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Comprehensive School-based Nutrition Interventions for Indigenous Children in Canada

  • Author / Creator
    Gillies, Christina
  • Indigenous communities in Canada (First Nations, Inuit, and Métis) face significant social and environmental barriers to healthy eating. Due in large part to these barriers, Indigenous children are disproportionally affected by nutrition-related chronic diseases such as obesity and diabetes. Comprehensive school-based nutrition interventions that integrate multiple components of the school environment (e.g., social and physical environments, teaching and learning, policy, and partnerships and services) offer a promising strategy for improving children’s access to healthy foods and sustaining positive eating behaviours. However, little is known about comprehensive school-based nutrition interventions for Indigenous children. The purpose of this thesis was to describe the current status of school-based nutrition interventions for Indigenous children, and to uncover the principles underlying their development, implementation, and evaluation.For this present thesis, two studies were conducted related to school-based nutrition interventions in Indigenous communities. Study 1 was a process evaluation of school nutrition policy implementation using a community-based participatory research approach. The evaluation was conducted using an explanatory sequential mixed methods design. Students in grades 4–12 (n=94) and parents of students attending the school (n=83) completed cross-sectional surveys to capture their perceptions of the policy. Survey data informed semi-structured interviews with students (n=20) and parents (n=10) to further identify barriers and facilitators to policy implementation. Study 2 was a scoping review that broadly searched the scientific and grey literature to identify school-based interventions that have been implemented to improve the nutrition of Indigenous children in Canada and to describe their components.Study 1 showed that facilitators of school nutrition policy implementation included parent and student support, student food preferences for healthy foods, and student interest in health education. The barriers to policy implementation identified included a lack of communication between students and their teachers and parents, lack of parent support for guidelines concerning celebrations and fundraisers, inadequate communication between the school and parents, and the broader socioeconomic conditions in the community. Study 2 found that few school-based nutrition interventions for Indigenous children in Canada are comprehensive, as there are limited examples of interventions that integrate multiple aspects of the school food environment. Although most interventions include components related to the social and physical environment (e.g., food programs) and engage in partnerships with the local community, few integrate teaching or policy components. Furthermore, few interventions have been evaluated to understand the factors influencing their implementation or effectiveness.Overall, the two studies discussed in this thesis indicate that school-based nutrition intervention in Indigenous communities require community engagement and evaluation components that involve a variety of stakeholders – including parents and students – to ensure interventions are relevant and sustainable. Comprehensive school-based nutrition interventions may benefit from incorporating two or more components (e.g., school food programs, classroom education, nutrition policies, and partnerships with local businesses) to improve student access to healthy foods. Moving forward, it is important that communities and researchers aim to disseminate knowledge about their interventions broadly. Increasing evidence-based knowledge concerning comprehensive school-based nutrition interventions may assist communities – and health promoters working with communities – to improve the school nutrition environments and health outcomes of Indigenous children in Canada.

  • Subjects / Keywords
  • Graduation date
    Fall 2019
  • Type of Item
    Thesis
  • Degree
    Doctor of Philosophy
  • DOI
    https://doi.org/10.7939/r3-en6g-cm10
  • License
    Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.