Lifecourse, immigrant status and acculturation in food purchasing and preparation among low-income mothers

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Public Health Nutrition (Impact Factor: 2.68). 05/2007; 10(4):396-404. DOI: 10.1017/S1368980007334058
Source: PubMed


This study investigates how lifecourse, immigrant status and acculturation, and neighbourhood of residence influence food purchasing and preparation among low-income women with children, living in the USA. This research sought to understand physical and economic access to food, from both 'individual' and 'community' perspectives.
This study used qualitative methodology (focus groups) to examine the mechanisms and pathways of food preparation and purchasing within the context of daily life activity for US- and foreign-born women, living in the USA. The study methodology analysed notes and verbatim transcripts, summarised recurring responses and identified new themes in the discussions.
A total of 44 women were purposively sampled from two metropolitan areas in Massachusetts, USA, based on (1) neighbourhood of residence and (2) primary language spoken. All focus groups were conducted in community health centres and community centres co-located with offices of the special supplemental nutritional programme for Women, Infants, and Children.
Analysis of key response themes suggested that scarcity of food and physical access to food purchasing points did not influence food purchasing and preparation as much as (1) limited time for food shopping, cooking and family activities; and (2) challenges in transportation to stores and childcare. The study results demonstrated differing attitudes toward food acquisition and preparation between immigrant and US-born women and between women who lived in two metropolitan areas in the western and eastern regions of the state of Massachusetts, USA.
The findings illustrate 'hidden' constraints that need to be captured in measures of physical and economic access and availability of food. US policies and programmes that aim to improve access, availability and diet quality would benefit from considering the social context of food preparation and purchasing, and the residential environments of low-income women and families.

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Available from: Tamara Dubowitz, Mar 31, 2014
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    • "It is challenging to collect data regarding specific historical exposures, and these data are subject to recall bias. Residential history is more objectively measured than individuals' opinions of the food supply or economic conditions throughout life and could be linked to existing sources of social, economic, and physical data to create summary measures of exposures (Bennett et al., 2007; Dubowitz et al., 2007; Lawlor et al., 2005; Tucker-Seeley et al., 2011), such as deprivation, food access, and economy of the local environment. Using residential history as a marker for past food-related exposures, the objective of this research was to evaluate current diet in relation to: (1) having ever resided outside of the US; (2) having resided outside the US at particular times; and (3) the influence of geographical regions of residence. "
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    ABSTRACT: To evaluate healthy dietary factors in relation to prior residence outside the United States (US) among university-affiliated individuals currently residing in the US. Current diet information was collected via a 4-day food record and residential history data were collected by in-person interview for 114 individuals. Residence outside of the US at any point during the interviewee's life was associated with higher diet quality (Healthy Eating Index-2005: 50.0 vs. 46.8) and lower added sugar intake (25.8 vs. 34.9 g/d). Concordance of residence as a child (≤12 years of age) and within the prior 5 years was more strongly associated with higher HEI-2005 score (52.7) than if childhood was outside of the US and recent within the US (47.1), compared with individuals who have only resided within the US (46.9). Results were similar when also accounting for self-reported current residence as permanent residence. Current diet quality, food groups, and nutrient intakes differed depending on where in the world region individuals resided as a child. Restricting the analyzes to a subgroup of individuals of younger age and similar education attenuated associations. Lower added sugar intake and higher overall diet quality were most consistently associated with residence outside of the US, and recent residence outside of the US may be more strongly associated than childhood residence. Some of these differences may be explained by demographic or socioeconomic factors. Future studies could evaluate explanatory factors for these observations, including detailed socioeconomic factors, exposure to diverse foods, and accessibility of processed foods. Am. J. Hum. Biol., 2013. © 2013 Wiley Periodicals, Inc.
    Full-text · Article · Jan 2014 · American Journal of Human Biology
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    • "Cross sectional surveys [15,20,21] and prospective cohort studies [5,22] have identified factors associated with breastfeeding initiation and duration amongst recent migrant and refugee women. These studies report similar barriers to breastfeeding as reported by non-migrant women, such as returning to work [5,17,23-25], pain [12,14,25,26], and perceived low breast milk supply [23-25,27-29]. "
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    ABSTRACT: Background Studies report mixed findings about rates of both exclusive and partial breastfeeding amongst women who are migrants or refugees in high income countries. It is important to understand the beliefs and experiences that impact on migrant and refugee women’s infant feeding decisions in order to appropriately support women to breastfeed in a new country. The aim of this paper is to report the findings of a meta-ethnographic study that explored migrant and refugee women’s experiences and practices related to breastfeeding in a new country. Methods CINAHL, MEDLINE, PubMed, SCOPUS and the Cochrane Library with Full Text databases were searched for the period January 2000 to May 2012. Out of 2355 papers retrieved 11 met the inclusion criteria. A meta-ethnographic synthesis was undertaken using the analytic strategies and theme synthesis techniques of reciprocal translation and refutational investigation. Quality appraisal was undertaken using the Critical Appraisal Skills Programme (CASP) tool. Results Eight qualitative studies and three studies reporting both qualitative and quantitative data were included and one overarching theme emerged: ‘Breastfeeding in a new country: facing contradictions and conflict’. This theme comprised four sub-themes ‘Mother’s milk is best’; ‘Contradictions and conflict in breastfeeding practices’; ‘Producing breast milk requires energy and good health’; and ‘The dominant role of female relatives’. Migrant women who valued, but did not have access to, traditional postpartum practices, were more likely to cease breastfeeding. Women reported a clash between their individual beliefs and practices and the dominant practices in the new country, and also a tension with family members either in the country of origin or in the new country. Conclusion Migrant women experience tensions in their breastfeeding experience and require support from professionals who can sensitively address their individual needs. Strategies to engage grandmothers in educational opportunities may offer a novel approach to breastfeeding support.
    Full-text · Article · Dec 2012 · BMC Pregnancy and Childbirth
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    • "Thus, nurses should be aware that culturally appropriate educational strategies will integrate an understanding of the specific social context in which Latino mothers' feeding practices are developed. Absent an understanding of the factors impacting low-income, Latino families, it is possible that efforts to prevent of child obesity will seen as just another stress among a multitude of daily challenges (Dubowitz,, 2007). "
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    ABSTRACT: To examine maternal beliefs and practices related to weight status, child feeding, and child overweight in the Latino culture that may contribute to the rising rates of overweight among preschool Latino children in the United States. This 2-phase qualitative study relies on data obtained in 6 focus groups with a total of 31 primarily Spanish-speaking, low-income mothers, followed by 20 individual, in-depth interviews with women participating in a health promotion educational program. Child-feeding beliefs, practices, and weight status perceptions were elicited. The findings indicated that most respondents reported personal struggles with weight gain, particularly during and after pregnancy, and were concerned that their children would become obese. Although subjects understood the health and social consequences related to overweight, many discussed the pressures of familial and cultural influences endorsing a "chubby child." Education and interventions that incorporate "culturally mediated" pathways to address mothers' feeding practices are essential for the prevention and control of childhood overweight among low-income Latinos. Nurses should be aware of the social and cultural influences on Latina mothers' beliefs and practices related to weight status and feeding practices and address these in their education approaches to prevent childhood overweight and obesity with this population group.
    Full-text · Article · Mar 2011 · Public Health Nursing
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