title: Food choices and practices during pregnancy of immigrant women with high-risk pregnancies in Canada: a pilot study.
abstract: BACKGROUND
  Immigrant women may be regarded as a vulnerable population with respect to access and navigation of maternity care services. They may encounter difficulties when accessing culturally safe and appropriate maternity care, which may be further exacerbated by language difficulties and discriminatory practices or attitudes. The project aimed to understand ethnocultural food and health practices and how these intersect in a particular social context of cultural adaptation and adjustment in order to improve the care-giving capacities of health practitioners working in multicultural perinatal clinics.
  
  
  METHODS
  This four-phase study employed a case study design allowing for multiple means of data collection and different units of analysis. Phase one consists of a scoping review of the literature. Phases two and three incorporate pictorial representations of food choices with semi-structured photo-elicited interviews. This study was undertaken at a Prenatal and Obstetric Clinic, in an urban Canadian city. In phase four, the research team will inform the development of culturally appropriate visual tools for health promotion.
  
  
  RESULTS
  Five themes were identified: (a) Perceptions of Health, (b) Social Support (c) Antenatal Foods (d) Postnatal Foods and (e) Role of Health Education. These themes provide practitioners with an understanding of the cultural differences that affect women's dietary choices during pregnancy. The project identified building collaborations between practitioners and families of pregnant immigrant women to be of utmost importance in supporting healthy pregnancies, along with facilitating social support for pregnant and breastfeeding mothers.
  
  
  CONCLUSIONS
  In a multicultural society that contemporary Canada is, it is challenging for health practitioners to understand various ethnocultural dietary norms and practices. Practitioners need to be aware of customary practices of the ethnocultural groups that they work with, while simultaneously recognizing the variation within-not everyone follows customary practices, individuals may pick and choose which customary guidelines they follow. What women choose to eat is also influenced by their own experiences, access to particular foods, socioeconomic status, family context, and so on. The pilot study demonstrated the efficacy of the employed research strategies and we subsequently acquired funding for a national study.
authors.affiliation: University of Alberta, Faculty of Nursing, 3rd Floor Edmonton Clinic Health Academy, 11405 87th Avenue, Edmonton, Alberta, T6G 1C9, Canada. gina.higginbottom@ualberta.ca.
authors.forename: Gina M A
authors.initials: GM
authors.lastname: Higginbottom
authors.affiliation: Department of Anthropology, University of Alberta, 13-15 HM Tory Building, Edmonton, Alberta, T6G 2H4, Canada. Vallianatos@ualberta.ca.
authors.forename: Helen
authors.initials: H
authors.lastname: Vallianatos
authors.affiliation: Alberta Health Services, Lois Hole Hospital for Women, 10240 Kingsway Avenue, Edmonton, Alberta, T5H 3 V9, Canada. joan.forgeron@albertahealthservices.ca.
authors.forename: Joan
authors.initials: J
authors.lastname: Forgeron
authors.affiliation: Alberta Health Services, Lois Hole Hospital for Women, 10240 Kingsway Avenue, Edmonton, Alberta, T5H 3 V9, Canada. donna.gibbons@albertahealthservices.ca.
authors.forename: Donna
authors.initials: D
authors.lastname: Gibbons
authors.affiliation: Department of Maternal-Infant and Public Health Nursing, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil. famamede@eerp.usp.br.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Mamede
authors.affiliation: University of Alberta, Faculty of Nursing, 3rd Floor Edmonton Clinic Health Academy, 11405 87th Avenue, Edmonton, Alberta, T6G 1C9, Canada. barolia@ualberta.ca.
authors.forename: Rubina
authors.initials: R
authors.lastname: Barolia
mesh_terms: D000069:Acculturation; D000349:Africa / Q000208:ethnology; D001208:Asia / Q000208:ethnology; D002170:Canada; D002755:Choice Behavior; D054521:Cultural Competency; D004032:Diet / Q000208:ethnology*; D054242:Emigrants and Immigrants; D005260:Female; D005518:Food Preferences; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006293:Health Promotion; D006801:Humans; D010781:Photography; D010865:Pilot Projects; D049590:Postpartum Period; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D012944:Social Support