The aim of this study was to increase our understanding of how people make sense of healthy eating discourses by exploring the 'ways of knowing' about healthy eating among members of three different ethnocultural groups in Canada: African Nova Scotians, Punjabi British Columbians and Canadian-born European Nova Scotians and British Columbians. Data for this paper come from in-depth, individual interviews with 105 adults where they described their experiences, interpretations, and reasoning used in learning and deciding what to believe and/or reject about healthy eating. Between and within ethnocultural group differences in how people come to know and use practices about healthy eating were examined as they were represented through three broad healthy eating discourses: cultural/traditional, mainstream and complementary/ethical. The discourses represented different ways to interpret the food-health relationship and make sense of the evidence about healthy eating in the everyday experience. Engagement with different discourses led participants to undertake different practices upon themselves in the name of healthy eating. We suggest that each of the discourses has a significant contribution to make in a dialogue about how healthy eating, as part of health and well-being, should be conceptualized by a society.
Black women bear a disproportionate burden of HIV/AIDS in North America. The purpose of this investigation was to explore Black Canadian women's perspectives on HIV risk and prevention. Four 90-minute focus groups (n=26) and six key informant interviews were conducted in Toronto with Black women of African and Caribbean descent and low socioeconomic status. Data analysis revealed a number of potent barriers to existing HIV preventive interventions: stigma, cultural disconnections, lack of engagement of Black religious institutions, and multiple intersecting forms of discrimination. Recommended HIV prevention opportunities included the Black church, mainstreaming, health care providers, and ethno-specific agencies. HIV prevention strategies for North American Black women, rather than focusing on HIV and individual risk behaviors, may benefit from a primary focus on social and structural factors (e.g., promoting gender equality, economic opportunity, women-controlled prevention technologies and combating racism in health care) thereby integrating HIV prevention into the larger context of community health and survival.
The future availability of HIV vaccines can increase options available to Canadian Black women for risk reduction. However, current conceptual frameworks do not adequately address barriers to HIV prevention for this population, and may be inadequate to address challenges with vaccines. This study explored knowledge and attitudes regarding HIV vaccines and associated prevention methods to inform appropriate conceptual frameworks for their dissemination to Canadian Black women. We completed four 90-min focus groups with women (n=26) of African or Caribbean origins, and six interviews with key informants providing health and social services in the Black communities of Toronto. The participants suggested that there were significant risks associated with seeking prevention information and attempting to reduce exposure to HIV infection. They described individual, familial, community and institutional domains of risk and predicted the same spectrum of risk for HIV vaccines. Participants advocated for education, empowerment and institutional change to create a supportive environment for vaccines and other HIV prevention methods. They further indicated that preparation for vaccine dissemination will need to prioritize building trust between women of the Black communities and institutions in the research, health and government sectors.
In Canada, there is a paucity of research aimed at understanding Black gay men and the antecedents to risk factors for HIV. This study is an attempt to move beyond risk factor analysis and explore the role of sexual and ethnic communities in the lives of these men. The study utilized a community-based research and critical race theory approach. Semi-structured interviews were conducted with eight key informants to augment our understanding of Black gay men and to facilitate recruitment of participants. In-depth interviews were done with 24 Black gay men. Our data showed that the construction of community for Black gay men is challenged by their social and cultural environment. However, these men use their resilience to navigate gay social networks. Black gay men expressed a sense of abjuration from both gay and Black communities because of homophobia and racism. It is essential for health and social programmers to understand how Black gay men interact with Black and gay communities and the complexities of their interactions in creating outreach educational, preventive and support services.
OBJECTIVES: to investigate Swedish midwives' perceptions and attitudes towards infibulation and infibulated women, midwives' experiences of providing care for them and the training the midwives describe having received to enable them to care for and deliver infibulated women. DESIGN: a multi-stage sampling procedure was used. Open-ended questionnaires were distributed to midwives in labour wards with the purpose of identifying midwives to contact for interviews and focus group discussions. SETTING AND PARTICIPANTS: twenty-six midwives from three labour wards and two antenatal clinics situated in two towns in central Sweden participated in eight focus group discussions and three individual interviews. FINDINGS: there were three major themes: (a) emotions and communicational challenges entailed in the care of infibulated women, (b) knowledge and skills needed for caring and (c) the midwives' reliance on the Swedish law when dealing with the dilemmas they face in their interactions with the women and their families. The data indicate communication problems on different levels between midwives and the women and their families. There appear to be few or no guidelines in the units on how to provide good care for infibulated women and little or no co-ordination between antenatal care and the maternity wards. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the care of infibulated women during pregnancy and childbirth seems to be a marginalised issue in the areas where this study was performed. Early acknowledgement of female genital mutilation during pregnancy as well as improved communication between health care units may help professionals to offer culturally sensitive professional care to the women and their families.
We sought to evaluate the experiences and knowledge of health care providers in Sweden regarding female genital cutting (FGC) as a health issue. Questionnaires (n = 2,707) were sent to providers in four major cities in Sweden and evaluated by means of descriptive statistics. Twenty-eight percent (n = 769/2,707) responded, of whom 60% had seen such patients. Seven providers, including 2 pediatricians, were suspicious of patients with signs of recent genital cutting. Ten percent had been asked to perform reinfibulation after delivery. Thirty-eight providers had received inquiries about the possibility of performing FGC in Sweden.A majority of Swedish health care providers meet patients presenting with evidence of FGC performed long ago. However, very few of them have suspected recently cut patients. The results support the hypothesis that this practice is not as active among African immigrants in Sweden as in their countries of origin. If the prevalence was the same as in African countries, more pediatricians would be expected to meet current cut girls. National efforts and policy programs to prevent FGC in Sweden are recommended as effective, in accordance with current research and should especially be directed toward pediatricians.