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Kuijper LEN, Lacroix E, Singh G, Champagne M, Beardy B, Dubois R, Wood L, Harper MJ, Muench K, Kisselgoff M, Mann K, Waugh A, Thériault C, Tait M, Bombak A, Riediger ND. Experiences and perspectives of sugar-sweetened beverage consumption among Indigenous adults living in Manitoba. Appetite 2024; 202:107637. [PMID: 39208478 DOI: 10.1016/j.appet.2024.107637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 08/14/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024]
Abstract
Sugar-sweetened beverages (SSB) are a health policy target. Indigenous populations are among the highest consumers of SSB in Canada. However, the Truth and Reconciliation Commission calls on governments to recognize health disparities among Indigenous populations as a consequence of colonialism and governmental policies. The purpose of this analysis was to explore emergent perspectives of Indigenous adults on experiences and perspectives of SSB consumption. We conducted a community-based participatory study in partnership with three Indigenous-led organizations. From 2019 to 2022, we completed qualitative interviews with Indigenous adults living in Island Lake Anisininew First Nation, Flin Flon, and Winnipeg's North End, a neighbourhood with high concentration of Indigenous people. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Seventy-four adults participated in interviews, including 46 women, 26 men, and two identifying as two-spirit. Many participants, across all three locations, repeatedly and consistently described SSB or sugar as an addiction, which formed the primary theme for this analysis: addictive-like consumption of SSB. Addictive-like SSB consumption included comparison to other addictive substances, loss of control, and physical symptoms resulting from SSB intake (both positive and adverse) or attempting to reduce SSB intake. We identified two other secondary themes, i) perceived drivers and contexts of SSB consumption, and ii) health outcomes as a motivator for change. Perceived drivers or contexts included consuming SSB as a means to cope with stress, boredom, and poverty; SSB intake as being intertwined with other addictions or addictive substances; and drinking alone. In conclusion, addictive-like SSB consumption was reported by Indigenous adults. To address SSB intake among Indigenous populations, trauma-informed approaches should be explored that consider the colonial context.
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Affiliation(s)
| | - Emilie Lacroix
- Department of Psychology, University of New Brunswick, 38 Dineen Drive, Fredericton, NB, E3C 1N8, Canada.
| | - Gurismrandeep Singh
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Michael Champagne
- Fearless R2W, PO Box 44095 Redwood Centre Postal Outlet Winnipeg, MB, Canada, R2W 5M3.
| | - Byron Beardy
- Four Arrows Regional Health Authority, Wasagamack Health Authority, General Delivery, Wasagamack, MB R0B Z0, Winnipeg Office: 500-338 Broadway, Winnipeg, MB, Canada.
| | - Riel Dubois
- Fearless R2W, PO Box 44095 Redwood Centre Postal Outlet Winnipeg, MB, Canada, R2W 5M3
| | - Larry Wood
- Four Arrows Regional Health Authority, Wasagamack Health Authority, General Delivery, Wasagamack, MB R0B Z0, Winnipeg Office: 500-338 Broadway, Winnipeg, MB, Canada
| | - Mary Jane Harper
- Four Arrows Regional Health Authority, Wasagamack Health Authority, General Delivery, Wasagamack, MB R0B Z0, Winnipeg Office: 500-338 Broadway, Winnipeg, MB, Canada
| | - Krista Muench
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Maria Kisselgoff
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Kelsey Mann
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Anne Waugh
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
| | - Céleste Thériault
- National Indigenous Diabetes Association, 160 Provencher Blvd, Unit 202, Winnipeg, MB, R2H 0G3, Canada.
| | | | - Andrea Bombak
- Department of Sociology, University of New Brunswick, 9 Macaulay Ln, Fredericton, NB, E3C 1N8, Canada.
| | - Natalie D Riediger
- Department of Food and Human Nutritional Sciences, University of Manitoba, 35 Chancellors Circle, Winnipeg, MB, R3T 2N2, Canada.
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Kisselgoff M, Champagne MR, Dubois R, Turnbull L, LaPlante J, Schultz A, Bombak A, Riediger N. Balancing on the redline: a qualitative study of the experiences purchasing sugar-sweetened beverages among Indigenous adults in a Canadian urban neighbourhood. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:99-110. [PMID: 38036852 PMCID: PMC10853129 DOI: 10.17269/s41997-023-00831-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 10/24/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE Growing evidence suggests that inner-city residents actively navigate their food landscape to meet a wide range of socio-economic needs. Given the increasing focus of health policies on sugar-sweetened beverages (SSB) through price-based strategies, it is critical to understand purchasing habits of populations with higher SSB intake. This study examined urban Indigenous adults' SSB shopping behaviour and experiences. METHODS We conducted a community-based participatory research study using semi-structured interviews with a purposive sample of Indigenous adults (≥ 18 years old) from the North End neighbourhood of Winnipeg. Interviews were audio recorded, transcribed verbatim, and thematically analyzed. RESULTS All 20 participants (women = 10; men = 8; two-spirit = 2) consumed SSB on a regular, daily basis either at the time of the interview or at a prior period in their lives. Themes defining residents' SSB shopping behaviour and experiences of shopping for SSB included balancing on the redline, specifically (1) balancing SSB purchasing constraints and facilitators with savvy shopping approaches and (2) balancing (stereo)typical reactions with resilient coping approaches. Residents procured SSB in various stores within and beyond the boundaries of the North End neighbourhood. SSB is a considerable, reoccurring expense, requiring savvy price-shopping strategies in order to access. Indigenous adults experience judgement and stereotyping when purchasing SSB, including intersecting racial, class, and weight stigma. CONCLUSION Purchasing SSB is perceived as a source of judgement when outside of inner-city neighbourhoods. Policymakers should consider how policies directed at SSB, which are consumed by Indigenous and food-insecure populations in greater quantities, may magnify existing racial, class, and weight-based discrimination.
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Affiliation(s)
- Maria Kisselgoff
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Lorna Turnbull
- Faculty of Law, University of Manitoba, Winnipeg, MB, Canada
| | - Jeff LaPlante
- National Indigenous Diabetes Association, Winnipeg, MB, Canada
| | - Annette Schultz
- College of Nursing, University of Manitoba, Winnipeg, MB, Canada
| | - Andrea Bombak
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Natalie Riediger
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada.
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Jevitt CM, Ketchum K. Pairing Evidence-Based Strategies With Motivational Interviewing to Support Optimal Nutrition and Weight Gain in Pregnancy. J Perinat Neonatal Nurs 2024; 38:25-36. [PMID: 38278641 DOI: 10.1097/jpn.0000000000000792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
OBJECTIVE Because eating, nutrition, and weight management patterns adopted during pregnancy may persist beyond the postpartum period, pregnancy provides an opportunity for health education that affects the future health of the pregnant person, the fetus, and the family. This systematic review aimed to find nutrition and weight management behaviors that could be used safely during pregnancy to optimize gestational weight gain. METHODS PubMed, MEDLINE, and Web of Science were searched for research or systematic reviews published in English from 2018 to 2023 using terms including gestational weight gain maintenance, weight, management, pregnancy, behavior, strategy, and strategies. Excluded research used pediatric or adolescent populations, restrictive diets such as no carbohydrate or no fat diets, fasting, bariatric surgery, weight loss medications, private industry, or profit-earning programs using food brands or specific diet programs. RESULTS The abstracts reviewed in these areas: excessive gestational weight gain (1019), low-glycemic index diet (640), Mediterranean diet (220), MyPlate diet (2), the Dietary Approaches to Stop Hypertension (DASH) diet (50), portion control (6), home meal preparation (6), mindful eating (13), intuitive eating (10), self-weighing (10), and motivational interviewing during pregnancy (107), were reduced to 102 studies. Studies in those 10 areas were reviewed for nutrition and eating behaviors that are safe to use during pregnancy and could be used along with motivational interviewing. CONCLUSION Clinicians can discuss these behaviors using motivational interviewing techniques to assist clients in optimizing gestational weight gain. Dialogue examples pairing these strategies with motivational interviewing principles are included.
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Affiliation(s)
- Cecilia M Jevitt
- Midwifery Program, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Sivak L, Reilly R, Lockton J, Treloar C, Roe Y, McKetin R, Butt J, Ezard N, Winkenweder H, Ward J. Psychosocial stress and methamphetamine use: A mixed-methods study of intersectional stigma and Aboriginal and Torres Strait Islander methamphetamine use. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 121:104189. [PMID: 37708599 DOI: 10.1016/j.drugpo.2023.104189] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/09/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Regular methamphetamine use can cause a range of physical, psychological and social harms. Stigma is one factor that impacts engagement and successful completion of treatment. In Australia, Aboriginal and Torres Strait Islander people who regularly use methamphetamine experience multiple stigmas, which further compounds access to treatment and quality of life. This paper explores the cumulative and compounding effects of participating in a stigmatised activity such as illicit drug use in relation to the stigma experienced by Aboriginal and Torres Strait Islander people as a population marginalised through colonisation. METHODS Ten sites nationally participated in a cross-sectional survey measuring a range of factors including psychosocial stress in methamphetamine users. The survey sample size was 734, with 59% identifying as Aboriginal and Torres Strait Islander (n = 433). In addition, a total of 147 mainly Aboriginal and Torres Strait Islander people who use methamphetamine, community and family members, and service providers took part in a total of 19 focus groups and 7 interviews. RESULTS Aboriginal and Torres Strait Islander participants experienced multiple psychosocial stressors at significantly higher rates than non-Indigenous participants. These stressors include diminished access to health care (33%), experiences of racism (34%), grief and sorrow (39%), worry for family (46%), and child welfare experiences (46%). The qualitative findings highlight the cumulative impact of historical, political and social stressors on an already stigmatised population. CONCLUSIONS The findings of this unique analysis demonstrate the disruptive impact of methamphetamine use on the lives of those who use methamphetamines and their family members. They also illustrate challenges, such as stigma, that may confront those seeking assistance for drug-related issues. Aboriginal and Torres Strait Islander community involvement is necessary to provide support and education for the individual, the family, and the community as a whole. Stigma reduction is therefore a worthy target for intervention.
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Affiliation(s)
- Leda Sivak
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Australia.
| | - Rachel Reilly
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Australia; School of Psychology, University of Adelaide, Australia
| | - Jane Lockton
- School of Psychology, University of Adelaide, Australia
| | - Carla Treloar
- Centre for Social Research in Health and the Social Policy Research Centre, University of New South Wales, Australia
| | - Yvette Roe
- Molly Wardaguga Research Centre, Charles Darwin University, Australia
| | - Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Julia Butt
- School of Arts and Humanities, Edith Cowan University, Australia
| | - Nadine Ezard
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | | | - James Ward
- Poche Centre for Indigenous Health, University of Queensland, Australia
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Ahmed F, Liberda EN, Solomon A, Davey R, Sutherland B, Tsuji LJS. Indigenous Land-Based Approaches to Well-Being: The Niska (Goose) Harvesting Program in Subarctic Ontario, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3686. [PMID: 36834382 PMCID: PMC9958717 DOI: 10.3390/ijerph20043686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/11/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Historically, goose harvesting provided a source of culturally significant, safe, and nutritious food for the Omushkego Cree of subarctic Ontario, Canada. Disruptions stemming from colonization and climate change have led to a decrease in harvesting, resulting in higher rates of food insecurity. The aim of the Niska program was to reconnect Elders and youth to revitalize goose harvesting activities and associated Indigenous knowledge within the community. The program and evaluation were built using a two-eyed seeing (Etuaptmumk) and community-based participatory research approach. Salivary cortisol, a biomedical measure of stress, was collected before (n = 13) and after (n = 13) participation in the spring harvest. Likewise, cortisol samples were collected before (n = 12) and after (n = 12) the summer harvest. Photovoice and semi-directed interviews were employed after the spring (n = 13) and summer (n = 12) harvests to identify key elements of well-being from an Indigenous perspective. The changes observed in cortisol levels for the spring (p = 0.782) and summer (p = 0.395) harvests were not statistically significant. However, there was a noteworthy increase in the subjective well-being observed through the qualitative measures (semi-directed interviews and photovoice), highlighting the importance of using multiple perspectives when assessing well-being, especially in Indigenous peoples. Future programs should incorporate multiple perspectives when addressing complex environmental and health issues, such as food security and environmental conservation, especially in Indigenous homelands worldwide.
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Affiliation(s)
- Fatima Ahmed
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada
| | - Eric N. Liberda
- School of Occupation and Public Health, Faculty of Community Services, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
| | - Andrew Solomon
- Fort Albany First Nation, Fort Albany, ON P0L 1H0, Canada
| | - Roger Davey
- Fort Albany First Nation, Fort Albany, ON P0L 1H0, Canada
| | - Bernard Sutherland
- Peetabeck Academy, Mundo Peetabeck Education Authority, Fort Albany, ON P0L 1H0, Canada
| | - Leonard J. S. Tsuji
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada
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Needing indigenous biometrics for health in Canada. Prev Med Rep 2023; 31:102115. [PMID: 36820375 PMCID: PMC9938322 DOI: 10.1016/j.pmedr.2023.102115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
This article presents a critical analysis of the use of biometrics in clinical practice and their inadequacies for Indigenous populations in Canada and globally. Misclassifications of health status based on biometrics have health implications across the lifespan, from gestation to older adulthood, which are also examined. The social determinants of health and of Indigenous health compound the impact of inaccurate biometrics on First Nations, Inuit and Métis populations. Moving forward, biometric use should be done in partnership with Indigenous peoples and with consideration of the surrounding context. Future research should consider bridging existing gaps in knowledge on this topic in culturally safe ways, to improve the quality and depth of information available and inform more equitable health care for Indigenous populations.
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Savila F, Leakehe P, Bagg W, Harwood M, Letele D, Bamber A, Swinburn B, Goodyear-Smith F. Understanding engagement with Brown Buttabean Motivation, an Auckland grassroots, Pacific-led holistic health programme: a qualitative study. BMJ Open 2022; 12:e059854. [PMID: 35393331 PMCID: PMC8990259 DOI: 10.1136/bmjopen-2021-059854] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES The aim was to understand how participants engage with Brown Buttabean Motivation (BBM) a grassroots, Pacific-led holistic health programme and the meaning it has in their lives. The objectives were to explore the impact BBM had on all aspects of their health and well-being, what attracted them, why they stayed, identify possible enablers and barriers to engagement, and understand impact of COVID-19 restrictions. DESIGN Qualitative study with thematic analysis of semi-structured interviews of BBM participants, followed by theoretical deductive analysis of coded data guided by Pacific Fonofale and Māori Te Whare Tapa Whā health models. In this meeting-house metaphor, floor is family, roof is culture, house-posts represent physical, mental, spiritual and sociodemographic health and well-being, with surroundings of environment, time and context. SETTING Interviews of BBM members conducted in South Auckland, New Zealand, 2020. PARTICIPANTS 22 interviewees (50% female) aged 24-60 years of mixed Pacific and Māori ethnicities with a mixture of regular members, attendees of the programme for those morbidly obese and trainers. RESULTS Two researchers independently coded data with adjudication and kappa=0.61 between coders. Participants identified the interactive holistic nature of health and well-being. As well as physical, mental and spiritual benefits, BBM helped many reconnect with both their family and their culture. CONCLUSIONS BBM's primary aim is weight-loss motivation. Many weight loss studies provide programmes to improve physical exercise and nutrition, but seldom address sustainability and other core factors such as mental health. Programmes are often designed by researchers or authorities. BBM is a community-embedded intervention, with no reliance external authorities for its ongoing implementation. It addresses many factors impacting participants' lives and social determinants of health as well as its core business of exercise and diet change. Our results indicate that BBM's holistic approach and responsiveness to perceived community needs may contribute to its sustained success.
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Affiliation(s)
| | - Paea Leakehe
- Pacific Health, The University of Auckland, Auckland, New Zealand
| | - Warwick Bagg
- School of Medicine, University of Auckland, Auckland, New Zealand
| | - Matire Harwood
- General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand
| | | | | | - Boyd Swinburn
- Epidemiology & Biostatistics, The University of Auckland, Auckland, New Zealand
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Diet quality among Indigenous and non-Indigenous children and youth in Canada in 2004 and 2015: a repeated cross-sectional design. Public Health Nutr 2021; 25:123-132. [PMID: 34108071 PMCID: PMC8825962 DOI: 10.1017/s1368980021002561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The objectives were to describe changes in diet quality between off-reserve Indigenous and non-Indigenous children and youth from 2004 to 2015 and examine the association between food security and diet quality. DESIGN We utilised a repeated cross-sectional design using both the 2004 and 2015 nutrition-focused Canadian Community Health Surveys, including 24-h dietary recall. Diet quality was estimated according to the Healthy Eating Index (HEI). SETTING The surveys were conducted off-reserve in Canada's ten provinces. PARTICIPANTS Our analysis included children and youth 2-17 years old (n 18 189). Indigenous and non-Indigenous participants were matched, and using a general linear model, we tested time period and (non-)Indigenous identifiers, including their interaction effect, as predictors of HEI. RESULTS Both Indigenous and non-Indigenous children and youth had significantly higher HEI scores in 2015 as compared to 2004. There was not a significant (non-)Indigenous and time period interaction effect, indicating the improvements in diet quality in 2015 were similar between both Indigenous and non-Indigenous populations. Improvements in diet quality are largely attributed to reductions in percentage energy from 'other' foods, though a disparity between Indigenous and non-Indigenous children and youth persisted in 2015. Overall, food security was lower among the Indigenous population and positively, and independently, associated with diet quality overall, though this relationship differed between boys and girls. CONCLUSIONS School policies may have contributed to similar improvements in diet quality among Indigenous and non-Indigenous populations. However, an in-depth sex and gender-based analysis of the relationship between food security and diet quality is required.
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