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Xie LF, Housni A, Roy-Fleming A, Bandini A, Delormier T, Costa DD, Brazeau AS. Evaluation of Support, a self-guided online type 1 diabetes self-management education and support web application-a mixed methods study. Digit Health 2023; 9:20552076231204435. [PMID: 37780064 PMCID: PMC10540604 DOI: 10.1177/20552076231204435] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/03/2023] Open
Abstract
Background Type 1 diabetes requires making numerous daily decisions to maintain normoglycemia. Support is an evidence-based self-guided web application for type 1 diabetes diabetes self-management. Objective Evaluate users' satisfaction with Support and investigate changes in self-reported frequency of-, fear of- hypoglycemia, and diabetes-related self-efficacy. Methods Adults from a Quebec type 1 diabetes registry used Support. Data was collected through online surveys or extracted from the registry at 0, 6, and 12 months (number of episodes and fear of hypoglycemia). At 6 months, participants reported satisfaction with Support and diabetes-related self-efficacy. A sub-group of 16 users was interviewed about their experience. Transcripts were analyzed using inductive and deductive approaches. Results In total, 207 accounts were created (35% men, 96% White, mean age and diabetes duration: 49.3 ± 13.8 and 25.2 ± 14.7 years). At 6 months, the median [Q1; Q3] satisfaction was 40/49 [35; 45] with a mean decrease in hypoglycemia frequency of 0.43 episodes over 3 days (95% CI: -0.86; 0.00, p = 0.051) and of -1.98 score for fear (95% CI: -3.76; -0.20, p = 0.030). Half of the participants reported increased diabetes-related self-efficacy. Conclusions Participants reported a high level of satisfaction with Support. Its use has the potential to facilitate hypoglycemia management and increase diabetes-related self-efficacy. Trial registration This study is registered on ClinicalTrials.gov NCT04233138.
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Affiliation(s)
- Li Feng Xie
- McGill University, School of Human Nutrition, Montreal, Canada
| | - Asmaa Housni
- McGill University, School of Human Nutrition, Montreal, Canada
| | | | - Aude Bandini
- Université de Montréal, Department of Philosophy, Montreal, Canada
| | | | - Deborah Da Costa
- McGill University, Department of Medicine, Montreal, Canada
- Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Anne-Sophie Brazeau
- McGill University, School of Human Nutrition, Montreal, Canada
- Montreal Diabetes Research Center, Montreal, Canada
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2
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Kennedy G, Kanter R, Chotiboriboon S, Covic N, Delormier T, Longvah T, Maundu P, Omidvar N, Vish P, Kuhnlein H. Traditional and Indigenous Fruits and Vegetables for Food System Transformation. Curr Dev Nutr 2021; 5:nzab092. [PMID: 34423230 PMCID: PMC8373596 DOI: 10.1093/cdn/nzab092] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 05/18/2021] [Accepted: 06/25/2021] [Indexed: 11/29/2022] Open
Abstract
Fruit and vegetable consumption is recommended in numerous food-based dietary guidelines and forms a key recommendation in many international statements related to healthy diets. There are thousands of fruit and vegetable species from which to choose, but despite this abundance from nature, populations in most countries neither produce nor consume the recommended daily amounts of fruits and vegetables. There is enormous potential to better incorporate the wealth of diverse fruit and vegetable species and varieties into food systems. Known and preserved by indigenous communities, these hidden food treasures can foster collaborative research and learning. This perspective from the Task Force on Traditional and Indigenous Food Systems and Nutrition of the International Union of Nutritional Sciences (IUNS) highlights 5 key actions that can be taken by individuals, communities, and nations to reshape dialogue about traditional and indigenous fruits and vegetables to benefit people and planetary ecosystems.
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Affiliation(s)
- Gina Kennedy
- Chair, International Union of Nutritional Sciences (IUNS) Task Force on Traditional and Indigenous Food Systems and Nutrition, Falls Church, VA, USA
| | - Rebecca Kanter
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - Namukolo Covic
- International Food Policy Research Institute, Addis Ababa, Ethiopia
| | - Treena Delormier
- Centre for Indigenous Peoples' Nutrition and Environment and School of Human Nutrition, McGill University, Montreal, Canada
| | | | - Patrick Maundu
- Kenya Resource Centre for Indigenous Knowledge, National Museums of Kenya, Nairobi, Kenya
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Prakash Vish
- Ramaiah University of Applied Sciences, Bangalore, India
| | - Harriet Kuhnlein
- Centre for Indigenous Peoples' Nutrition and Environment and School of Human Nutrition, McGill University, Montreal, Canada
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3
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Aflague TF, Leon Guerrero RT, Delormier T, Novotny R, Wilkens LR, Boushey CJ. Examining the Influence of Cultural Immersion on Willingness to Try Fruits and Vegetables among Children in Guam: The Traditions Pilot Study. Nutrients 2019; 12:E18. [PMID: 31861756 PMCID: PMC7019652 DOI: 10.3390/nu12010018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/25/2019] [Accepted: 10/29/2019] [Indexed: 11/16/2022] Open
Abstract
This pilot study examined the influence of cultural immersion on willingness to try fruits and vegetables (FV) among children 3-12 years old in three summer camps in Guam with different cultural exposure levels: cultural immersion camp (CIC), high exposure; university day camp (UDC), moderate exposure; and recreational sports camp (RSC), zero exposure. Children, ages 3-12 years old for CIC and UDC and 5-12 years old for RSC, participated: CIC (n = 47), UDC (n = 23), and RSC (n = 33). Children's willingness to try FV was assessed with the Adapted WillTry tool before and after each program. Whole FV intakes were assessed concurrently using the mobile food record in CIC and UDC. Using multivariate regression, WillTry post-assessment outcomes were modeled adjusting for pre-assessment, child characteristics, exposure, and parent cultural affiliation. Unique to the Adapted WillTry tool are three FV scales, local novel, local common, and imported, which are classified by source (local or imported) and/or familiarity (novel or common). WillTry adjusted mean FV post-scores by highest exposure camp to lowest were 2.2, 2.3, and 2.2 for local novel and 2.6, 2.6, and 2.6 for local common. No differences among camps were significant; however, there was an increase in the willingness to try scores for all FV score types and camps. The Traditions pilot study demonstrated: (1) feasibility of a multi-arm parallel design using existing community programs in limited-resource environments and (2) further examination of nutrition education components and contexts are needed to understand diet behaviors of indigenous populations.
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Affiliation(s)
- Tanisha F. Aflague
- College of Natural and Applied Sciences, University of Guam, Mangilao, GU 96923, USA;
| | | | - Treena Delormier
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3L9, Canada;
| | - Rachel Novotny
- Human Nutrition, Food, and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI 96822, USA;
| | - Lynne R. Wilkens
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI 96813, USA; (L.R.W.); (C.J.B.)
| | - Carol J. Boushey
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI 96813, USA; (L.R.W.); (C.J.B.)
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4
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Murdoch-Flowers J, Tremblay MC, Hovey R, Delormier T, Gray-Donald K, Delaronde E, Macaulay AC. Understanding how Indigenous culturally-based interventions can improve participants' health in Canada. Health Promot Int 2019; 34:154-165. [PMID: 28973378 DOI: 10.1093/heapro/dax059] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
There is increasing recognition that culturally-based diabetes prevention programs can facilitate the adoption and maintenance of healthy behaviours in the communities in which they are implemented. The Kahnawake School Diabetes Prevention Project (KSDPP) is a health promotion, community-based participatory research project aiming to reduce the incidence of Type 2 diabetes in the community of Kahnawake (Mohawk territory, Canada), with a large range of interventions integrating a Haudenosaunee perspective of health. Building on a qualitative, naturalistic and interpretative inquiry, this study aimed to assess the outcomes of a suite of culturally-based interventions on participants' life and experience of health. Data were collected through semi-structured qualitative interviews of 1 key informant and 17 adult, female Kahnawake community members who participated in KSDPP's suite of interventions from 2007 to 2010. Grounded theory was chosen as an analytical strategy. A theoretical framework that covered the experiences of all study participants was developed from the grounded theory analysis. KSDPP's suite of interventions provided opportunities for participants to experience five different change processes: (i) Learning traditional cooking and healthy eating; (ii) Learning physical activity; (iii) Learning mind focusing and breathing techniques; (iv) Learning cultural traditions and spirituality; (v) Socializing and interacting with other participants during activities. These processes improved participants' health in four aspects: mental, physical, spiritual and social. Results of this study show how culturally-based health promotion can bring about healthy changes addressing the mental, physical, spiritual and social dimensions of a holistic concept of health, relevant to the Indigenous perspective of well-being.
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Affiliation(s)
- Jayne Murdoch-Flowers
- Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Kanien'keha, Mohawk Nation, QC, Canada.,School of Dietetics and Human Nutrition, McGill University, Montréal, QC, Canada
| | - Marie-Claude Tremblay
- Department of Family Medicine and Emergency Medicine, Office of Education and Continuing Professional Development, Université Laval, QC, Canada
| | - Richard Hovey
- Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Kanien'keha, Mohawk Nation, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montréal, QC, Canada
| | - Treena Delormier
- Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Kanien'keha, Mohawk Nation, QC, Canada.,Office of Public Health Studies, University of Hawai'i, Honolulu, HI, USA
| | - Katherine Gray-Donald
- Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Kanien'keha, Mohawk Nation, QC, Canada.,School of Dietetics and Human Nutrition, McGill University, Montréal, QC, Canada
| | - Elaine Delaronde
- Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Kanien'keha, Mohawk Nation, QC, Canada
| | - Ann C Macaulay
- Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Kanien'keha, Mohawk Nation, QC, Canada.,Participatory Research at McGill, Department of Family Medicine, McGill University, Montréal, QC, Canada
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Ratima M, Martin D, Castleden H, Delormier T. Indigenous voices and knowledge systems – promoting planetary health, health equity, and sustainable development now and for future generations. Glob Health Promot 2019; 26:3-5. [DOI: 10.1177/1757975919838487] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Debbie Martin
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Heather Castleden
- Departments of Geography and Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Treena Delormier
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada
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6
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Ratima M, Martin D, Castleden H, Delormier T. Les voix et les systèmes de connaissances des populations autochtones : promouvoir la santé planétaire, l’équité en santé et le développement durable, maintenant et pour les générations futures. Glob Health Promot 2019. [DOI: 10.1177/1757975919838729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mihi Ratima
- Taumata Associates, Hawera, Nouvelle-Zélande
| | - Debbie Martin
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Heather Castleden
- Departments of Geography and Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Treena Delormier
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Québec, Canada
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7
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Ratima M, Martin D, Castleden H, Delormier T. Voces indígenas y sistemas de conocimiento: promover la salud del planeta, la equidad en salud y el desarrollo sostenible ahora y para las generaciones futuras. Glob Health Promot 2019. [DOI: 10.1177/1757975919838730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Debbie Martin
- Facultad de Salud, Universidad de Dalhousie, Halifax, Nueva Escocia, Canadá
| | - Heather Castleden
- Departamentos de Geografía y Ciencias de la Salud Pública, Universidad de Queen, Kingston, Ontario, Canadá
| | - Treena Delormier
- Escuela de Nutrición Humana, Universidad de McGill, Ste-Anne-de-Bellevue, Quebec, Canadá
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8
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Delormier T, Horn-Miller K, McComber AM, Marquis K. Reclaiming food security in the Mohawk community of Kahnawà:ke through Haudenosaunee responsibilities. Matern Child Nutr 2019; 13 Suppl 3. [PMID: 29359439 DOI: 10.1111/mcn.12556] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/22/2017] [Accepted: 09/27/2017] [Indexed: 11/28/2022]
Abstract
Indigenous Peoples are reclaiming their food security, nutrition, and well-being by revitalizing food systems, livelihoods, knowledge-systems, and governance. Our food security research is guided by sustainable self-determination that focuses on restoring Indigenous cultural responsibilities and relationships to land, each other, and the natural world (Corntassel, 2008). Our Kanien'kehá:ka (Mohawk) research team from Kahnawà:ke, in Quebec, Canada, examines food insecurity experiences in our community to explore ways of upholding our Haudenosaunee responsibilities and enhancing local food security. We collaboratively designed the study and interviewed Kahnawakehró:non (people from the Kahnawake community) with traditional knowledge, extensive community experience, and interests in food and culture. Interviews were audio-recorded, transcribed, and analysed by the team. Analysis characterized food insecurity experiences and conditions that challenge and enable food security with attention to traditional food systems, relationships to land, and gender-related responsibilities. Findings show that communal responsibilities generate resilient strategies that provide for all in times of crisis, and long-term food insecurity is managed through social programs, organized charities, and family support. Enhancing food security involves healing and protecting a limited land-base for food production, integrating food production with community priorities for education, training, health, economic development, and scientific innovation. Nurturing spiritual connections with tionhnhéhkwen (life sustaining foods), the natural world, and each other calls for accelerated teaching and practicing our original instructions. Challenges in developing food security leadership, balancing capitalism and subsistence economies, and strengthening social relationships are rooted in the historical colonial and current settler-colonial context that disrupts all aspects of Kanien'kehá:ka society.
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Affiliation(s)
- Treena Delormier
- Office of Public Health Studies, University of Hawaii, Honolulu, HI, USA
| | - Kahente Horn-Miller
- School of Indigenous and Canadian Studies, Carleton University, Ottawa, ON, Canada
| | - Alex M McComber
- Kahnawake Schools Diabetes Prevention Project, Kahnawake, QC, Canada
| | - Kaylia Marquis
- Kahnawake Schools Diabetes Prevention Project, Kahnawake, QC, Canada
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9
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Lemke S, Delormier T. Indigenous Peoples' food systems, nutrition, and gender: Conceptual and methodological considerations. Matern Child Nutr 2019; 13 Suppl 3. [PMID: 29359433 DOI: 10.1111/mcn.12499] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 06/16/2017] [Accepted: 06/16/2017] [Indexed: 12/21/2022]
Abstract
Indigenous Peoples, especially women and children, are affected disproportionately by malnutrition and diet-related health problems. Addressing this requires an investigation of the structural conditions that underlie unequal access to resources and loss of traditional lifestyles and necessitates inclusive approaches that shed light onto these issues and provide strategies to leverage change. Indigenous Peoples' food systems are inextricably connected to land, which in turn is interwoven with issues of self-determination, livelihoods, health, cultural and spiritual heritage, and gender. Ongoing loss of land and the dominant agri-food model further threaten Indigenous Peoples' food systems. Continuing gender-based discrimination undermines the self-determination and rights of women and negatively impacts their health, nutritional status, and overall well-being, as well as the well-being of households and communities. We suggest that feminist political ecology and modern matriarchal studies provide holistic interlinking frameworks for investigating underlying issues of power and inequality. We further argue that a focus on the principles of respect, responsibility, and relationships, and an openness to different worldviews, can facilitate a bridging of Indigenous and Western approaches in research and community action conducted in partnership with Indigenous Peoples. This can contribute to creating new ways of knowing regarding Indigenous Peoples' food systems, equally valuing both knowledge systems. Indigenous Peoples' rights, right to food, and food sovereignty are frames that, despite some tensions, have the common goal of self-determination. Through their ability to inform, empower, and mobilize, they provide tools for social movements and communities to challenge existing structural inequalities and leverage social change.
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Affiliation(s)
- Stefanie Lemke
- Centre for Agroecology, Water and Resilience, Coventry University, Coventry, UK.,Societal Transition and Agriculture, University of Hohenheim, Stuttgart, Germany
| | - Treena Delormier
- Office of Public Health Studies, University of Hawaii, Honolulu, Hawaii, USA
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10
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Abstract
ABSTRACTBackgroundFood insecurity disproportionately affects Indigenous Peoples and is linked to poor health outcomes. Indigenous Peoples’ food systems once sustained their thriving societies; however, colonial policies of displacement and imposed assimilation severed connections to Indigenous food systems and lands, disrupting identity, culture, and well-being.ObjectiveIn this article we share a grass-roots designed program that addresses food security and heeds Haudenosaunee teachings. The Story of Creation, the Great Law, and Ohénton Karihwatéhkwen (the words that come before all else) were the basis of the framework. The program acknowledges and uses community strengths and skills to enhance social connections and links with land and creation.MethodsThe program brought together interested and knowledgeable community members and stakeholders to discuss and better understand food security in the community. This group formed as an advisory group called Ieiénthos Akotióhkwa – ‘Planting Group’ who shaped the food security activities.ResultsThe program delivered workshops to build skills and share knowledge about food production and preparation. It targeted diverse participant interests and needs within an environment meant to nurture social connections. The program planted food-bearing trees and plants and created a seed library to create edible landscapes. We invited a broad scope of community knowledge- and skill-holders to share their talents with the community, to reinforce positive connections with each other, and to carry on cultural practices.ConclusionsChallenges included program sustainability linked to short-term funding and personnel turnover. Strengths involved using a culturally based framework that enhanced program coherence, and facilitated collaboration with local initiatives focused on well-being, practicing culture, and respecting the environment. Haudenosaunee teachings hold values and principles for a society that provides food for all. These teachings are a framework for a culturally rich program to support food security skills and resources, but also Indigenous cultural identity and practices.
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Affiliation(s)
- Treena Delormier
- School of Human Nutrition, McGill University, Quebec, Canada
- Kahnawake Schools Diabetes Prevention Project, Kahnawake, Quebec, Canada
| | - Kaylia Marquis
- Kahnawake Schools Diabetes Prevention Project, Kahnawake, Quebec, Canada
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Hovey RB, Delormier T, McComber AM, Lévesque L, Martin D. Enhancing Indigenous Health Promotion Research Through Two-Eyed Seeing: A Hermeneutic Relational Process. Qual Health Res 2017; 27:1278-1287. [PMID: 28682710 DOI: 10.1177/1049732317697948] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The intention of this article is to demonstrate how Indigenous and allied health promotion researchers learned to work together through a process of Two-Eyed Seeing. This process was first introduced as a philosophical hermeneutic research project on diabetes prevention within an Indigenous community in Quebec Canada. We, as a research team, became aware that hermeneutics and the principles of Haudenosaunee decision making were characteristic of Two-Eyed Seeing. This article describes our experiences while working with each other. Our learning from these interactions emphasized the relational aspects needed to ensure that we became a highly functional research team while working together and becoming Two-Eyed Seeing partners.
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Affiliation(s)
- Richard B Hovey
- 1 McGill University, Montreal, Quebec, Canada
- 2 Kahnawake Schools Diabetes Prevention Project, Kahnawake Mohawk Territory, Quebec, Canada
| | - Treena Delormier
- 2 Kahnawake Schools Diabetes Prevention Project, Kahnawake Mohawk Territory, Quebec, Canada
- 3 University of Hawaii at Mānoa, Honolulu, Hawaii, USA
| | - Alex M McComber
- 2 Kahnawake Schools Diabetes Prevention Project, Kahnawake Mohawk Territory, Quebec, Canada
| | - Lucie Lévesque
- 2 Kahnawake Schools Diabetes Prevention Project, Kahnawake Mohawk Territory, Quebec, Canada
- 4 Queen's University, Kingston, Ontario, Canada
| | - Debbie Martin
- 5 Dalhousie University, Halifax, Nova Scotia, Canada
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Fialkowski MK, Delormier T, Hattori-Uchima M, Leslie JH, Greenberg J, Kim JH, Deenik JL, Dunn MA, Areta IA, Novotny R. Children's Healthy Living Program (CHL) Indigenous Workforce Training to Prevent Childhood Obesity in the Underserved U.S. Affiliated Pacific Region. J Health Care Poor Underserved 2016; 26:83-95. [PMID: 25981090 DOI: 10.1353/hpu.2015.0054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The U.S. Affiliated Pacific Region (USAPR) is an underserved region with high rates of obesity-related, non-communicable diseases and a low proportion of trained obesity prevention professionals, especially indigenous professionals. The Children's Healthy Living Training Program was developed to enhance the USAPR's capacity to address childhood obesity prevention.
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13
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Mosley M, Delormier T, Banna J. Food-related Beliefs of Adolescent Girls Ages 9-13 and Their Mothers on O'ahu, Hawai'i. Hawaii J Med Public Health 2016; 75:101-108. [PMID: 27099805 PMCID: PMC4832877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A number of factors contribute to the development of obesity in adolescents, including various dietary and lifestyle behaviors, and a host of social and environmental factors, such as socioeconomic status, parental education, and culture. Research examining beliefs about behaviors related to weight status in adolescents, such as food intake, can create a better understanding of risk factors for obesity. This study explored beliefs about behaviors related to weight status in 20 early adolescent girls aged 9 to 13 years and their mothers in O'ahu, Hawai'i. Semi-structured individual interviews were conducted to elucidate beliefs through discussion of food purchasing, feeding practices, portion control strategies, eating outside the home, and body size perception. Interviews were transcribed verbatim and examined using directed content analysis. Both mothers and daughters believed that diets should consist of fresh foods and be based on principles of variety, balance, and moderation, and had negative perceptions of school lunch. In describing ideal body size, mothers expressed greater concern for overweight, as well as ethno-cultural beauty standards, than daughters. Mothers believed daughters should have a positive relationship with food but also applied various portion control strategies with them. Findings reveal how mothers' and daughters' beliefs may influence daily food-related practices in adolescent girls. Future studies may seek to investigate the role these factors may play in determining weight status in adolescents in Hawai'i, with findings to be used to inform health promotion programs.
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Affiliation(s)
- Michelle Mosley
- University of Hawai'i at Manoa, Department of Human Nutrition, Food, and Animal Sciences, Honolulu, HI (MAM, JCB)
| | - Treena Delormier
- University of Hawai'i at Manoa, Department of Human Nutrition, Food, and Animal Sciences, Honolulu, HI (MAM, JCB)
| | - Jinan Banna
- University of Hawai'i at Manoa, Department of Human Nutrition, Food, and Animal Sciences, Honolulu, HI (MAM, JCB)
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14
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Banna JC, Buchthal OV, Delormier T, Creed-Kanashiro HM, Penny ME. Influences on eating: a qualitative study of adolescents in a periurban area in Lima, Peru. BMC Public Health 2016; 16:40. [PMID: 26772177 PMCID: PMC4714484 DOI: 10.1186/s12889-016-2724-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 01/12/2016] [Indexed: 11/16/2022] Open
Abstract
Background Peruvian adolescents are at high nutritional risk, facing issues such as overweight and obesity, anemia, and pregnancy during a period of development. Research seeking to understand contextual factors that influence eating habits to inform the development of public health interventions is lacking in this population. This study aimed to understand socio-cultural influences on eating among adolescents in periurban Lima, Peru using qualitative methods. Methods Semi-structured interviews and pile sort activities were conducted with 14 adolescents 15–17 years. The interview was designed to elicit information on influences on eating habits at four levels: individual (intrapersonal), social environmental (interpersonal), physical environmental (community settings), and macrosystem (societal). The pile sort activity required adolescents to place cards with food images into groups and then to describe the characteristics of the foods placed in each group. Content analysis was used to identify predominant themes of influencing factors in interviews. Multidimensional scaling and hierarchical clustering analysis was completed with pile sort data. Results Individual influences on behavior included lack of financial resources to purchase food and concerns about body image. Nutrition-related knowledge also played a role; participants noted the importance of foods such as beans for anemia prevention. At the social environmental level, parents promoted healthy eating by providing advice on food selection and home-cooked meals. The physical environment also influenced intake, with foods available in schools being predominantly low-nutrient energy-dense. Macrosystem influences were evident, as adolescents used the Internet for nutrition information, which they viewed as credible. Conclusions To address nutrition-related issues such as obesity and iron-deficiency anemia in Peruvian adolescents, further research is warranted to elucidate the roles of certain factors shaping behavior, particularly that of family, cited numerous times as having a positive influence. Addressing nutrition-related issues such as obesity and iron-deficiency anemia in this population requires consideration of the effect of social and environmental factors in the context of adolescent lifestyles on behavior. Nutrition education messages for adolescents should consider the cultural perceptions and importance of particular foods, taking into account the diverse factors that influence eating behaviors.
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Affiliation(s)
- Jinan C Banna
- Department of Human Nutrition, Food, and Animal Sciences, College of Tropical Agriculture and Human Resources, Agricultural Sciences 216, University of Hawaii at Manoa, 1955 East-west Road, Honolulu, HI, 96822, USA.
| | - Opal Vanessa Buchthal
- Office of Public Health Studies, University of Hawaii at Manoa, 1960 East-west Road, Honolulu, HI, 96822, USA
| | - Treena Delormier
- Office of Public Health Studies, University of Hawaii at Manoa, 1960 East-west Road, Honolulu, HI, 96822, USA
| | | | - Mary E Penny
- Instituto de Investigación Nutricional, Av. La Molina 1885, Lima 12, Peru
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Banna J, Buchthal V, Delormier T, Creed‐Kanashiro H, Penny M. Influences on eating and physical activity: a qualitative study in adolescents in a periurban area in Lima, Peru (806.13). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.806.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jinan Banna
- Human Nutrition, Food and Animal SciencesUniversity of Hawaii at ManoaHonoluluHIUnited States
| | - Vanessa Buchthal
- Public Health Studies University of Hawaii at ManoaHonoluluHIUnited States
| | - Treena Delormier
- Public Health Studies University of Hawaii at ManoaHonoluluHIUnited States
| | | | - Mary Penny
- Instituto DE Investigación NutricionalLimaPeru
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Taualii M, Delormier T, Maddock J. A new and innovative public health specialization founded on traditional knowledge and social justice: Native Hawaiian and Indigenous Health. Hawaii J Med Public Health 2013; 72:143-145. [PMID: 23795316 PMCID: PMC3689511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Maile Taualii
- Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI, USA
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Willows ND, Hanley AJG, Delormier T. A socioecological framework to understand weight-related issues in Aboriginal children in Canada. Appl Physiol Nutr Metab 2012; 37:1-13. [PMID: 22269027 DOI: 10.1139/h11-128] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Obesity prevention efforts in Aboriginal (First Nations, Métis, or Inuit) communities in Canada should focus predominantly on children given their demographic significance and the accelerated time course of occurrence of type 2 diabetes mellitus in the Aboriginal population. A socioecological model to address childhood obesity in Aboriginal populations would focus on the numerous environments at different times in childhood that influence weight status, including prenatal, sociocultural, family, and community environments. Importantly, for Aboriginal children, obesity interventions need to also be situated within the context of a history of colonization and inequities in the social determinants of health. This review therefore advocates for the inclusion of a historical perspective and a life-course approach to obesity prevention in Aboriginal children in addition to developing interventions around the socioecological framework. We emphasize that childhood obesity prevention efforts should focus on promoting maternal health behaviours before and during pregnancy, and on breastfeeding and good infant and child nutrition in the postpartum and early childhood development periods. Ameliorating food insecurity by focusing on improving the sociodemographic risk factors for it, such as increasing income and educational attainment, are essential. More research is required to understand and measure obesogenic Aboriginal environments, to examine how altering specific environments modifies the foods that children eat and the activities that they do, and to examine how restoring and rebuilding cultural continuity in Aboriginal communities modifies the many determinants of obesity. This research needs to be done with the full participation of Aboriginal communities as partners in the research.
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Affiliation(s)
- Noreen D Willows
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, AB T6G 2P5, Canada.
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Cargo MD, Delormier T, Lévesque L, McComber AM, Macaulay AC. Community Capacity as an “Inside Job”: Evolution of Perceived Ownership within a University-Aboriginal Community Partnership. Am J Health Promot 2011; 26:96-100. [DOI: 10.4278/ajhp.091229-arb-403] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To assess the evolution of perceived ownership of a university-Aboriginal community partnership across three project stages. Design. Survey administration to project partners during project formalization (1996—T1), mobilization (1999—T2), and maintenance (2004—T3). Setting. Aboriginal community of Kahnawake, outside Montreal, Quebec, Canada. Participants. Partners involved in influencing decision making in the Kahnawake Schools Diabetes Prevention Project (KSDPP). Measure and Analysis. A measure of perceived primary ownership subjected to linear trend analysis. Results. KSDPP staff were perceived as primary owner at T1 and shared ownership with Community Advisory Board (CAB) members at T2 and T3. Trend tests indicated greater perceived ownership between T1 and T3 for CAB (χ21 = 12.3, p < .0001) and declining KSDPP staff (χ21 = 10.5, p < .001) ownership over time. Academic partners were never perceived as primary owners. Conclusion. This project was community driven from the beginning. It was not dependent on an external academic change agent to activate the community and develop the community's capacity to plan and implement a solution. It still took several years for the grassroots CAB to take responsibility from KSDPP staff, thus indicating the need for sustained funding to build grassroots community capacity.
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Affiliation(s)
- Margaret D. Cargo
- Margaret D. Cargo, PhD, is with the School of Health Sciences, University of South Australia, Adelaide, South Australia. Margaret D. Cargo, PhD, is also with the Douglas Hospital Research Centre, McGill University, Verdun, Quebec, Canada. Ann C. Macaulay, CM, MD, FCFP, is with Participatory Research at McGill, Department of Family Medicine, McGill University, Verdun, Québec, Canada. Treena Delormier, PDt, and Alex M. McComber, MEd, are with the Kahnawake Schools Diabetes Prevention Project, Kahnawake
| | - Treena Delormier
- Margaret D. Cargo, PhD, is with the School of Health Sciences, University of South Australia, Adelaide, South Australia. Margaret D. Cargo, PhD, is also with the Douglas Hospital Research Centre, McGill University, Verdun, Quebec, Canada. Ann C. Macaulay, CM, MD, FCFP, is with Participatory Research at McGill, Department of Family Medicine, McGill University, Verdun, Québec, Canada. Treena Delormier, PDt, and Alex M. McComber, MEd, are with the Kahnawake Schools Diabetes Prevention Project, Kahnawake
| | - Lucie Lévesque
- Margaret D. Cargo, PhD, is with the School of Health Sciences, University of South Australia, Adelaide, South Australia. Margaret D. Cargo, PhD, is also with the Douglas Hospital Research Centre, McGill University, Verdun, Quebec, Canada. Ann C. Macaulay, CM, MD, FCFP, is with Participatory Research at McGill, Department of Family Medicine, McGill University, Verdun, Québec, Canada. Treena Delormier, PDt, and Alex M. McComber, MEd, are with the Kahnawake Schools Diabetes Prevention Project, Kahnawake
| | - Alex M. McComber
- Margaret D. Cargo, PhD, is with the School of Health Sciences, University of South Australia, Adelaide, South Australia. Margaret D. Cargo, PhD, is also with the Douglas Hospital Research Centre, McGill University, Verdun, Quebec, Canada. Ann C. Macaulay, CM, MD, FCFP, is with Participatory Research at McGill, Department of Family Medicine, McGill University, Verdun, Québec, Canada. Treena Delormier, PDt, and Alex M. McComber, MEd, are with the Kahnawake Schools Diabetes Prevention Project, Kahnawake
| | - Ann C. Macaulay
- Margaret D. Cargo, PhD, is with the School of Health Sciences, University of South Australia, Adelaide, South Australia. Margaret D. Cargo, PhD, is also with the Douglas Hospital Research Centre, McGill University, Verdun, Quebec, Canada. Ann C. Macaulay, CM, MD, FCFP, is with Participatory Research at McGill, Department of Family Medicine, McGill University, Verdun, Québec, Canada. Treena Delormier, PDt, and Alex M. McComber, MEd, are with the Kahnawake Schools Diabetes Prevention Project, Kahnawake
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Delormier T, Frohlich KL, Potvin L. Food and eating as social practice--understanding eating patterns as social phenomena and implications for public health. Sociol Health Illn 2009; 31:215-228. [PMID: 19220802 DOI: 10.1111/j.1467-9566.2008.01128.x] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Globally, public health agencies recognise obesity trends among populations as a priority. Explanations for population obesity patterns are linked to obesogenic environments and societal trends which encourage patterns of overeating and little physical activity. However, obesity prevention and nutrition intervention focus predominantly on changing individual level eating behaviours. Disappointingly, behaviour-based nutrition education approaches to changing population eating patterns have met with limited success. Sociological perspectives propose that underlying social relations can help explain collective food and eating patterns, and suggest an analysis of the sociocultural context for understanding population eating patterns. We propose a theoretical framework for the examination of eating patterns as social phenomena. Giddens' structuration theory, in particular his concept of social practices understood as an interplay of 'agency' and 'social structure' (rules and resources), is used to study food choice patterns. We discuss the application of these concepts for understanding routine food choice practices of families, elaborating how rules and resources configure the enabling or constraining conditions under which actors make food choices. The framework assists in characterising how social structural properties are integral to food choice practices, and could direct attention to these when considering nutrition interventions aimed at changing population eating patterns.
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Affiliation(s)
- Treena Delormier
- Department of Social and Preventive Medicine, University of Montréal, Canada.
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Delormier T, Whitebean S, Jacobs A, Peterson L, Macaulay A, Whitebean Sisters S, McComber [deceased] R, Leclaire P, Deer M, Delaronde E. Diabetes shockers - short films to raise diabetes awareness in an indigenous community. Can J Diabetes 2009. [DOI: 10.1016/s1499-2671(09)33147-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cargo M, Delormier T, Lévesque L, Horn-Miller K, McComber A, Macaulay AC. Can the democratic ideal of participatory research be achieved? An inside look at an academic-indigenous community partnership. Health Educ Res 2008; 23:904-914. [PMID: 18187491 DOI: 10.1093/her/cym077] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Democratic or equal participation in decision making is an ideal that community and academic stakeholders engaged in participatory research strive to achieve. This ideal, however, may compete with indigenous peoples' right to self-determination. Study objectives were to assess the perceived influence of multiple community (indigenous) and academic stakeholders engaged in the Kahnawake Schools Diabetes Prevention Project (KSDPP) across six domains of project decision making and to test the hypothesis that KSDPP would be directed by community stakeholders. Self-report surveys were completed by 51 stakeholders comprising the KSDPP Community Advisory Board (CAB), KSDPP staff, academic researchers and supervisory board members. KSDPP staff were perceived to share similar levels of influence with (i) CAB on maintaining partnership ethics and CAB activities and (ii) academic researchers on research and dissemination activities. KSDPP staff were perceived to carry significantly more influence than other stakeholders on decisions related to annual activities, program operations and intervention activities. CAB and staff were the perceived owners of KSDPP. The strong community leadership aligns KSDPP with a model of community-directed research and suggests that equitable participation-distinct from democratic or equal participation-is reflected by indigenous community partners exerting greater influence than academic partners in decision making.
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Affiliation(s)
- Margaret Cargo
- Psychosocial Research Division, Douglas Hospital Research Centre-McGill University, Verdun, Québec, Canada H4H 1R3.
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Cargo M, Salsberg J, Delormier T, Desrosiers S, Macaulay AC. Understanding the social context of school health promotion program implementation. Health Education 2006. [DOI: 10.1108/09654280610650936] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lévesque L, Guilbault G, Delormier T, Potvin L. Unpacking the black box: a deconstruction of the programming approach and physical activity interventions implemented in the Kahnawake Schools Diabetes Prevention Project. Health Promot Pract 2005; 6:64-71. [PMID: 15574530 DOI: 10.1177/1524839903260156] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An ecological lens was used to deconstruct the programming approach and unpack physical activity interventions implemented through the Kahnawake Schools Diabetes Prevention Project. Despite a surge of interest in ecologically based health promotion programming, optimal combinations of interventions and programming approaches to promote community physical activity involvement have not been systematically studied. The authors obtained physical activity intervention descriptions through archive retrieval and face-to-face interviews with intervention staff. Programming approach, intervention targets, strategies for change, and delivery settings were assessed by applying the intervention analysis procedure to intervention descriptions. A complex intervention package was found containing a host of multitarget, multisetting intervention strategies designed and implemented through dynamic exchanges between a diversity of community partners. This study provides a first step toward better understanding community intervention packages and programming strategies for promoting physical activity involvement within a community setting.
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Affiliation(s)
- Lucie Lévesque
- School of Physical and Health Education at Queen's University, Kingston, Ontario, Canada.
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Bisset S, Cargo M, Delormier T, Macaulay AC, Potvin L. Legitimizing diabetes as a community health issue: a case analysis of an Aboriginal community in Canada. Health Promot Int 2004; 19:317-26. [PMID: 15306616 DOI: 10.1093/heapro/dah305] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The Kahnawake Schools Diabetes Prevention Project (KSDPP) is an ongoing participatory research and intervention project aimed at the primary prevention of type 2 diabetes. Formally initiated in 1994 with strong community support, KSDPP provides a fertile opportunity to learn about how a community came to identify the need for preventive action on a health problem such as diabetes. The purpose of our study was to describe the various conditions in the community of Kahnawake, which gave rise to its mobilization for the prevention of type 2 diabetes. Qualitative data consisted of 12 individual interviews and one focus group with key community members and health professionals living and/or working in the community of Kahnawake, along with historically relevant documents. The data collection and analysis procedures of the grounded theory method were applied. Results describe a preceding phase to formal KSDPP implementation, triggered by returning research results on the community prevalence of type 2 diabetes. This phase of 'legitimizing diabetes as a community health issue' is characterized by a shift in the perceived preventability of diabetes among community members; from a problem that was to be lived with to a problem that was to be prevented. The shift in perceptions was facilitated by the context in the community, described by structural developments, cognitive and relational elements. In addition to reaffirming the critical importance of utilizing lay knowledge during the planning of a health promotion intervention, our study has uncovered some of the key conditions through which individuals in the community came to participate in the identification and planning of a diabetes prevention project.
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Affiliation(s)
- Sherri Bisset
- Groupe de Recherche Interdisciplinarie en Santé, Université de Montréal, C.P. 6128, Succ. Centre-ville, Montréal, Québec, Canada H3C 3J7.
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Cargo M, Lévesque L, Macaulay AC, McComber A, Desrosiers S, Delormier T, Potvin L. Community governance of the Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Mohawk Nation, Canada. Health Promot Int 2003; 18:177-87. [PMID: 12920138 DOI: 10.1093/heapro/dag013] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Health promotion emphasizes the importance of community ownership in the governance of community-based programmes, yet little research has been conducted in this area. This study examined perceptions of community ownership among project partners taking responsibility for decision-making related to the Kahnawake Schools Diabetes Prevention Project (KSDPP). Project partners were surveyed cross-sectionally at 18 months (T1) and 60 months (T2) into the project. The perceived influence of each project partner was assessed at T1 and T2 for three domains: (i) KSDPP activities; (ii) KSDPP operations; and (iii) Community Advisory Board (CAB) activities. Project staff were perceived to have the greatest influence on KSDPP activities, KSDPP operations and CAB activities at both T1 and T2. High mean scores of perceived influence for CAB members and community researchers, however, suggests that project decision-making was a shared responsibility among multiple community partners. Although academic researcher influence was consistently low, they were satisfied with their level of influence. This was unlike community affiliates, who were less satisfied with their lower level of influence. In keeping with Kanien'kehaka (Mohawk) culture, the findings suggest a participatory democracy or shared decision-making as the primary mode of governance of KSDPP.
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Affiliation(s)
- Margaret Cargo
- KSDPP, Kahnawake Territory, Kanien'keh (Mohawk Nation), Québec, Canada.
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Potvin L, Cargo M, McComber AM, Delormier T, Macaulay AC. Implementing participatory intervention and research in communities: lessons from the Kahnawake Schools Diabetes Prevention Project in Canada. Soc Sci Med 2003; 56:1295-305. [PMID: 12600366 DOI: 10.1016/s0277-9536(02)00129-6] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Community public health interventions based on citizen and community participation are increasingly discussed as promising avenues for the reduction of health inequalities and the promotion of social justice. However, very few authors have provided explicit principles and guidelines for planning and implementing such interventions, especially when they are linked with research. Traditional approaches to public health programming emphasise expert knowledge, advanced detailed planning, and the separation of research from intervention. Despite the usefulness of these approaches for evaluating targeted narrow-focused interventions, they may not be appropriate in community health promotion, especially in Aboriginal communities. Using the experience of the Kahnawake Schools Diabetes Prevention Project, in Canada, this paper elaborates four principles as basic components for an implementation model of community programmes. The principles are: (1) the integration of community people and researchers as equal partners in every phase of the project, (2) the structural and functional integration of the intervention and evaluation research components, (3) having a flexible agenda responsive to demands from the broader environment, and (4) the creation of a project that represents learning opportunities for all those involved. The emerging implementation model for community interventions, as exemplified by this project, is one that conceives a programme as a dynamic social space, the contours and vision of which are defined through an ongoing negotiation process.
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Affiliation(s)
- Louise Potvin
- Kahnawake Schools Diabetes Prevention Project, P.O. Box 1000, Kahnawake Territory, Mohawk Nation, Québec, Canada J0L 1B0.
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Arbour L, Christensen B, Delormier T, Platt R, Gilfix B, Forbes P, Kovitch I, Morel J, Rozen R. Spina bifida, folate metabolism, and dietary folate intake in a Northern Canadian aboriginal population. Int J Circumpolar Health 2002; 61:341-51. [PMID: 12546192 DOI: 10.3402/ijch.v61i4.17492] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Inhabitants of the subarctic region of the Eastern James Bay of Northern Quebec consume a diet low in folate. This is largely secondary to poor access to plant-foods and a preferred diet high in meat, fowl, and fish as in many other northern populations. Furthermore, there is a high frequency of spina bifida in the Cree of the region. It was hypothesized that genetically altered folate metabolism as well as low folate intake contributes to the high frequency of spina bifida. METHODS A case-control study evaluating folate metabolism and the common 677C-T polymorphism of the gene for methylenetetrahydrofolate reductase (MTHFR) in mothers of children with spina bifida, and controls (n=23) of Cree descent from the Eastern James Bay region. These results were compared to a similar Montreal cohort (n=152) who were not of First Nations descent. Dietary intake of folate of 219 women of the Eastern James Bay region was also determined. RESULTS No Cree mothers of children with spina bifida were homozygous for the 677C-T polymorphism of MTHFR. Although serum cobalamin was significantly higher in Cree mothers, RBC folate was significantly lower than in the Montreal cohort. In addition, plasma homocysteine was significantly lower in the Cree. Dietary intake of folate of women in the same region was substantially lower (100 microg/day) than widely recommended daily intakes. CONCLUSIONS In this remote Canadian aboriginal community there is no evidence of altered folate metabolism in the mothers of children with spina bifida. Nonetheless, it remains essential that culturally appropriate public health efforts be continued to increase the intake of folic acid in the hope of reducing the high frequency of spina bifida in this population.
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Affiliation(s)
- Laura Arbour
- Department of Human Genetics, School of Dietetics and Human Nutrition, McGill University Montreal, Quebec Canada.
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Macaulay AC, Cross EJ, Delormier T, Potvin L, Paradis G, McComber A. Developing a Code of Research Ethics for research with a Native community in Canada: a report from the Kahnawake Schools Diabetes Prevention Project. Int J Circumpolar Health 1999; 57 Suppl 1:38-40. [PMID: 10093242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
This paper describes the background and evolution of a Code of Research Ethics that was developed for a primary diabetes prevention project in the Native Mohawk community of Kahnawake in Canada. Embodying the principles of participatory research, this code was written by the researchers in conjunction with the community in the first year of the three-year project. The code ensures that the community is a full partner for the entire research process. For this project a Community Advisory Board is representative of the community.
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Affiliation(s)
- A C Macaulay
- Kateri Memorial Hospital Center, Kahnawake, Quebec, Canada
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Macaulay AC, Delormier T, McComber AM, Cross EJ, Potvin LP, Paradis G, Kirby RL, Saad-Haddad C, Desrosiers S. Participatory research with native community of Kahnawake creates innovative Code of Research Ethics. Can J Public Health 1998. [PMID: 9583251 DOI: 10.1007/bf03404399] [Citation(s) in RCA: 109] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Participatory research requires ethical guidelines to incorporate the needs of the partners, i.e., the researchers and the community. This paper describes the background, development and implementation of an innovative Code of Research Ethics developed for a participatory research project with a Native community in Canada. The document ensures that responsibility and control will be shared by both researchers and community throughout the project including joint publication of the results. It defines community control of data, means of resolving dissension at time of publication, incorporation of new researchers and the differences between community-based and academic researchers.
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Macaulay AC, Delormier T, McComber AM, Cross EJ, Potvin LP, Paradis G, Kirby RL, Saad-Haddad C, Desrosiers S. Participatory research with native community of Kahnawake creates innovative Code of Research Ethics. Can J Public Health 1998; 89:105-8. [PMID: 9583251 PMCID: PMC6990238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/20/1997] [Accepted: 07/28/1997] [Indexed: 02/07/2023]
Abstract
Participatory research requires ethical guidelines to incorporate the needs of the partners, i.e., the researchers and the community. This paper describes the background, development and implementation of an innovative Code of Research Ethics developed for a participatory research project with a Native community in Canada. The document ensures that responsibility and control will be shared by both researchers and community throughout the project including joint publication of the results. It defines community control of data, means of resolving dissension at time of publication, incorporation of new researchers and the differences between community-based and academic researchers.
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