title: A mixed methods inquiry into the determinants of traditional food consumption among three Cree communities of Eeyou Istchee from an ecological perspective.
abstract: The Aboriginal nations of Canada have higher incidences of chronic diseases, coinciding with profound changes in their environment, lifestyle and diet. Traditional foods can protect against the risks of chronic disease. However, their consumption is in decline, and little is known about the complex mechanisms underlying this trend.
  
  
  
  To identify the factors involved in traditional food consumption by Cree Aboriginal people living in 3 communities in northern Quebec, Canada. Design. A mixed methods explanatory design, including focus group interviews to interpret the results of logistic regression.
  
  
  
  This study includes a secondary data analysis of a cross-sectional survey of 3 Cree communities (n=374) and 4 focus group interviews (n=23). In the first, quantitative phase of the study, data were collected using a food-frequency questionnaire along with a structured questionnaire. Subsequently, the focus group interviews helped explain and build on the results of logistic regressions.
  
  
  
  People who consume traditional food 3 days or more weekly were more likely to be 40 years old and over, to walk 30 minutes or more per day, not to have completed their schooling, to live in Mistissini and to be a hunter (p<0.05 for all comparisons). The focus group participants provided explanations for the quantitative analysis results or completed them. For example, although no statistical association was found, focus group participants believed that employment acts as both a facilitator and a barrier to traditional food consumption, rendering the effect undetectable. In addition, focus group participants suggested that traditional food consumption is the result of multiple interconnected influences, including individual, family, community and environmental influences, rather than a single factor.
  
  
  
  This study sheds light on a number of factors that are unique to traditional foods, factors that have been understudied to date. Efforts to promote and maintain traditional food consumption could improve the overall health and wellbeing of Cree communities.
authors.affiliation: Public Health Department, Cree Board of Health and Social Services of James Bay, Mistissini, QC, Canada; Department of Social and Preventative Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
authors.forename: Véronique Laberge
authors.initials: VL
authors.lastname: Gaudin
authors.affiliation: Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
authors.forename: Olivier
authors.initials: O
authors.lastname: Receveur
authors.affiliation: Department of Social and Preventative Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
authors.forename: Leah
authors.initials: L
authors.lastname: Walz
authors.affiliation: Department of Oral Health, Faculty of Dentistry, Université de Montréal, Montreal, QC, Canada; felix.girard@umontreal.ca.
authors.forename: Félix
authors.initials: F
authors.lastname: Girard
authors.affiliation: Department of Social and Preventative Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
authors.forename: Louise
authors.initials: L
authors.lastname: Potvin
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004435:Eating / Q000208:ethnology*; D004463:Ecology; D004782:Environmental Health; D005006:Ethnicity; D005247:Feeding Behavior / Q000208:ethnology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011792:Quebec / Q000453:epidemiology; D011795:Surveys and Questionnaires
keywords: determinants; ecological perspective; first nations; mixed methods research; traditional foods