Improving the quality of life for long-term care (LTC) residents is of vital importance. Researchers need to involve LTC staff in planning and implementing interventions to maximize the likelihood of success. The purposes of this study were to (a) identify barriers and facilitators of LTC homes' readiness to implement evidence-based interventions, and (b) develop strategies to facilitate their implementation. A mixed methods design was used, primarily driven by the qualitative method and supplemented by two smaller, embedded quantitative components. Data were collected from health care providers and administrators using 13 focus groups, 26 interviews, and two surveys. Findings revealed that participants appreciated being involved at early stages of the project, but receptiveness to implementing innovations was influenced by study characteristics and demands within their respective practice environment. Engaging staff at the planning stage facilitated effective communication and helped strategize implementation within the constraints of the system.
In Canada, many people do not meet all the recommended nutrient intakes with food alone; the use of supplements may be one strategy to compensate for some of these inadequacies. Previous research has revealed several barriers to supplement use, including a lack of knowledge. In this qualitative study, we developed a resource to help inform and educate consumers on the selection of appropriate nutrition supplements.
Three focus groups with participants residing in low-income neighbourhoods in Saskatoon, Saskatchewan, and seven key informant interviews were conducted using a semi-structured interview guide and four resource examples. After transcription of the discussion and interviews, thematic analysis was used to identify emergent themes.
Analysis yielded three overarching themes: barriers to use, interdisciplinary issues, and resource expectations. Each overarching theme had several subthemes. Subthemes of the overarching theme of resource expectations were subsequently used to create a new tool to help consumers select an appropriate multivitamin.
A tool was developed after available resources were explored and stakeholders were interviewed. The new resource was based on community members' and health care professionals' expressed needs, ideas, and beliefs.
We explored infant nutrition in Saskatoon by assessing current accessibility to all forms of infant nourishment, investigating challenges in terms of access to infant nutrition, and determining the use and effectiveness of infant nutrition programs and services. We also examined recommendations to improve infant food security in Saskatoon.
Semi-structured community focus groups and stakeholder interviews were conducted between June 2006 and August 2006. Thematic analysis was used to identify themes related to infant feeding practices and barriers, as well as recommendations to improve infant food security in Saskatoon.
Our study showed that infant food security is a concern among lower-income families in Saskatoon. Barriers that limited breastfeeding sustainability or nourishing infants through other means included knowledge of feeding practices, lack of breastfeeding support, access and affordability of infant formula, transportation, and poverty.
Infant nutrition and food security should be improved by expanding education and programming opportunities, increasing breastfeeding support, and identifying acceptable ways to provide emergency formula. If infant food security is to be addressed successfully, discussion and change must occur in social policy and family food security contexts.
Vitamin D plays a critical role in bone metabolism and many cellular and immunological processes. Recent research indicates that concentrations of serum 25-hydroxyvitamin D [25(OH)D], the main indicator of vitamin D status, should be in excess of 75 nmol/L. Low levels of 25(OH)D have been associated with several chronic and infectious diseases. Previous studies have reported that many otherwise healthy adults of European ancestry living in Canada have low vitamin D concentrations during the wintertime. However, those of non-European ancestry are at a higher risk of having low vitamin D levels. The main goal of this study was to examine the vitamin D status and vitamin D intake of young Canadian adults of diverse ancestry during the winter months.
One hundred and seven (107) healthy young adults self-reporting their ancestry were recruited for this study. Each participant was tested for serum 25(OH)D concentrations and related biochemistry, skin pigmentation indices and basic anthropometric measures. A seven-day food diary was used to assess their vitamin D intake. An ANOVA was used to test for significant differences in the variables among groups of different ancestry. Linear regression was employed to assess the impact of relevant variables on serum 25(OH)D concentrations.
More than 93% of the total sample had concentrations below 75 nmol/L. Almost three-quarters of the subjects had concentrations below 50 nmol/L. There were significant differences in serum 25(OH)D levels (p
Dietitians are experts on nutrition, and yet much uncertainty remains about their readiness and capacity to address a rapidly evolving marketplace of novel foods, nutrients, and nutrient-like substances (i.e., natural health products [NHPs]), which are available to consumers. In 2011, we conducted a qualitative examination of current thinking on the scope of practice, as well as barriers to and facilitators of dietitians' role as experts in providing guidance on NHP use.
We sought rich descriptions of existing and future dietetic competencies with NHPs. We therefore conducted six focus groups. Participants were 18 dietitians practising in rural settings and 21 practising in urban settings of Atlantic Canada.
Themes identified included people, products, and information; future education and training underlay these themes. The "food first" philosophy of dietetics practice was a primary convergent theme, the consensus being that NHPs can be used for select populations, lifestyles, and health conditions. The less food-related the NHP, the more divergent opinions were on specific competencies and scope of practice; focus group participants often referred to the importance of "doing no harm" and evidence-based practice.
Dietitians' achievement of competency in providing guidance on NHPs will require core, consistent, and cross-disciplinary information and competencies, as well as enhanced integrative practice models.
Vitamin D deficiency is a global health problem, but little is known about the vitamin D status of Canadians.
The data are from the 2007 to 2009 Canadian Health Measures Survey, which collected blood samples. Descriptive statistics (frequencies, means) were used to estimate 25-hydroxyvitamin D [25(OH)D] concentrations among a sample of 5,306 individuals aged 6 to 79 years, representing 28.2 million Canadians from all regions, by age group, sex, racial background, month of blood collection, and frequency of milk consumption. The prevalence of deficiency and the percentages of the population meeting different cut-off concentrations were assessed.
The mean concentration of 25(OH)D for the Canadian population aged 6 to 79 years was 67.7 nmol/L. The mean was lowest among men aged 20 to 39 years (60.7 nmol/L) and highest among boys aged 6 to 11 (76.8 nmol/L). Deficiency (less than 27.5 nmol/L) was detected in 4% of the population. However, 10% of Canadians had concentrations considered inadequate for bone health (less than 37.5 nmol/L) according to 1997 Institute of Medicine (IOM) Standards (currently under review). Concentrations measured in November-March were below those measured in April-October. White racial background and frequent milk consumption were significantly associated with higher concentrations.
As measured by plasma 25(OH)D, 4% of Canadians aged 6 to 79 years were vitamin D-deficient, according to 1997 IOM standards (currently under review). Based on these standards, 10% of the population had inadequate concentrations for bone health.