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Dietary changes often accompany management of a cancer diagnosis, but how and why patients with colorectal cancer (CRC) make dietary decisions requires further investigation.To learn about patients' food-related beliefs and understand whether and why dietary changes were made by patients starting chemotherapy after a CRC diagnosis.A qualitative semi-structured interview study was conducted as a secondary analysis among a subset of patients with stages II-IV CRC enrolled at baseline in a randomized controlled trial.Twenty-nine patients participated in the interview. Data were collected at the University of Alberta (Edmonton, Alberta, Canada) from 2016-2019 before any trial intervention.Audio-recorded interviews were transcribed verbatim then coded inductively by two research team members. Qualitative content analysis was applied to capture emergent themes.Patients reported varied degrees of dietary change that stemmed from internal and external influences. Four main themes emerged to describe patients' dietary decisions after a CRC diagnosis: 1) Medical Influences: eating to live; 2) Health Beliefs: connecting lived experiences with new realities; 3) Static Diets: no changes postdiagnosis; and 4) Navigating External Influences: confluence of personal agency and social constraints.The extent to which patients altered their dietary choices depended on perspectives and beliefs. These included the degree to which dietary decisions provided some agency (ie, feeling of control) for dealing with physical ramifications of cancer treatment, individuals' personal understandings of healthy foods, and the role of diet in managing their new physical reality postdiagnosis. This information provides registered dietitian nutritionists and health care providers with insight into dietary intentions of select patients being treated for CRC. These findings can guide future research focused on effective strategies for streamlined nutritional support that aligns with patient needs.

In this article, we explore temporary foreign workers’ (TFWs) access to and experiences with formal and informal supports in Canada. Our study utilized a participatory action research design and four overlapping phases of data collection: individual interviews with current and former TFWs, focus groups, individual interviews with settlement service agencies, and a cross-sectional survey with current and former TFWs. We used an intersectional theoretical framework to analyze these data and explore ways that TFWs interact with formal and informal sources of support for navigating their precarious immigration status and integration in Canada. Our findings show these supports have the potential to both benefit and harm TFWs, depending on their social positioning and availability of institutional resources. The benefits include information that aids settlement and integration processes in Canada, while the harms include misinformation that contributes to status loss. Future research and policy should recognize the complexity of informal and formal support networks available to TFWs. An absence of government support is apparent, as is the need for increased funding for settlement service agencies that serve these workers. In addition, Canada should better monitor employers, immigration consultants, and immigration lawyers to ensure these agents support rather than oppress TFWs.

Our case study draws on emerging ideas of degrowth, showing how degrowth values and strategies may emerge where cities rely heavily on global food systems, and contributes to literature on food for degrowth in local contexts. Degrowth rejects the imperative of economic growth as a primary indicator of social wellness. A holistic understanding of wellness prescribes radical societal transformation, downscaling and decreasing consumption, strengthening community relationships and promoting resilience. Building on Bloemmen et al. (2015), we apply a holistic model of degrowth in a small-scale context, embedded within larger capitalist economies, to examine degrowth opportunities and constraints in Edmonton, Canada. Emergent themes in interviews reveal opportunities and challenges for local food for degrowth, by altering local food supplies, reducing food waste and decreasing consumption. We explore the role of social relationships in food justice work, increasing food knowledge, and building capacity for local, sustainable food production.

Despite the large number of immigrant adolescents in Canada, research on their knowledge of sexual and reproductive health and rights (SRHR) and information needs is nearly nonexistent. A scoping review was undertaken following the PRISMA-ScR statement to identify and assess the existing literature regarding SRHR needs of immigrant adolescents in Canada. Of the 1514 articles retrieved from our search strategy, 15 studies met our inclusion criteria. The results from our review identifies three unique themes related to immigrant adolescents’ SRHR needs: knowledge needs, access to SRHR education and services, and approaches to SRHR education and services. Immigrant adolescents’ knowledge needs includes needs on HIV/STI transmission and protection, unintended pregnancy, sexual activity, family planning, pubertal education, navigating the health care system, and confidentiality legislations. Our results revealed that immigrant adolescents’ access SRHR education and services through both school-based and community-based settings. Lastly, approaches to SRHR education and services for immigrant adolescents should include cultural sensitivity, an intersectional approach, interactive learning, a strength-based approach, and reassuring confidentiality rights. The multi-faceted SRHR needs of immigrant adolescents in Canada demonstrates that future research, program development, and policymaking requires careful consideration of these intersecting forces. Inclusive SRHR education and services can be achieved through the employment of a critical cultural approach and intersectional strategies.

African immigrant children experience some of the poorest mental health outcomes in Canada, yet limited research has systematically mental health determinants among this growing demographic. Our participatory action research project (PAR) explored, from the perspectives of parents, the factors influencing the mental health of African immigrant children in Alberta, Canada. The project utilized an intersectionality theoretical lens to collect and analyze data from a sample of 81 African immigrant parents who participated in nine conversation cafes and five focus groups. This PAR approach provided an ideal structure to engage parents and generate knowledge on the factors influencing their children’s mental health. Parents identified racial discrimination, limited mental health awareness, limited access to mental health supports, changing family dynamics, parental absenteeism, and unresolved pre-migration trauma as factors influencing their children’s mental health. These factors were perceived as contributing to children’s experiences of material deprivation, social problems, and emotional difficulties. Our findings suggest that interventions to overcome these factors and enhance the mental health of African immigrant children must target transformation of the family, community, and cultural systems within which their lives are embedded, as well as the policies and institutions that produce and reproduce child mental health vulnerabilities.

A key objective of Pakistan’s family planning program has been to increase awareness of the benefits of a small family. Despite five decades of effort, family size ideals of four children persist. ...

The purpose of the study was to explore health literacy and community engagement in relation to active living with newcomer young people and their families. We employed a case study design and a participatory approach. The data collected included photovoice and photo-assisted focus group interviews, which included an initial stage when youth participated in workshops creating collages on healthy living. A follow-up focus group centred on discussion of the collages with subsequent training on the photovoice method and the use of the cameras, and a second focus group, which incorporated photos taken by participants during the programming and their leisure time. Different themes were developed from the data: active living, balance, body talk, challenges, environment and health, culture and health, family, health and food, health and safety, knowledge, source of knowledge, peers and friends, personal hygiene, recreational activities, socio-emotional health, social isolation and spiritual health. Excerpts were taken from the different themes to demonstrate the immigrant/refugee youths’ understanding of levels of health literacy and its contribution to healthy eating and active living. The qualitative findings are presented under the different tenets of health literacy. Health literacy extends beyond the individual level and effects the whole family and communities; intervention need to extend to include community connections and involvement activities. Future research needs to focus on the long-term effects of critical health literacy among immigrant communities.

In this paper, we utilised a critical discourse analysis methodology to highlight the discursive representation of African immigrant parenting in Canadian newspapers. We explored unquestioned ideol...

Health development efforts to decrease maternal and neonatal morbidity and mortality in South Asia have included a role for trained and/or traditional birth attendants since the late 20th century. Birth attendants are typically older women, who assist not only during birth but who also can provide counsel during pregnancy and lactation. Based on an ethnographic case study, focused on a jhuggi-jhopri (squatter) settlement in New Delhi, this chapter differentiates between two types of birth attendants. Traditional birth attendants are women who have learned their skills and knowledge, typically from elder women relatives, through apprenticeship. Their tools of practice include herbal knowledge as well as ‘modern’ medical kits they may have received through health education efforts (for example, scissors to cut the umbilical cord). In contrast, trained birth attendants are older women who were recruited through local health organizations (both governmental and non-governmental) and trained by biomedical practitioners to provide frontline care. This chapter examines both traditional and trained birth attendants’ perspectives on assisting local mothers, examining how local mothers view traditional versus trained birth attendants and, in turn, how this may affect their birth experiences

This paper places Latour’s (2004) concept of “body talk” alongside literature on symbolic boundaries to consider how the symbolic judgements and evaluations that comprise body talk frame the impact of structural pressures on the body. Drawing from individual and focus group interviews with 36 first-generation Arab Canadian immigrant women, this study shows that the female body, and practices of feeding and exercising it, are sites where structural inequalities embedded in the immigration process are materially experienced, resisted, and managed. In constructing boundaries between Arab women’s bodies in Canada and the Arab world alongside those of so-called “Canadian” women, we argue that women communicate their immigration and settlement struggles and recoup dignity otherwise compromised in the migration process—ultimately allowing them to frame their struggles as products of their moral integrity as immigrant wives and mothers. Through these findings, this paper demonstrates the role of body talk in framing the impact of structural pressures on the body, while simultaneously highlighting the centrality of boundary work to that framing.

Aim Demands for mental health services in post‐secondary institutions are increasing. This paper describes key features of a response to these needs: ACCESS Open Minds University of Alberta (ACCESS OM UA) is focused on improving mental health services for first‐year students, as youth transition to university and adulthood. Methods The core transformation activities at ACCESS OM UA are described, including early case identification, rapid access, appropriate and timely connections to follow‐up care and engagement of students and families/carers. In addition, we depict local experiences of transforming existing services around these objectives. Results The ACCESS OM UA Network has brought together staff with diverse backgrounds in order to address the unique needs of students. Together with the addition of ACCESS Clinicians these elements represent a systematic effort to support not just mental health, but the student as a whole. Key learnings include the importance of community mapping to developing networks and partnerships, and engaging stakeholders from design through to implementation for transformation to be sustainable. Conclusions Service transformation grounded in principles of community‐based research allows for incorporation of local knowledge, expertise and opportunities. This approach requires ample time to consult, develop rapport between staff and stakeholders across diverse units and develop processes in keeping with local opportunities and constraints. Ongoing efforts will continue to monitor changing student needs and to evaluate and adapt the transformations outlined in this paper to reflect those needs.

As the population of Pakistan has increased beyond 200 million, it is evident that the country's family planning program has been unable to sufficiently expand contraceptive use. To understand the obstacles, researchers have tended to focus on service delivery failures, ‘cultural’ barriers and varying political support. However, a small body of literature documents citizen's suspicions of an ulterior motive underlying Pakistan's family planning program. Often dismissed as unfounded conspiracies, a gap in our knowledge is the role these beliefs might be playing in the failure of the program. Using a critical ethnographic approach, we conduced 242 observations of daily life, 109 informal and 197 in-depth interviews with 41 women and 35 men living in a village in Khyber Pakhtunkhwa. Data were collected between September 2013 and April 2015 and analysed using latent content analysis. Our respondents viewed Western support for family planning as confirmation of their suspicions of the program's hidden agenda. Western military intervention in the region complicated their beliefs about the potential altruistic nature of foreign support for the family planning program. Awareness of rampant corruption among Pakistani government officials had fractured their trust in the state while contributing to the notion that the government was complicit with foreign interference. These considerations coupled with the fact that the priorities of Pakistani Family Planning program did not align with the reality of their lives contributed to the skepticism of family planning. For our respondents, resisting family planning and its ideology was a means to resist the perceived violence inflicted by the West and the complicity of the Pakistani government. These findings signal how geopolitics influence the use of family planning services. By demonstrating the importance of embedding perceptions of family planning programs in their local and global contexts, these findings suggest potential areas for future research in the field.

Breastfeeding is the safest mode of infant feeding during disasters and displacement. Although challenges associated with breastfeeding during humanitarian emergencies are global, they are particularly problematic in low- and middle-income countries such as Pakistan. To examine the factors that affect breastfeeding practices of displaced mothers in disaster relief camps, an integrative review of literature was undertaken. The review suggests that the breastfeeding experiences, behaviors, and practices of displaced mothers are shaped by a combination of gender-based, sociocultural, economic, and geopolitical factors. A thorough understanding of these factors will assist nurses and other stakeholders to improve breastfeeding practices and decrease child deaths in disaster relief camps.

The health of migrant children is a pressing issue. While most African migration takes place within Africa, a significant number of African migrants travel to outside of the continent. This article reports findings from a scoping review on the health of African immigrant children from sub-Saharan Africa now living outside of Africa. A systematic search for studies published between 2000 and 2019 resulted in only 20 studies reporting on the health of children up to 18 years of age migrating from sub-Saharan Africa. Data from these articles were thematically analyzed, highlighting concerns related to the children's nutrition status (n = 8), mental health (n = 7), and physical health (n = 5). Study participants were primarily from Somali and Ethiopia, and most studies were conducted in Australia or Israel. The review highlights several gaps related to the scope, range, and nature of evidence on the health of African immigrant children living outside of Africa. In particular, most focus on children's nutritional and mental health, but pay little attention to other health concerns this specific population may encounter or to the benefits associated with effective responses., Highlights • A systematic search for studies published between 2000 and 2019 resulted in only 20 studies reporting on the health of children up to 18 years of age migrating from sub-Saharan Africa. • Data highlight concerns related to the children's nutrition status (n = 8), mental health (n = 7), and physical health (n = 5). • Most focus on children's nutritional and mental health, but pay little attention to other health concerns. • Gaps related to the scope, range, and nature of evidence on the health of this population.

Driven by the global economic crisis, families are developing strategies for survival, including self-directed female migration. Female migration has negative and positive impacts on families in rural areas. The purpose of the project was to explore the health and wellness experiences of elderly family caregivers who have female family members who have migrated to improve the status of their families. In this focused ethnographic study, we interviewed elderly family members who had a female family member who migrated outside their community for employment. Participants were enrolled from northern Ghanaian communities known to be economically disadvantaged in comparison to their southern counterparts. All interviews were audio-recorded, transcribed verbatim, and translated into English. Data were analyzed based on thematic content. Majors themes that emerged were reasons for children leaving their families, physical, emotional, and spiritual health, and social and economic struggles. Challenges of family care work undertaken by the elderly in families with emigrated female kin strongly also emerged as a theme. New contextual knowledge was developed about the impact of self-directed female migration on the health and wellness of elderly family caregivers. The information is valuable for the development of culturally appropriate social support and health practices for female migrants and their families.

The sixth most populous country, Pakistan's modern contraceptive use rate is just 25%. Of the multiple reasons for avoiding contraceptives, women cite side effects as a significant deterrent to contraceptive uptake. Efforts to understand these side effects are limited by overreliance on the biomedical framework, which typically dismisses some of women's negative experiences and explanatory models as misperceptions. Drawing on 13 months of ethnographic data from a village in Khyber Pakhtunkhwa, Pakistan, our study sought to provide an emic description of contraceptive side effects. Respondents' described what we call "spiritual" and "somatic" side effects. While the latter included experiences such as irregular bleeding and leg pain, spiritual side effects had more severe implications ranging from job loss, birth defects, to child death. In a context of a firm belief that family planning was a sin, contraceptives were believed to negatively impact spiritual well-being and invite God's wrath. Our data suggest these perceptions and experiences played a crucial role in contraceptive decision-making. The spiritual and somatic experiences of contraceptive use described by respondents also demonstrate the importance of broadening dominant biomedical approaches to holistically understand contraceptive side effects and usage.

More people are migrating than ever before. There are an estimated 1 billion migrants globally—of whom, 258 million are international migrants and 763 million are internal migrants. Almost half of these migrants are women, and most are of reproductive age. Female migration has increased. The socioeconomic contexts of women migrants need investigation to better understand how migration intersects with accessing health care. We employed a focused ethnography design. We recruited 29 women from three African countries: Ghana, Nigeria, and South Africa. We used purposive and convenient sampling techniques and collected data using face-to-face interviews. Interviews were audio-recorded and transcribed verbatim. Data were analyzed with the support of ATLAS.ti 8 Windows (ATLAS.ti Scientific Software Development GmbH), a computer-based qualitative software for data management. We interviewed 10 women from both South Africa and Ghana and nine women from Nigeria. Their ages ranged between 24 and 64 years. The four themes that developed included social connectedness to navigate access to care, the influence of place of origin on access to care, experiences of financial accessibility, and historical and cultural orientation to accessing health care. It was clear that theses factors affected economic migrant women’s access to health care after migration. Canada has a universal health care system but multiple research studies have documented that migrants have significant barriers to accessing health care. Most migrants indeed arrive in Canada from a health care system that is very different than their country of origin. Access to health care is one of the most important social determinants of health.

Aim Youth mental health is of paramount significance to society globally. Given early onset of mental disorders and the inadequate access to appropriate services, a meaningful service transformation, based on globally recognized principles, is necessary. The aim of this paper is to describe a national Canadian project designed to achieve transformation of mental health services and to evaluate the impact of such transformation on individual and system related outcomes. Method We describe a model for transformation of services for youth with mental health and substance abuse problems across 14 geographically, linguistically and culturally diverse sites, including large and small urban, rural, First Nations and Inuit communities as well as homeless youth and a post-secondary educational setting. The principles guiding service transformation and objectives are identical across all sites but the method to achieve them varies depending on prevailing resources, culture, geography and the population to be served and how each community can best utilize the extra resources for transformation. Results Each site is engaged in community mapping of services followed by training, active stakeholder engagement with youth and families, early case identification initiatives, providing rapid access (within 72 hours) to an assessment of the presenting problems, facilitating connection to an appropriate service within 30 days (if required) with no transition based on age within the 11 to 25 age group and a structured evaluation to track outcomes over the period of the study. Conclusions Service transformation that is likely to achieve substantial change involves very detailed and carefully orchestrated processes guided by a set of values, principles, clear objectives, training and evaluation. The evidence gathered from this project can form the basis for scaling up youth mental health services in Canada across a variety of environments.

Bhutanese refugees represent one of Canada’s most recent immigrant populations, and little is known about their dietary traditions and habits. The purpose of this study was to improve the wellbeing and health of re-settled refugee Bhutanese women by understanding how culturally informed postpartum food choices are practiced post-migration. As part of a larger community-based participatory research project, semi-structured interviews were conducted with 12 Bhutanese refugee women. The traditional dietary choices that Bhutanese women revealed to be important in the postpartum period were organized into five themes: (1) “foods consumed as part of a regular healthy diet,” (2) “foods to regain strength and heal the body,” (3) “foods to ward off back and joint pain,” (4) “foods to promote lactation,” (5) “foods avoided due to negative effects.” Traditional foods and culturally situated beliefs in the postpartum period play a significant role in the lives of Bhutanese women. Healthcare workers in countries of re-settlement should work with the traditional health and nutritional beliefs of women in this community in order to provide optimal dietary and health recommendations.

Background: Gender inequality is a global issue. In Canada, 70% of women experience some form of inequality in their lifetime. Immigrant adolescents in Canada make up a substantial proportion of newcomers, and immigrant girls face the threat of subjugation and oppression, which has a significant impact on their health, development, and economic outcomes as well as gender inequality. Research on girls’ empowerment and resilience-building programs and interventions is virtually nonexistent. In this project, we implemented the ‘Girls’ Voices’ Curriculum. The aim of this project was to engage and empower South Asian (SA) immigrant adolescent girls and to promote gender equality in Canada. Methods: This study utilized a qualitative descriptive design. Pre- and post-curriculum implementation focus group discussions were conducted. Results: A total of 16 adolescent girls ranging from 11 to 18 years of age participated in this study. The participants described challenges many young girls face in relation to gender inequality such as gender discrimination, gendered stereotyping, barriers to education, etc. The ‘Girls’ Voices’ Curriculum allowed participants to highlight and reflect on the various problems faced by SA immigrant adolescents in their communities. The participants learned to examine these challenges through a variety of engaging activities to identify their root cause, effects and propose solutions to bring long-lasting change. The curriculum equipped them with useful tools such as decision-makers maps and advocacy skills to educate decision-makers by creating and delivering powerful messages influenced by personal stories and evidence-based literature. Conclusion: The study provided significant insight into understanding the diverse challenges encountered by SA immigrant adolescent girls in Canada and linking them to the effectiveness of the ‘Girls’ Voices’ Curriculum. The girl-focused development programs that emphasize developing self-confidence, communication skills, problem-solving skills, and decision making are effective in empowering the socially deprived adolescent girls locally and in the global context.

People's perceptions of local food environments influence their abilities to eat healthily. PhotoVoice participants from four communities in Alberta, Canada took pictures of barriers and opportunities for healthy eating and shared their stories in one-on-one semi-structured interviews. Using a socioecological framework, emergent themes were organized by type and size of environment. Findings show that, while availability and access to food outlets influence healthy eating practices, these factors may be eclipsed by other non-physical environmental considerations, such as food regulations and socio-cultural preferences. This study identifies a set of meta-themes that summarize and illustrate the interrelationships between environmental attributes, people's perceptions, and eating behaviors: a) availability and accessibility are interrelated and only part of the healthy eating equation; b) local food is synonymous with healthy eating; c) local food places for healthy eating help define community identity; d) communal dining (commensality) does not necessarily mean healthy eating; e) rewarding an achievement or celebrating special occasions with highly processed foods is socially accepted; f) food costs seemed to be driving forces in food decisions; g) macro-environmental influences are latent in food decisions. Recognizing the interrelationship among multiple environmental factors may help efforts to design effective community-based interventions and address knowledge gaps on how sociocultural, economic, and political environments intersect with physical worlds.

Pakistan, with a population of over 207 million, is the sixth most populous country in the world. Yet, only 25% of eligible couples' report using a modern contraceptive method. A large body of literature indicates the existence of a widely-held perception among Pakistanis that family planning use is a sin, which is then often cited as evidence that Islamic beliefs impede contraceptive use (see Agha, 2010; Ali and Ushijima, 2005; Azmat, 2011; Zafar et al., 2003). We argue that this body of literature, which has relied primarily on quantitative measures and survey methodology, is highly reductive. Missing from this discourse is a nuanced analysis of how individuals engage with their Islamic beliefs to make fertility decisions. Drawing on 13 months of ethnographic data, our findings demonstrate that despite most of our respondents overwhelmingly believing that family planning use was a sin, many had, at some stage, tried to control their fertility. Our findings evidenced that respondents' beliefs surrounding the morality of fertility control was informed by multiple moral registers beyond Islam. For our respondents, moral action was informed by interpretations of Islamic teachings, economic insecurity, socioeconomic inequities, community/public discourse, and geopolitics. We argue there is a need to complicate our understanding of how Islam shapes reproductive strategies in Pakistan, and its relative importance in contraceptive decisions.

Child discipline remains a topic of public health interest across the globe. Despite this enduring interest, very little is known about the child disciplinary practices of African immigrants in Canada. This paper explores the disciplinary practices of African immigrant parents in Alberta, a Canadian province with a recent surge in the population of African immigrants. Employing a critical ethnographic methodology, informed by transnational theory, we collected data through in-depth qualitative interviews with a purposive sample of African community leaders (n = 14), African immigrant parents (n = 32), policymakers (n = 2), and health and immigrant settlement workers (n = 10). As members of the African immigrant community, we were deeply immersed in the research settings, which afforded us the opportunity to collect pertinent observational data in the form of reflexive notes. Thematic analysis of the data revealed child disciplinary approaches that incorporate Canadian and African parenting practices, as well as practices that appear somewhat unique to this demographic. We found that African immigrant parents used corporal discipline, persuasive discipline, and a hybrid of the two, as well as emerging practices involving transnational fostering and emotional isolation of children who persistently misbehaved. These practices, in their totality, appeared to be influenced by the transnational experiences of parents and precepts that are traceable to Canada’s legal and educational systems. We present theoretical, policy, and service implications of our findings, including a recommendation to incorporate sociocultural dimensions of child discipline into Canadian child welfare policies and practices.

Introduction Le surpoids et l’obésité dépendent de l’interaction complexe entre facteurs liés à l’indivu et facteurs liés à l’environnement ayant une influence sur l’activité physique et une alimentation saine. Il existe pourtant peu d’information sur les perceptions des individus à l’égard de ces facteurs. Afin de combler cette lacune importante et de répondre aux besoins de nos partenaires des collectivités, nous examinons comment les individus perçoivent l’influence des facteurs micro- et macroenvironnementaux sur leur activité physique et leur alimentation. Méthodologie Nos partenaires des collectivités souhaitaient que les résultats de l’étude soient diffusés dans un format facile à utiliser par les décideurs locaux. Avec la méthode photovoix, nous avons motivé 35 membres issus de quatre collectivités de l’Alberta (Canada) à fournir leurs témoignages à propos de leur activité physique et d’une alimentation saine. Nous avons employé une combinaison d’analyses inductives et déductives pour classer les données par niveau (micro et macro) d’environnement et par type (environnement physique, politique, économique et socioculturel), à l’aide de la Grille d’analyse des environnements liés à l’obésité (ANGELO). Résultats Pour les participants, les facteurs liés à la santé étaient plus larges que l’activité physique et une alimentation saine, incluant la « santé sociocommunautaire ». Les participants ont parlé plus souvent de l’influence du microenvironnement (score de 792 après codage au moyen du cadre ANGELO) sur l’activité physique, une alimentation saine ou la santé sociocommunautaire que sur l’influence du macroenvironnement (score de 93). Les résultats obtenus avec la méthode photovoix ont fourni aux partenaires des collectivités et aux décideurs un témoignage visuel de la manière dont la capacité des individus à faire des choix sains peut être restreinte par des forces macroenvironnementales qui échappent à leur contrôle. Conclusion Axer les recherches ultérieures sur les influences macroenvironnementales et microenvironnementales ainsi que sur la santé sociocommunautaire locale sera utile, car cela alimentera les stratégies de changement en vue d’améliorer la santé des collectivités tout en garantissant que la recherche et les interventions font écho aux perceptions diverses de la population.

Purpose. To identify perceptions of how sociocultural environment enabled and hindered physical activity (PA) participation. Design. Community-based participatory research. Setting. Two semirural and two urban communities located in Alberta, Canada. Participants. Thirty-five people (74.3% females, 71.4% aged 25–64 years) across the four communities. Method. PhotoVoice activities occurred over 3 months during the spring of 2009. Participants were asked to document perceived environmental attributes that might foster or inhibit PA in their community. Photographs and narratives were shared in one-on-one interviews. Line-by-line coding of the transcripts was independently conducted by two researchers using an inductive approach. Codes were arranged into themes and subthemes, which were then organized into the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. Results. Six main themes (accompanied by subthemes) emerged: sociocultural aesthetics, safety, social involvement, PA motivation, cultural ideas of recreation, and car culture. Representative quotes and photographs illustrate enablers and obstacles identified by participants. Conclusion. This PhotoVoice study revealed how aspects of participants' sociocultural environments shaped their decisions to be physically active. Providing more PA resources is only one step in the promotion of supportive environments. Strategies should also account for the beautification and maintenance of communities, increasing feelings of safety, enhancement of social support among community members, popularization of PA, and mitigating car culture, among others.

Acculturation has been associated with decreased physical activity among immigrants. This study assessed the process of changing physical activity patterns within the context of Latin American immigrant women’s migration experiences to Canada. Using the ecological model of health promotion, we applied a mixed methods research design. Thirty-six Latin American immigrant women, 18 recent ( 10 years in Canada), participated. Six focus groups and 14 in-depth individual interviews were conducted. The Godin Leisure-Time Exercise Questionnaire was administered. Overall, 86 % of the participants reported gaining weight since coming to Canada. Participants reported becoming more sedentary upon arriving in Canada. Only 27.3 % of recent and 41.7 % of non-recent immigrant women were considered sufficiently physically active. Lack of time, resources, social support, and migration stress were identified as key barriers to physical activity. Migration stress associated with social integration barriers strongly influence physical activity among Latin American immigrant women.

Peoples' perceptions of healthy eating are influenced by the cultural context in which they occur. Despite this general acceptance by health practitioners and social scientists, studies suggest that there remains a relative homogeneity around peoples' perceptions that informs a hegemonic discourse around healthy eating. People often describe healthy eating in terms of learned information from sources that reflect societies' norms and values, such as the Canada Food Guide and the ubiquitous phrase "fruits and vegetables". Past research has examined how built environments shape people's access to healthy living options, such as distribution of grocers versus convenience stores and fast food restaurants. Often overlooked is an in-depth understanding of how social contexts interact with built environments, molding peoples' perceptions of healthy eating. This paper reports on perceptions of healthy eating in four communities across Alberta, Canada. A photovoice methodology was employed to elicit perceptions of healthy eating with 35 participants. This study illustrates how participants' photographs and their stories convey multiple meanings about healthy eating within their own lives and communities. Findings suggest that a 'local' context is an important part of the discourse centered around the promotion of healthy eating practices in these and potential other communities.