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Objective: To explore influences on women's sugar consumption behaviors during pregnancy. Design: Focused ethnography guided this qualitative study. Contrasting experiences between women with varying sugar intakes were investigated using semi-structured interviews. Setting: Metropolitan area, Canada. Participants: Fifteen women with varying intakes of added sugar, who were in the third trimester of their first pregnancy, participated in this study. Phenomenon of Interest: Sugar consumption behaviors during pregnancy. Analysis: Interviews were audio-recorded, transcribed, and analyzed using qualitative content analysis to inductively derive themes. Results: Pregnant women increased their intake of sugars in an effort to achieve a compromise between meeting nutrition recommendations, lifestyle adjustments, physical symptoms, and cultural norms. Physical symptoms, lack of nutritional guidance, and social pressures were identified as barriers to achieving a diet low in sugars, whereas implementing dietary strategies guided by nutritional knowledge was a facilitator. Conclusions and Implications: This research provides insights that may be used to design effective interventions to improve maternal health. Strategies to help pregnant women achieve a healthy diet and limit sugar intake should be guided by nutritional knowledge, dietary awareness, and internal motivations to engage in healthy dietary changes. [ABSTRACT FROM AUTHOR]

Objective: To identify factors that influenced early adoption and implementation of the Alberta Nutrition Guidelines for Children and Youth (ANGCY) in schools in Alberta, Canada; and to identify healthy eating strategies that were implemented as a result of the guidelines. Barriers and facilitators were also investigated. Design: Multiple case study design (n = 3). Semi-structured interviews and direct observations were used to collect data. Setting and Participants: Three schools in Alberta were selected for individual case studies. Eighteen key informants were interviewed from the 3 cases. Phenomenon of Interest: To investigate how the motivation shown by school administration and stakeholders for the ANGCY influenced the early adoption and implementation of the guidelines. Analysis: Content analysis was used to analyze data. Results: Various healthy eating strategies were implemented within the 3 cases after uptake of the guidelines. Support from the school superintendent and the work of a health champion facilitated the adoption and implementation of the guidelines, whereas parents posed some barriers to the adoption and implementation of the ANGCY. Conclusions and Implications: This study reinforces the importance of identifying a health champion to oversee healthy eating strategies in schools, and of involving parents in the promotion of children's healthy lifestyles. [ABSTRACT FROM AUTHOR]

Objective: To explore the barriers associated with the adoption of the Alberta Nutrition Guidelines for Children and Youth in schools according to characteristics of the innovation (guidelines) and the organization (schools). Design: Cross-sectional telephone survey. Setting and Participants: Schools in Alberta, Canada. Principals from 357 schools. Main Outcome Measure: Barriers to adopting the nutrition guidelines. Analysis: A 19-question telephone survey, including open- and closed-ended questions, was used to obtain information regarding schools' characteristics and barriers to adopting the guidelines. Qualitative data were coded according to common themes a priori, based on constructs from the Diffusion of Innovations framework. Results: Schools reported many barriers related to the relative advantage, compatibility, and complexity of adopting the guidelines. Parents' resistance to change and cost were the key reported barriers. Lack of knowledge, student preferences, the physical location of the school, and barriers related to the provision of healthful food were also reported. Conclusions and Implications: Disseminating guidelines without providing adequate support for their implementation may not promote change within the school setting. School nutrition initiatives need to involve the parents and have access to sufficient financial and human resource support. [ABSTRACT FROM AUTHOR]