Use of Ethnographic Methods for Applied Research on Diabetes Among the Ojibway-Cree in Northern Ontario

Gittelsohn, Joel; Harris, Stewart B.; Burris, Krista L.; Kakegamic, Louisa; Landman, Laura T.; Sharma, Anjali; Wolever, Thomas M. S.; Logan, Alexander G.; Barnie, Annette; Zinman, Bernard

doi:10.1177/109019819602300307

Cited by 64 publications

(47 citation statements)

References 27 publications

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“…In Native American concepts, very similar classifications of food into traditional versus introduced categories exist, with similar perceptions of the negative health consequences of recent changes in the diet. 24,42,56 We have also found parallels in terms of the salience of newly emerging chronic diseases, such as diabetes 24 and in terms of modifications in the traditional valuation of larger and smaller body sizes. 57 The study had some limitations.…”

Section: Discussionmentioning

confidence: 73%

Formative Research to Inform Intervention Development for Diabetes Prevention in the Republic of the Marshall Islands

Cortés

Gittelsohn

Alfred³

et al. 2001

Health Educ Behav

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Formative research was conducted in the Republic of the Marshall Islands to help develop a diabetes prevention intervention. Methods included in-depth interviews, semistructured interviews, and direct observation of household behaviors in urban and remote settings. Foods were classified into two main conceptual spheres: foods from the islands/Marshallese foods and imported/American foods. Diabetes (nanimij in tonal) is a highly salient illness and is believed to be caused by foods high in fat and sugar, consumption of imported/American foods, family background, and the atomic bomb testing. Physical activity and eating a traditional diet were viewed as important for preventing diabetes. The traditional belief system links a large body with health, and a thin body with illness; however, perceptions are changing with increased acculturation and education about the health risks of obesity. These findings were used to develop a diabetes prevention home visit intervention currently being implemented and evaluated in Marshallese households.This article presents formative research on the prevention of non-insulin-dependent diabetes mellitus (NIDDM) in the Republic of the Marshall Islands. NIDDM is a major cause of debilitating morbidity and mortality in industrialized countries and increasingly in nonindustrialized countries. As the onset of diabetes in the nonindustrialized world is linked with lifestyle changes associated with the globalization of the world economy and acculturative Western influence, effective primary prevention strategies are desperately needed.1,2 Unfortunately, interventions aimed at the primary prevention

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Section: Discussionmentioning

confidence: 73%

Formative Research to Inform Intervention Development for Diabetes Prevention in the Republic of the Marshall Islands

Cortés

Gittelsohn

Alfred³

et al. 2001

Health Educ Behav

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“…Currently, almost 50% of the First Nation population is Ͻ20 years of age and still in the process of forming lifelong lifestyle habits that will affect their future susceptibility to developing diabetes and its complications. A number of very promising primary prevention programs that draw upon Aboriginal traditions and ways of life have been implemented across Canada (15)(16)(17)(18)(19)(20)(21).…”

Section: Distribution By Geographic Regionmentioning

confidence: 99%

The Epidemiology of Diabetes in the Manitoba-Registered First Nation Population

et al. 2003

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OBJECTIVE -This study provides an overview of the epidemiology of diabetes in the Manitoba First Nation population. RESEARCH DESIGN AND METHODS -The study uses data derived from the population-based Manitoba Diabetes Database to compare the demographic and geographic patterns of diabetes in the Manitoba First Nation population to the non-First Nation population.RESULTS -Although the prevalence of diabetes rose steadily in both the First Nation and the non-First Nation populations between 1989 and 1998, the epidemiological pattern of diabetes in these two populations differed significantly. The First Nation population was observed to have age-standardized incidence and prevalence rates of diabetes up to 4.5 times higher than those found in the non-First Nation population. The sex ratio and the geographic patterning of diabetes incidence and prevalence in the two study populations were reversed.CONCLUSIONS -The results of the study suggest that diabetes prevalence will likely continue to rise in the Manitoba First Nation population into the foreseeable future, and that the impact of this rising diabetes prevalence can only be effectively managed through a populationbased public health approach focusing on primary and secondary prevention. The dramatically higher rates of diabetes in Manitoba First Nation population as compared with the non-First Nation population highlight the urgency of this activity. These prevention efforts need to be supported by further research into the reasons for the unique epidemiological patterns of diabetes incidence and prevalence in the First Nation population observed in this study. These include investigating why First Nation populations living in the Northern areas of the province seem to be protected from developing high rates of diabetes and why First Nation women experience much higher rates of the disease. Diabetes Care 26:1993-1998, 2003D iabetes is increasingly responsible for substantial morbidity and mortality in Canada's First Nation populations. Planning and implementing effective primary and secondary intervention programs to deal with this disease and its devastating effects in First Nation people requires accurate populationbased data on the temporal trends and geographic distribution of diabetes (1).This study uses Manitoba Health administrative databases to examine trends in the incidence and prevalence of diabetes among Registered First Nation adults in Manitoba from 1989 to 1998. Comparisons are made to the non-First Nation adult population to highlight the magnitude of the diabetes epidemic in First Nation people. The geographic variation in diabetes rates across Manitoba is also examined.The study was conducted in the Canadian province of Manitoba. Manitoba has a population of 1.14 million people, of whom more than one-half (645,000) reside in the City of Winnipeg, the provincial capital. The majority of Manitobans are of European descent, whereas ϳ10% of the population is self-identified as having Aboriginal ancestry (2). Manitoba has a universal health insuranc...

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“…Historically, First Nations were hunter-gatherers and had seasonal patterns of food consumption. Traditional foods are still highly valued among aboriginal people for maintaining health and cultural identity (26) .…”

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confidence: 99%

Dietary intake and development of a quantitative food-frequency questionnaire for a lifestyle intervention to reduce the risk of chronic diseases in Canadian First Nations in north-western Ontario

Sharma

Cao

Gittelsohn

et al. 2008

Public Health Nutr.

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Objectives: To characterise the diet of First Nations in north-western Ontario, highlight foods for a lifestyle intervention and develop a quantitative foodfrequency questionnaire (QFFQ). Design: Cross-sectional survey using single 24 h dietary recalls. Setting: Eight remote and semi-remote First Nations reserves in north-western Ontario. Subjects: 129 First Nations (Oji-Cree and Ojibway) men and women aged between 18 and 80 years. Results: The greatest contributors to energy were breads, pasta dishes and chips (contributing over 20 % to total energy intake). 'Added fats' such as butter and margarine added to breads and vegetables made up the single largest source of total fat intake (8?4 %). The largest contributors to sugar were sugar itself, soda and other sweetened beverages (contributing over 45 % combined). The mean number of servings consumed of fruits, vegetables and dairy products were much lower than recommended. The mean daily meat intake was more than twice that recommended. A 119-item QFFQ was developed including seven bread items, five soups or stews, 24 meat-or fish-based dishes, eight rice or pasta dishes, nine fruits and 14 vegetables. Frequency of consumption was assessed by eight categories ranging from 'Never or less than one time in one month' to 'two or more times a day'. Conclusion: We were able to highlight foods for intervention to improve dietary intake based on the major sources of energy, fat and sugar and the low consumption of fruit and vegetable items. The QFFQ is being used to evaluate a diet and lifestyle intervention in First Nations in north-western Ontario.

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Use of Ethnographic Methods for Applied Research on Diabetes Among the Ojibway-Cree in Northern Ontario

Cited by 64 publications

References 27 publications

Formative Research to Inform Intervention Development for Diabetes Prevention in the Republic of the Marshall Islands

Formative Research to Inform Intervention Development for Diabetes Prevention in the Republic of the Marshall Islands

The Epidemiology of Diabetes in the Manitoba-Registered First Nation Population

Dietary intake and development of a quantitative food-frequency questionnaire for a lifestyle intervention to reduce the risk of chronic diseases in Canadian First Nations in north-western Ontario

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