Using first nations children's perceptions of food and activity to inform an obesity prevention strategy

Obesity and associated health risks disproportionately affect Aboriginal (First Nations) children in Canada. The purpose of this research study was to elicit First Nations children's perceptions of food, activity, and health to inform a community-based obesity prevention strategy. Fifteen 4th- and 5th-Grade students participated in one of three focus group interviews that utilized drawing and pile-sorting activities. We used an ecological lens to structure our findings. Analyses revealed that a variety of interdependent sociocultural factors influenced children's perceptions. Embedded within a cultural/traditional worldview, children indicated a preference for foods and activities from both contemporary Western and traditional cultures, highlighted family members as their main sources of health information, and described information gaps in their health education. Informed by children's perspectives, these findings offer guidance for developing an obesity prevention strategy for First Nations children in this community.     

‘Active play may be lots of fun,but it's certainly not frivolous’: the emergence of active play as a health practice in Canadian public health

In the context of what has been termed a childhood obesity epidemic, public health institutions have recently begun to promote active play as a means of addressing childhood obesity, thus advancing play for health. Drawing on Foucault, this article problematises the way that children's play is being taken up as a health practice and further considers some of the effects this may have for children. Six Canadian public health websites were examined, from which 150 documents addressing children's health, physical activity, obesity, leisure activities and play were selected and coded deductively (theoretical themes) and inductively (emerging themes). Bacchi's ( 2009 ) question‐posing approach to critical discourse analysis deepened our analysis of dominant narratives. Our findings suggest that several taken‐for‐granted assumptions and practices underlie this discourse: (i) play is viewed as a productive activity legitimises it as a health practice; (ii) tropes of ‘fun’ and ‘pleasure’ are drawn on to promote physical activity; (iii) children are encouraged to self‐govern their leisure time to promote health. We underscore the need to recognise this discourse as contingent and as only one of many ways of conceptualising children's leisure activities and their health and social lives more generally.     

Strategies for Increasing Cervical Cancer Screening Amongst First Nations Communities in Northwest Ontario,Canada

The high burden of cervical cancer in Indigenous populations worldwide is due to underscreening and inadequate follow-up. Using qualitative, participatory action research, we interviewed health care staff to identify ways to increase screening recruitment in First Nations communities in Northwest Ontario, Canada. Our findings suggest the value of a multilevel social–ecological model to promote behavioral changes at the community, health care service and stakeholder, and decision-maker level. Participants emphasized the central role of First Nations women as nurturers of life and for the well-being of their family members. They stressed the importance of building awareness and motivation for cervical cancer screening through various activities including continuous education, hosting screening events specifically for women, improving the attitude and service of health care providers, and promoting screening tools and policies that complement and are respectful of First Nations women.     

基于基因与环境交互作用的儿童肥胖病因研究进展

儿童肥胖是全球性的公共健康问题,不仅危害儿童自身健康,还是成年期慢性病发病的重要诱因。近年来,随着精准医学研究的深入开展,越来越多的研究证据指明环境、行为因素,如早期宫内环境、儿童饮食、体力活动等,与儿童自身基因风险对肥胖的发病具有显著的交互作用,可以促进或抑制儿童肥胖的发生发展。本文对该领域现有研究进行综述,总结基因风险和环境暴露因素对儿童肥胖发病的交互作用及潜在机制,为不同遗传背景儿童的肥胖精准防控提供参考依据。     

Health literacy in relation to cancer: addressing the silence about and absence of cancer discussion among Aboriginal people,communities and health services

Cancer outcomes for Aboriginal Australians are poorer when compared with cancer outcomes for non‐Aboriginal Australians despite overall improvements in cancer outcomes. One concept used to examine inequities in health outcomes between groups is health literacy. Recent research and advocacy have pointed to the importance of increasing health literacy as it relates to cancer among Aboriginal people. This study examined individual, social and cultural aspects of health literacy relevant to cancer among Aboriginal patients, carers and their health workers in New South Wales. Qualitative interviews were conducted with 22 Aboriginal people who had been diagnosed with cancer, 18 people who were carers of Aboriginal people with cancer and 16 healthcare workers (eight Aboriginal and eight non‐Aboriginal health workers). Awareness, knowledge and experience of cancer were largely absent from people's lives and experiences until they were diagnosed, illustrating the need for cancer awareness raising among Aboriginal people, communities and services. Some beliefs about cancer (particularly equating cancer to death) differed from mainstream Western biomedical views of the body and cancer and this served to silence discussion on cancer. As such, these beliefs can be used to inform communication and help illuminate how beliefs can shape responses to cancer. Participants proposed some practical strategies that could work to fill absences in knowledge and build on beliefs about cancer. These results were characterised by a silence about cancer, an absence of discussions of cancer and an acknowledgement of an already full health agenda for Aboriginal communities. To promote health literacy in relation to cancer would require a multi‐layered programme of work involving grass‐roots community education, workers and Board members of Aboriginal community‐controlled health organisations and speciality cancer services, with a particular focus on programmes to bridge community‐based primary care and tertiary level cancer services.     

Mothers' perceptions of childhood immunizations in First Nations communities of the Sioux Lookout Zone

OBJECTIVE: Low uptake of childhood immunizations is a problem in many First Nations communities. This article describes the results of a study that examined mothers' perceptions of childhood immunizations and the factors that influence uptake. METHOD: Person-centred interviews focussing on childhood immunizations and child health were conducted with 28 mothers of young children in two First Nations communities in the Sioux Lookout Zone. Content analysis was applied to the interview data and patterns and themes were developed. RESULTS: Data analysis identified four key factors as negatively influencing immunization uptake: knowledge barriers, the influence of others, vaccine barriers, and missed opportunities. CONCLUSIONS: Further research with Elders and community members along with culturally sensitive education initiatives are required to address low immunization uptake. Changes in health professionals' behaviours may serve to reduce missed opportunities.     

A socioecological framework to understand weight-related issues in Aboriginal children in Canada

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.     

Using appreciative inquiry methodology to develop a weight management program for obese children in New Zealand

Objectives : Paediatric obesity predicts adult obesity, and alarming new data in New Zealand reveals that obesity among the young continues to rise. In this study, we used a novel solution‐focused paradigm, or appreciative inquiry perspective, to explore the factors that influence not just obese but non‐obese states (that is, healthy weight as well as obesity), in Pacific adolescents (aged 13–17) living in socioeconomically deprived neighbourhoods. Methods : Sixty‐eight parents and adolescents from 30 families were recruited and interviewed, resulting in 15 obese and 15 healthy weight adolescents participating in the study. Results : Our findings showed that, despite living in low socioeconomic circumstances, parents were able to alter their micro‐environments to prevent obesity in their children. Parents with healthy weight adolescents had food rules in the home and monitored their children's eating and television viewing time. Conclusions : An appreciative inquiry approach to obesity research can uncover resiliency factors within families that can be applied to obesity prevention and treatment programs. Implications for public health : Appreciative inquiry methodology is a promising alternative qualitative research strategy for developing health interventions for low‐income ethnic minority communities.     

A Qualitative Study of Provider Perspectives of Structural Barriers to Cervical Cancer Screening Among First Nations Women

ObjectiveIn Canada, opportunistic screening programs have successfully reduced mortality from cervical cancer; however, minority or disadvantaged groups, as well as women in northern and rural areas, are inadequately recruited by this approach. Hence, we set out to examine the structural barriers that prevent First Nations women's participation in cervical cancer screening.MethodsUsing a participatory action research approach and semistructured interview guides, we conducted in-depth interviews with 18 experienced health care professionals, 12 of whom were also community members. These individuals included nurses, nurse practitioners, community health representatives, social workers and physicians who provide care to women in our First Nations partner communities. In the current report, we explored perceived barriers to cervical cancer screening through the lens of service providers.ResultsStructural barriers to cervical cancer screening for First Nations women included shortage of appropriate health care providers, lack of a recall-based screening system, geographic and transportation barriers; health literacy and socioeconomic inequalities, generational effects, and the colonial legacy.ConclusionExisting, opportunistic cervical cancer screening programs do not perform well for First Nations women who experience significant screening-related health inequalities that are largely influenced by structural barriers. Sustainable screening interventions in First Nations communities require approaches that resolve these structural barriers, explore new ways of screening, and provide education for both women and health care providers. Many of the structural barriers are rooted in colonial history. Given the negative impact of the consequences of colonization on indigenous women worldwide, many of our findings strongly resonate with marginalized populations in other countries.     

进一步推动我国儿童伤害预防控制工作

伤害是危害我国儿童健康的重要公共卫生问题。我国已开展了大量预防儿童伤害的实践和科学研究，儿童伤害疾病负担已有所减轻，但伤害仍是造成儿童死亡的第1位原因，预防儿童伤害应被列为促进儿童健康的优先工作领域。健全和完善以政府为主导、多部门合作的儿童伤害预防机制，开展系统、全面、科学的儿童伤害预防控制工作，是降低我国儿童伤害疾病负担的重要策略。建议依托《"健康中国2030"规划纲要》完善伤害预防相关政策法规，制定和颁布实施儿童伤害预防行动计划，深入开展预防儿童伤害的实践和科学研究，加强儿童伤害防控的队伍建设和人才培养，以达到减少儿童伤害，促进儿童健康的目的。     

Contemplative practices in early childhood: implications for self-regulation skills and school readiness

This article examines the development of self-regulation skills in early childhood and the possibilities of children's contemplative practices as a viable tool to facilitate this development. Current research indicates that self-regulation skills in early childhood education make a significant contribution to school readiness, and long-term academic success. This link establishes the need to bridge the gap between scientific research and classroom practice to implement more programmes that facilitate this development in early childhood classrooms. The development of self-regulation skills are discussed and examined specifically in relation to being mindful, achieving focussed attention and increased awareness of social–emotional behaviours. The contemplative practices, an umbrella term for mindfulness and meditational-based practices, are viewed as potential vehicles to facilitate self-regulation skills in the early childhood classrooms. Additional research is recommended to determine whether children exposed to these programmes will demonstrate more appropriate social–emotional behaviours, including enhancing children's self-regulation skills leading to long-term academic success.     

Engaging Indigenous families in a community‐based Indigenous early childhood programme in British Columbia,Canada: A cultural safety perspective

This article is part of a larger study that explored how an Indigenous early intervention programme in British Columbia (BC), Canada, known as the ‘Aboriginal Infant Development Program’ (AIDP), influenced family and children's health and well‐being and was responsive to child health inequities. Postcolonial feminist and Indigenous feminist perspectives provided a critical analytical lens to this qualitative inquiry. The study was undertaken with AIDPs based in diverse community organisations located in off‐reserve urban municipalities throughout the province of BC. From September 2013 to March 2014, in‐depth, semi‐structured interviews were undertaken with: Indigenous primary caregivers (n = 10), Indigenous Elders (n = 4), AIDP workers (n = 18) and administrative leaders (n = 3). The purpose of this article is to examine and analyse the findings that focus on how AIDP workers supported family and children's health and well‐being by transforming their routine policies and practices in ways that fostered caregivers' active engagement in their programmes. Findings centre on three main themes: (i) overcoming mistrust; (ii) ‘being willing to move a step forward’ and (iii) resisting what's taken‐for‐granted. These inter‐related themes are examined and discussed in relation to the concept of cultural safety. The findings have international relevancy for social and healthcare community‐based programmes that are questioning how to engage with parents who may be hard to reach as a result of multi‐faceted social and structural factors.     

Children's understanding of psychological problems displayed by their peers: a review of the literature

Background There is a widespread consensus in the literature that children who have psychological problems are more likely than other children to be excluded or rejected by their peers. The existence of this phenomenon has been established, primarily with the use of research on their sociometric status within groups of peers. Much less research has been performed on the way in which children develop attitudes and behavioural intentions towards peers with problems. Aims The primary aim of this article is to introduce readers to research on children's understanding of the nature of common childhood psychological problems, with a view to exploring the factors that might contribute to the development of negative attitudes and behaviour. Method Relevant publications were identified through searches of electronic databases and articles in print. Results From the early years of primary school, children are able to identify peers whose behaviour deviates from the norm and to suggest causes for the behaviour of peers with psychological problems. Furthermore, their beliefs about peers' personal responsibility for these problems appear to be a significant determinant of attitudes and behavioural intentions. The article identifies the need for more research on the role of factors such as gender and personal contact in determining children's understanding of, and attitudes towards, peers with psychological problems. In addition, the article calls for more research on mental health education programmes and the extension of these programmes to younger children, given the fact that even young primary school children appear to have beliefs about the causes of psychological problems and negative attitudes to peers who display such problems. Conclusions Research on children's understanding of mental health can make an important contribution to our understanding of why children with problems are so much more likely to be excluded from their peer group.     

When two sides go to war: newspaper reporting of ‘television food advertising restrictions’ as a solution to childhood obesity

Childhood overweight and obesity is a major public health problem in Australia and overseas. Food advertising during children's television programmes has been identified as one contributing factor to childhood obesity. The media plays an important role in informing the public and presenting arguments supporting and opposing solutions to childhood obesity. The aim of this study was to analyse newspaper coverage of the debate over restricting television food advertising as a solution to preventing childhood obesity. A newspaper search was conducted over the period July 2002 to July 2005. One hundred and sixty-six articles were analysed for article characteristics, speakers quoted, causes and solutions of childhood obesity and arguments presented. The majority of the articles (82, 49%) took a positive slant towards restricting television food advertising to children while 35 (21%) had a negative slant. The main causes of childhood obesity presented were: television advertising of unhealthy foods, lack of physical activity, increased screen time and time stretched parents. The main areas presented as solutions of childhood obesity were: policy changes to food advertising, supportive environments for physical activity, supportive environments for healthy eating and healthy eating policies. Strong arguments and strong language dominated the debate which remained polarised between health professionals and Federal government and industry. In spite of opposition towards restrictions on television food advertising to children, the media's stories played an important part in keeping the issue on the public and political agenda.     

Social class,anxieties and mothers' foodwork

In the context of concerns about childhood obesity, mothers are placed at the forefront of responsibility for shaping the eating behaviour and consequently the health of their young children. This is evident in a multitude of diverse sites such as government reports, health promotion materials, reality TV shows and the advice of childcare nurses and preschools. These sites produce a range of resources available to mothers to draw on to constitute themselves as mothers in terms of caring for their children's health. Drawing on a qualitative study of mothers recruited through three Australian preschool centres, this article examines how the working‐class and middle‐class mothers of preschool‐aged children engage with knowledge about motherhood, children and health and how those engagements impact on their mothering, their foodwork and their children. We argue that, unlike the working‐class mothers pathologised in some literature on obesity, these working‐class mothers demonstrated a no‐nonsense (but still responsibilised) approach to feeding their children. The middle‐class mothers, on the other hand, were more likely to engage in practices of self‐surveillance and to demonstrate considerable anxieties about the appropriateness of their practices for their children's current and future health.     

Peer Reviewed: Reaching Staff,Parents, and Community Partners to Prevent Childhood Obesity in Head Start, 2008

Introduction

Lowering the prevalence of childhood obesity requires a multilevel approach that targets the home, school, and community. Head Start, the largest federally funded early childhood education program in the United States, reaches nearly 1 million low-income children, and it provides an ideal opportunity for implementing such an approach. Our objective was to describe obesity prevention activities in Head Start that are directed at staff, parents, and community partners.

Methods

We mailed a survey in 2008 to all 1,810 Head Start programs in the United States.

Results

Among the 1,583 (87%) responding programs, 60% held workshops to train new staff about children''s feeding and 63% held workshops to train new staff about children''s gross motor activity. Parent workshops on preparing or shopping for healthy foods were offered by 84% of programs and on encouraging children''s gross motor activity by 43% of programs. Ninety-seven percent of programs reported having at least 1 community partnership to encourage children''s healthy eating, and 75% reported at least 1 to encourage children''s gross motor activity.

Conclusion

Head Start programs reported using a multilevel approach to childhood obesity prevention that included staff, parents, and community partners. More information is needed about the content and effectiveness of these efforts.     

Where are the schools? Children,families and food practices

Reducing childhood obesity is an international priority and children's diets, food knowledge and practices have come under intense scrutiny in both policy and popular discourse. Notwithstanding evidence that health interventions which resonate with children's own views are the most effective, there is still relatively little research which mobilises children's everyday perspectives on food to inform public health policy. We report key findings from a qualitative study with 53 children aged 9–10, attending two socio-economically contrasting schools in the UK. The study explored children's understandings of food in everyday life and their ideas about the relationship between food and health. Throughout the study, despite recent attempts to position schools as key sites for public health interventions, children consistently emphasised families as the locus for enduring food practices. The research highlights the value of listening to children and applying our understanding of their perspectives to ensure that public health initiatives work with the important influences on their diet and health that they themselves identify.     

Does the earned income tax credit increase children's weight? The impact of policy‐driven income on childhood obesity

I exploit substantial increases in the earned income tax credit to study how a policy‐driven change in family income affects childhood obesity. Using the National Longitudinal Survey of Youth 1979, my difference‐in‐differences estimates indicate that the probability of being obese increased by 3 percentage points among children whose families experienced a greater income shock. A further investigation suggests that a reduction in maternal time with children played a greater role in children's weight gain than income. The paper's finding shows that a program that is not designed for health purposes, such as earned income tax credit, can have unintended effects on health outcomes.     

Pre-service and in-service preschool teachers' views regarding creativity in early childhood education

This research investigated the views of pre-service and in-service preschool teachers concerning the developing of children's creativity in early childhood education by determining the similarities and/or differences among their views. The data were gathered from 10 pre-service and 11 in-service teachers through focus group meetings, and then from the participants' views four basic themes were constituted consisting of their opinions on ‘creativity’, ‘creative people’, ‘importance of creativity in early childhood education’, and ‘obstacles to creativity in early childhood education’. The findings indicated that although the subjects had their own creativity definitions, they also had some common ideas. The subjects also shared their ideas about some of the essential characteristics of creative individuals. Furthermore, although the participants were aware of the value of creativity for young children's development and the need to implement activities that would nurture children's creativity, they still face many obstacles preventing them from achieving this crucial goal.