistic health or definitions of health as defined by Indigenous populations involved in the study). RECENT FINDINGS Of fifty included articles (1996-2019), the largest proportions described Indigenous communities in Canada (20 studies, 40%), the USA (16, 32%) and Australia (9, 18%). Among articles that specified the Indigenous population of focus (42 studies, 84%), the largest proportion (11 studies, 26%) took place in Inuit communities, followed by Aboriginal and Torres Strait Islander communities (8 studies, 19%). The included literature encompassed four main study designs: type A, dietary intakes of store foods (14 studies, 28%), and type B, store food environments (16, 32%), comprised the greatest proportion of articles; the remainder were type C, store food environments and diet (7, 14%), and type D, store food environment interventions (13, 26%). Of the studies that assessed diet or health outcomes (36, 72%), 22 (61%) assessed dietary intakes; 16 (44%) sales/purchasing; and 8 (22%) weight-related outcomes. Store foods tended to contribute the greatest amount of dietary energy to the diets of Indigenous peoples and increased non-communicable disease risk as compared to traditional foods. Multi-pronged interventions appeared to have positive impacts on dietary behaviours, food purchasing and nutrition knowledge; promotion and nutrition education alone had more mixed effects. Of the nine studies which were found to have strong engagement with Indigenous populations, eight had moderate or high methodological quality. Eighteen studies (36%) did not mention any engagement with Indigenous populations. The literature confirmed the importance of store foods to the total energy intake of the contemporary diets of Indigenous people, the gaps in accessing both retail food environments and traditional foods and the potential for both new dietary assessment research and retail food environment intervention strategies to better align with and privilege Indigenous Ways of Knowing.
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Affiliation(s)
- Gabriella Luongo
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd floor, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Kelly Skinner
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Breanna Phillipps
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Ziwa Yu
- School of Nursing, Dalhousie University, 5869 University Avenue, PO BOX 15000, Halifax, NS, B3H 4R2, Canada
| | - Debbie Martin
- School of Health and Human Performance, Dalhousie University, Stairs House, 6230 South Street, PO Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Catherine L Mah
- School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, 2nd floor, PO Box 15000, Halifax, NS, B3H 4R2, Canada
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Richmond C, Steckley M, Neufeld H, Kerr RB, Wilson K, Dokis B. First Nations Food Environments: Exploring the Role of Place, Income, and Social Connection. Curr Dev Nutr 2020; 4:nzaa108. [PMID: 32734134 PMCID: PMC7382622 DOI: 10.1093/cdn/nzaa108] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 04/06/2020] [Accepted: 06/17/2020] [Indexed: 11/12/2022] Open
Abstract
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.
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Affiliation(s)
| | | | | | | | - Kathi Wilson
- University of Toronto–Mississauga, Mississauga, Ontario, Canada
| | - Brian Dokis
- The Southwest Ontario Aboriginal Health Access Centre, London, Ontario, Canada
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Mah CL, Taylor N. Store patterns of availability and price of food and beverage products across a rural region of Newfoundland and Labrador. Canadian Journal of Public Health 2019; 111:247-256. [PMID: 31667780 DOI: 10.17269/s41997-019-00260-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 08/28/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Rural populations bear a disproportionate burden of diet-related risk, and one important explanation is retail food access disparities. Much existing literature has focused on subjective measures of the rural retail food environment, as well as urban-rural differences. The purpose of this paper is to examine how objectively measured food availability and prices vary within a rural region, and to explore how store features predict rural food availability and prices. METHODS We conducted an observational audit of a census of rural food stores (n = 78) using a modified Nutrition Environment Measures Survey instrument. The study was conducted on the Avalon Peninsula in Newfoundland and Labrador. Observed prices in-store were matched to nutrient composition data and converted to three units of measure for all analyses: unit price ($/kg), serving price ($/serving), and energy price ($/kcal). We examined average availability and prices across the region, and how store features were associated with prices. RESULTS Healthy food options were generally less available across the stores than regular items. However, with few exceptions, there were no clear or consistent patterns of difference in availability or pricing between stores of different types. No single product category stood out in terms of a clear price pattern. Store characteristics (including store type, size, ownership, or rurality) did not predict food prices. CONCLUSIONS Food availability and prices varied in this rural region, but with limited differences between stores of different types. More research is needed on measuring rural environmental determinants of diet in Canada.
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Affiliation(s)
- Catherine L Mah
- School of Health Administration, Faculty of Health, Dalhousie University, PO Box 15000, Sir Charles Tupper Medical Building, 5850 College Street, Halifax, NS, B3H 4R2, Canada. .,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.
| | - Nathan Taylor
- School of Health Administration, Faculty of Health, Dalhousie University, PO Box 15000, Sir Charles Tupper Medical Building, 5850 College Street, Halifax, NS, B3H 4R2, Canada
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Nutrient Concentrations of Bush Bean (Phaseolus vulgaris L.) and Potato (Solanum tuberosum L.) Cultivated in Subarctic Soils Managed with Intercropping and Willow (Salix spp.) Agroforestry. SUSTAINABILITY 2017. [DOI: 10.3390/su9122294] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fuller D, Engler-Stringer R, Muhajarine N. Retail food environments research: Promising future with more work to be done. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2016; 107:5622. [PMID: 27281524 PMCID: PMC6972069 DOI: 10.17269/cjph.107.5622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 04/12/2016] [Indexed: 11/17/2022]
Abstract
As members of the scientific committee for the Food Environments in Canada conference, we reflect on the current state of food environments research in Canada. We are very encouraged that the field is growing and there have been many collaborative efforts to link researchers in Canada, including the 2015 Food Environments in Canada Symposium and Workshop. We believe there are 5 key challenges the field will need to collectively address: theory and causality; replication and extension; consideration of rural, northern and vulnerable populations; policy analysis; and intervention research. In addressing the challenges, we look forward to working together to conduct more sophisticated, complex and community-driven food environments research in the future.
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