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Addressing embodied inequities in health: how do we enable improvement in women's diet in pregnancy?

Addressing embodied inequities in health: how do we enable improvement in women's diet in pregnancy?
Addressing embodied inequities in health: how do we enable improvement in women's diet in pregnancy?
Objective:
To disrupt cycles of health inequity, traceable to dietary inequities in the earliest stages of life, public health interventions should target improving nutritional wellbeing in preconception/pregnancy environments. This requires a deep engagement with pregnant/postpartum people (PPP) and their communities (including their health and social care providers, HSCP). We sought to understand the factors that influence diet during pregnancy from the perspectives of PPP and HSCP, and to outline intervention priorities.

Design:
We carried out thematic network analyses of transcripts from ten focus group discussions (FGD) and one stakeholder engagement meeting with PPP and HSCP in a Canadian city. Identified themes were developed into conceptual maps, highlighting local priorities for pregnancy nutrition and intervention development.

Setting:
FGD and the stakeholder meeting were run in predominantly lower socioeconomic position (SEP) neighbourhoods in the sociodemographically diverse city of Hamilton, Canada.

Participants:
All local, comprising twenty-two lower SEP PPP and forty-three HSCP.

Results:
Salient themes were resilience, resources, relationships and the embodied experience of pregnancy. Both PPP and HSCP underscored that socioeconomic-political forces operating at multiple levels largely determined the availability of individual and relational resources constraining diet during pregnancy. Intervention proposals focused on cultivating individual and community resilience to improve early-life nutritional environments. Participants called for better-integrated services, greater income supports and strengthened support programmes.

Conclusions:
Hamilton stakeholders foregrounded social determinants of inequity as main factors influencing pregnancy diet. They further indicated a need to develop interventions that build resilience and redistribute resources at multiple levels, from the household to the state.
Community engagement, Developmental origins, Dietary inequities, Health inequities, Pregnancy
1368-9800
2994-3004
McKerracher, L.
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Oresnik, S.
318bdbf0-d4f5-4088-9e0e-d02ee359fdb7
Moffat, T.
96237a64-3039-4cbe-b9d3-ce5c2a06523a
Murray Davies, B.
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Vickers-Manzin, J.
e5b02f15-9929-425b-8165-8d3f2c194d27
Zalot, L.
00da562d-8d1b-4eff-8d2b-2cb6f3c4f7d4
Williams, D
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Sloboda, D.M.
6ce36e7c-9182-450e-820d-3de47c1fc5fb
Barker, M.E.
374310ad-d308-44af-b6da-515bf5d2d6d2
McKerracher, L.
fbdb8e61-5a2e-41a6-a2e3-b429fd7e79fb
Oresnik, S.
318bdbf0-d4f5-4088-9e0e-d02ee359fdb7
Moffat, T.
96237a64-3039-4cbe-b9d3-ce5c2a06523a
Murray Davies, B.
4485fb9b-665f-47a7-ab16-ab23293c79a5
Vickers-Manzin, J.
e5b02f15-9929-425b-8165-8d3f2c194d27
Zalot, L.
00da562d-8d1b-4eff-8d2b-2cb6f3c4f7d4
Williams, D
08e26dc1-a8a8-4e3e-8fe3-d21b73ffeae9
Sloboda, D.M.
6ce36e7c-9182-450e-820d-3de47c1fc5fb
Barker, M.E.
374310ad-d308-44af-b6da-515bf5d2d6d2

McKerracher, L., Oresnik, S., Moffat, T., Murray Davies, B., Vickers-Manzin, J., Zalot, L., Williams, D, Sloboda, D.M. and Barker, M.E. (2020) Addressing embodied inequities in health: how do we enable improvement in women's diet in pregnancy? Public Health Nutrition, 23 (16), 2994-3004. (doi:10.1017/S1368980020001093).

Record type: Article

Abstract

Objective:
To disrupt cycles of health inequity, traceable to dietary inequities in the earliest stages of life, public health interventions should target improving nutritional wellbeing in preconception/pregnancy environments. This requires a deep engagement with pregnant/postpartum people (PPP) and their communities (including their health and social care providers, HSCP). We sought to understand the factors that influence diet during pregnancy from the perspectives of PPP and HSCP, and to outline intervention priorities.

Design:
We carried out thematic network analyses of transcripts from ten focus group discussions (FGD) and one stakeholder engagement meeting with PPP and HSCP in a Canadian city. Identified themes were developed into conceptual maps, highlighting local priorities for pregnancy nutrition and intervention development.

Setting:
FGD and the stakeholder meeting were run in predominantly lower socioeconomic position (SEP) neighbourhoods in the sociodemographically diverse city of Hamilton, Canada.

Participants:
All local, comprising twenty-two lower SEP PPP and forty-three HSCP.

Results:
Salient themes were resilience, resources, relationships and the embodied experience of pregnancy. Both PPP and HSCP underscored that socioeconomic-political forces operating at multiple levels largely determined the availability of individual and relational resources constraining diet during pregnancy. Intervention proposals focused on cultivating individual and community resilience to improve early-life nutritional environments. Participants called for better-integrated services, greater income supports and strengthened support programmes.

Conclusions:
Hamilton stakeholders foregrounded social determinants of inequity as main factors influencing pregnancy diet. They further indicated a need to develop interventions that build resilience and redistribute resources at multiple levels, from the household to the state.

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Anon_addr_inequitiesPHN_feb242020rev - Accepted Manuscript
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More information

Accepted/In Press date: 20 March 2020
e-pub ahead of print date: 6 July 2020
Keywords: Community engagement, Developmental origins, Dietary inequities, Health inequities, Pregnancy

Identifiers

Local EPrints ID: 444178
URI: http://eprints.soton.ac.uk/id/eprint/444178
ISSN: 1368-9800
PURE UUID: 637e4e7c-65e2-43f6-bf3f-cf17ab8c7253
ORCID for M.E. Barker: ORCID iD orcid.org/0000-0003-2976-0217

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Date deposited: 30 Sep 2020 16:30
Last modified: 28 Apr 2022 04:17

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Contributors

Author: L. McKerracher
Author: S. Oresnik
Author: T. Moffat
Author: B. Murray Davies
Author: J. Vickers-Manzin
Author: L. Zalot
Author: D Williams
Author: D.M. Sloboda
Author: M.E. Barker ORCID iD

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