title: Community perspectives on food insecurity and obesity: Focus groups with caregivers of metis and Off-reserve first nations children.
abstract: BACKGROUND
  Aboriginal children in Canada are at a higher risk for overweight and obesity than other Canadian children. In Northern and remote areas, this has been linked to a lack of affordable nutritious food. However, the majority of Aboriginal children live in urban areas where food choices are more plentiful. This study aimed to explore the experiences of food insecurity among Métis and First Nations parents living in urban areas, including the predictors and perceived connections between food insecurity and obesity among Aboriginal children.
  
  
  METHODS
  Factors influencing children's diets, families' experiences with food insecurity, and coping strategies were explored using focus group discussions with 32 parents and caregivers of Métis and off-reserve First Nations children from Midland-Penetanguishene and London, Ontario. Four focus groups were conducted and transcribed verbatim between July 2011 and March 2013. A thematic analysis was conducted using NVivo software, and second coders ensured reliability of the results.
  
  
  RESULTS
  Caregivers identified low income as an underlying cause of food insecurity within their communities and as contributing to poor nutrition among their children. Families reported a reliance on energy-dense, nutrient-poor foods, as these tended to be more affordable and lasted longer than more nutritious, fresh food options. A lack of transportation also compromised families' ability to purchase healthful food. Aboriginal caregivers also mentioned a lack of access to traditional foods. Coping strategies such as food banks and community programming were not always seen as effective. In fact, some were reported as potentially exacerbating the problem of overweight and obesity among First Nations and Métis children.
  
  
  CONCLUSIONS
  Food insecurity manifested itself in different ways, and coping strategies were often insufficient for addressing the lack of fruit and vegetable consumption in Aboriginal children's diets. Results suggest that obesity prevention strategies should take a family-targeted approach that considers the unique barriers facing urban Aboriginal populations. This study also reinforces the importance of low income as an important risk factor for obesity among Aboriginal peoples.
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada. jbhawra@uwaterloo.ca.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Bhawra
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada. cooke@uwaterloo.ca.|Department of Sociology and Legal Studies, University of Waterloo, Waterloo, ON, Canada. cooke@uwaterloo.ca.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Cooke
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada. rhanning@uwaterloo.ca.
authors.forename: Rhona
authors.initials: R
authors.lastname: Hanning
authors.affiliation: Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. piotr.wilk@schulich.uwo.ca.
authors.forename: Piotr
authors.initials: P
authors.lastname: Wilk
authors.affiliation: Métis Nation of Ontario, Ottawa, ON, Canada. ShelleyG@Metisnation.org.
authors.forename: Shelley L H
authors.initials: SL
authors.lastname: Gonneville
mesh_terms: D000293:Adolescent; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D005260:Female; D017144:Focus Groups; D005523:Food Supply; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007198:Indians, North American; D008297:Male; D009864:Ontario; D010290:Parents / Q000523:psychology*; D063766:Pediatric Obesity; D044382:Population Groups; D014505:Urban Population