Kelly Skinner

Barriers and supports for healthy eating and physical activity for first nation youths in northern Canada

Objectives. To investigate barriers and supports for healthy eating and physical activity in youths in a remote sub-arctic community, Fort Albany First Nation, Ontario, Canada. Study design. A qualitative multi-method participatory approach. Methods. The study included a purposive convenience sample of two adult (n = 22) and three youths (n = 30; students in grades 6 to 8) focus groups, unstructured one-on-one interviews with adult key informants (n = 7), and a scan of the community environment. Data were coded and analysed by hand and using NVivo software. Hurricane thinking and concept mapping were used to illustrate findings and relationships between concepts. Results. Dominant emerging themes included empowerment, trust, resources, barriers and opportunities, while major sub-themes included food security, cost, accessibility/availability, capacity building, community support, programs/training and the school snack/breakfast program. Conclusions. Numerous barriers to healthy nutrition and physical activity exist in this community and are possibly similar in other remote communities. Empowerment is a core issue that should be considered in the design of public health interventions for First Nations youths in remote sub-arctic communities.

Giving voice to food insecurity in a remote indigenous community in subarctic Ontario, Canada: traditional ways, ways to cope, ways forward

BackgroundFood insecurity is a serious public health issue for Aboriginal people (First Nations [FN], Métis, and Inuit) living in Canada. Food security challenges faced by FN people are unique, especially for those living in remote and isolated communities. Conceptualizations of food insecurity by FN people are poorly understood. The purpose of this study was to explore the perceptions of food insecurity by FN adults living in a remote, on-reserve community in northern Ontario known to have a high prevalence of moderate to severe food insecurity.MethodsA trained community research assistant conducted semi-directed interviews, and one adult from each household in the community was invited to participate. Questions addressed traditional food, coping strategies, and suggestions to improve community food security and were informed by the literature and a community advisory committee. Thematic data analyses were carried out and followed an inductive, data-driven approach.ResultsFifty-one individuals participated, representing 67% of eligible households. The thematic analysis revealed that food sharing, especially with family, was regarded as one of the most significant ways to adapt to food shortages. The majority of participants reported consuming traditional food (wild meats) and suggested that hunting, preserving and storing traditional food has remained very important. However, numerous barriers to traditional food acquisition were mentioned. Other coping strategies included dietary change, rationing and changing food purchasing patterns. In order to improve access to healthy foods, improving income and food affordability, building community capacity and engagement, and community-level initiatives were suggested.ConclusionsFindings point to the continued importance of traditional food acquisition and food sharing, as well as community solutions for food systems change. These data highlight that traditional and store-bought food are both part of the strategies and solutions participants suggested for coping with food insecurity. Public health policies to improve food security for FN populations are urgently needed.

Vegetable and Fruit Intakes of On-Reserve First Nations Schoolchildren Compared to Canadian Averages and Current Recommendations

This study investigated, in on-reserve First Nations (FN) youth in Ontario, Canada, the following: (a) the intakes of vegetable and fruit, “other” foods and relevant nutrients as compared to current recommendations and national averages, (b) current prevalence rates of overweight and obesity and (c) the relationship between latitude and dietary intakes. Twenty-four-hour diet recalls were collected via the Waterloo Web-Based Eating Behaviour Questionnaire (WEB-Q) (n = 443). Heights and weights of participants were self reported using measured values and Body Mass Index was categorized using the International Obesity Task Force cutoffs. Food group and nutrient intakes were compared to current standards, Southern Ontario Food Behaviour data and the Canadian Community Health Survey, Cycle 2.2, using descriptive statistics. Mean vegetable and fruit, fibre and folate intakes were less than current recommendations. Girls aged 14–18 years had mean intakes of vitamin A below current recommendations for this sub-group; for all sub-groups, mean intakes of vegetables and fruit were below Canadian averages. All sub-groups also had intakes of all nutrients and food groups investigated that were less than those observed in non-FN youth from Southern Ontario, with the exception of “other” foods in boys 12–18 years. Prevalence rates of overweight and obesity were 31.8% and 19.6%, respectively, exceeding rates in the general population. Dietary intakes did not vary consistently by latitude (n = 248), as revealed by ANOVA. This study provided a unique investigation of the dietary intakes of on-reserve FN youth in Ontario and revealed poor intakes of vegetables and fruit and related nutrients and high intakes of “other” foods. Prevalence rates of overweight and obesity exceed those of the general population.

Traditional food consumption behaviour and concern with environmental contaminants among Cree schoolchildren of the Mushkegowuk territory

Objectives: To investigate factors influencing consumption of traditional foods (e.g. wild game, fish) and concerns about environmental contaminants among schoolchildren of the Mushkegowuk Territory First Nations (Moose Factory, Fort Albany, Kashechewan, Attawapiskat, and Peawanuck). Study design: Cross-sectional data collection from a Web-based Eating Behaviour Questionnaire (WEB-Q). Methods: Schoolchildren in grades 6–12 (n = 262) responded to 4 of the WEB-Q questions: (a) Do you eat game? (b) How often do you eat game? (c) How concerned are you about the environmental contaminants in the wild game and fish that you eat? (d) I would eat more game if… [6 response options]. Data were collected in 2004 (Fort Albany), 2005 (Peawanuck), 2006 (Attawapiskat), 2007 (Moose Factory) and 2009 (Kashechewan). Hierarchical log-linear modelling (LLM) was used for analyses of multi-way frequency data. Results: Of the schoolchildren answering the specific questions: 174 consumed game; 95 reported concerns about contaminants in game; and 84 would increase their game consumption if it were more available in their homes. LLM revealed significant differences between communities; schoolchildren in Moose Factory consumed game “rarely or never” at greater than expected frequency, and fewer than expected consumed game “at least once a day”. Schoolchildren in Kashechewan had greater frequency of daily game consumption and few were concerned about contaminants in game. Using LLM, we found that sex was an insignificant variable and did not affect game consumption frequency or environmental contaminant concern. Conclusion: The consumption of traditional foods differed between communities and appears to be related to contamination concerns. In addition, latitudinal variation appears to influence the frequency of traditional food consumption in children; children in the most southerly location consumed traditional food less frequently.

Using a SWOT Analysis to Inform Healthy Eating and Physical Activity Strategies for a Remote First Nations Community in Canada

Purpose. To plan community-driven health promotion strategies based on a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the healthy eating and physical activity patterns of First Nation (FN) youth. Design. Cross-sectional qualitative and quantitative data used to develop SWOT themes and strategies. Setting. Remote, subarctic FN community of Fort Albany, Ontario, Canada. Subjects. Adult (n = 25) and youth (n = 66, grades 6–11) community members. Measures. Qualitative data were collected using five focus groups with adults (two focus groups) and youth (three focus groups), seven individual interviews with adults, and an environmental scan of 13 direct observations of events/locations (e.g., the grocery store). Quantitative data on food/physical activity behaviors were collected using a validated Web-based survey with youth. Analysis. Themes were identified from qualitative and quantitative data and were analyzed and interpreted within a SWOT matrix. Results. Thirty-two SWOT themes were identified (e.g., accessibility of existing facilities, such as the gymnasium). The SWOT analysis showed how these themes could be combined and transformed into 12 strategies (e.g., expanding and enhancing the school snack/breakfast program) while integrating suggestions from the community. Conclusion. SWOT analysis was a beneficial tool that facilitated the combination of local data and community ideas in the development of targeted health promotion strategies for the FN community of Fort Albany.

Eating in the City: A Review of the Literature on Food Insecurity and Indigenous People Living in Urban Spaces

Indigenous people often occupy different overlapping or co-existing food environments that include market-based foods, land and water based foods, and combinations of the two. Studying these food environments is complicated by the cultural and geographic diversity of Indigenous people and the effects of colonialism, land dispossession, relocation and forced settlement on static reserves, and increasing migration to urban areas. We conducted a scoping study of food insecurity and Indigenous peoples living in urban spaces in Canada, the United States, and Australia. The 16 studies reviewed showed that food insecurity among urban Indigenous populations is an issue in all three nations. Findings highlight both the variety of experiences of urban Indigenous peoples within and across the three nations, and the commonalities of these experiences.

Challenges in assessing food environments in northern and remote communities in Canada

Effective tools for retail food environments in northern and remote communities are lacking. This paper examines the challenges of conducting food environment assessments in northern and remote communities in Canada encountered during our experience with a food costing project. One of the goals of the Paying for Nutrition in the North project is to develop guidelines to improve current food costing tools for northern Canada. Paying for Nutrition illustrates the complex context of measuring food environments in northern and remote communities. Through the development of a food costing methodology guide to assess northern food environments, several contextual issues emerged, including retail store oligopolies in communities; the importance of assessing food quality; informal social food economies; and the challenge of costing the acquisition and consumption of land- and water-based foods. Food environment measures designed for northern and remote communities need to reflect the geographic context in which they are being employed and must include input from local residents.

Design of a human biomonitoring community-based project in the Northwest Territories Mackenzie Valley, Canada, to investigate the links between nutrition, contaminants and country foods

ABSTRACT Community-based projects place emphasis on a collaborative approach and facilitate research among Indigenous populations regarding local issues and challenges, such as traditional foods consumption, climate change and health safety. Country foods (locally harvested fish, game birds, land animals and plants), which contribute to improved food security, can also be a primary route of contaminant exposure among populations in remote regions. A community-based project was launched in the Dehcho and Sahtù regions of the Northwest Territories (Canada) to: 1) assess contaminants exposure and nutrition status; 2) investigate the role of country food on nutrient and contaminant levels and 3) understand the determinants of message perception on this issue. Consultation with community members, leadership, local partners and researchers was essential to refine the design of the project and implement it in a culturally relevant way. This article details the design of a community-based biomonitoring study that investigates country food use, contaminant exposure and nutritional status in Canadian subarctic First Nations in the Dehcho and Sahtù regions. Results will support environmental health policies in the future for these communities. The project was designed to explore the risks and benefits of country foods and to inform the development of public health strategies.

Health and Nutritional Literacy of New Zealand Nursing Students

BACKGROUND The published literature suggests that RNs are more overweight and obese than the general population. This research investigates associations between nutrition literacy, anthropometry measures, and nutritional biomarkers in an undergraduate nursing student population. METHOD Year-one nursing students from two tertiary education institutions in New Zealand were invited to participate in an observational, convenience sample study. Data collection from participants (N = 103) included a nutrition literacy questionnaire, anthropometry measures, and blood lipid, glucose, and HbA1c concentrations. RESULTS Approximately 51% of participants were either overweight or obese, which is a similar prevalence to the New Zealand demographic-matched population. Mean body mass index was 26.7 ± 6.3 kg/m2 and body fat was 29% ± 8.3%. The mean literacy score was 56.7% ± 13.2%. The literacy score was inversely associated with anthropometry measures and total cholesterol/high-density lipoprotein cholesterol ratio and positively associated with high-density lipoprotein cholesterol. CONCLUSIONS Nutrition literacy had a statistically significant influence on anthropometry and lipid measures. [J Nurs Educ. 2017;56(1):43-48.].

Sugar content of supermarket beverages commonly consumed by children in New Zealand

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