Determinants of Perinatal Food Choices among African-Caribbean Immigrant Women in Canada: A Photo-Voice Study

Background: Food practices are an important component of marking individual and group identity. How an individual reproduces or resists normative practices is a means of understanding their social location. Migration, provides both opportunities and disjunctions for maternal health practices, including food practices. Post-migration women may aspire to achieve acculturation in part by adopting a Western diet. For many immigrant women, however, Western diets and patterns of food consumption differ considerably from those in their country of origin. Many maternal health and birth outcomes, however, are influenced by food consumption thus making education in perinatal nutrition important. The need for culturally safe and competent care is especially great during the perinatal period, since the maternal health characteristics and birth outcomes of immigrant women are often affected negatively.  This is particularly important in western nations such as Canada, whose ethno-culturally diverse population calls for effective cross-cultural health care.

Purpose: This paper presents the findings of a recent study that examined how the health practices of immigrant women affect their food choices and practices during the perinatal period. The study aimed to elicit understanding of ethno-cultural food choices and practices and to develop and evaluate cultural competency of maternity care.

Methodology. A focused ethnography informed by the theoretical lens of postcolonial theory guided the research process. Postcolonial theory helped to explicate how the intersectionality of ethnicity, gender, social class, and culture shapes immigrant women’s beliefs and practices related to food choices and health practices in the perinatal period. The research was implemented in four phases comprising of photovoice, interviews, KT tool creations and focus groups to evaluate tool implementation and practices. Study participants comprise of six ethno-cultural groups in this study; Sudanese, Indian, Pakistani, Chinese, African, and Caribbean, however, this paper will focus on the African and Caribbean women data set. Photo-assisted interviews were transcribed verbatim and coded. Thematic analysis was completed guided by Roper and Shapira’s analytical framework for ethnographic data, to identify key patterns and themes. Atlas ti facilitated data management and storage. Member-checks

 Results: The paper will discuss two major themes: a). Personal determinants of food choices and practices including, general health beliefs and practices, knowledge and beliefs about foods, and cravings and aversions; b). Other determinants of perinatal food choices and health practices including the role of others in supporting and enforcing health beliefs and practices, socio-economic factors, temperature and religion.

 Implication: The paper will conclude with key recommendations for policy decisions including the need for national food guide with due consideration of ethno-cultural foods. It will also discuss ways of improving health care providers’ access to study findings such as education tools for health care the health professional, public health, and obstetrical communities using multiple formats and media.