NOTICE: We are experiencing technical issues with Academy members trying to log into the JAND site using Academy member login credentials. We are working to resolve the issue as soon as possible. Alternatively, if you are an Academy member, you can access the JAND site by registering for an Elsevier account and claiming access using the links at the top of the JAND site. Email us at [email protected] for assistance. Thanks for your patience!

Factors Associated with Effective Nutrition Interventions for Pregnant Indigenous Women: A Systematic Review

      Abstract

      Introduction

      Indigenous people continue to experience health disparities relative to non-Indigenous populations. Interventions to improve nutrition during pregnancy in these groups may improve health outcomes for mothers and their infants. The effectiveness of existing nutrition intervention programs has not been reviewed previously.

      Objective

      The objective was to identify interventions targeting improving nutrition-related outcomes for pregnant Indigenous women residing in Organisation for Economic Co-operation and Development countries, and to identify positive factors contributing to successful programs.

      Methods

      Thirteen electronic databases were searched up until October 2015. Key words identified studies intervening to improve nutrition-related outcomes for pregnant Indigenous women. Two reviewers assessed articles for inclusion and study quality and extracted data. Only studies published in English were included. Data were summarized narratively.

      Results

      Abstracts and titles were screened (n=2,566) and 315 full texts were reviewed for eligibility. This review included 27 articles from 20 intervention programs from Australia, Canada, and the United States. The most prevalent measurable outcomes were birth weight (n=9) and breastfeeding initiation/duration (n=11). Programs with statistically significant results for these outcomes employed the following nutrition activities: individual counseling/education (n=8); delivery by senior Indigenous woman (n=2), peer counselor (n=3), or other Indigenous health worker (n=4); community-wide interventions (n=2); media campaigns (n=2); delivery by non-Indigenous health professional (n=3); and home visits (n=3).

      Conclusions

      Heterogeneity of included studies made it challenging to make firm recommendations regarding program success. Authors of included studies recommended community consultation be included when designing studies and working with communities at all stages of the research process. Individualized counseling/education can contribute to successful program outcomes, as can the use of Indigenous workers to deliver program content. Limitations of some studies included a lack of details on interventions and the use of nonrandom control groups. Future studies should include detailed descriptions of intervention components and include appropriate evaluation protocols.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. United Nations Permanent Forum on Indigenous Issues. Who are Indigenous peoples? http://www.un.org/esa/socdev/unpfii/documents/5session_factsheet1.pdf. Accessed September 3, 2014.

      2. World Health Organization. Health of indigenous peoples, fact sheet no. 326. 2007; http://www.who.int/mediacentre/factsheets/fs326/en/. Accessed December 2014.

      3. Australian Bureau of Statistics Australian Aboriginal and Torres Strait Islander Health Survey: Biomedical Results, 2012-13. http://www.abs.gov.au/ausstats/[email protected]/Lookup/by%20Subject/4727.0.55.003∼2012-13∼Main%20Features∼Key%20Findings∼1. Published 2014. Accessed September 10, 2014.

      4. Wallace S. Inuit health: Selected findings from the 2012 Aboriginal Peoples Survey. 2014; http://www.statcan.gc.ca/pub/89-653-x/89-653-x2014003-eng.htm. Accessed February 9, 2015.

      5. National Center for Health Statistics. Health data interactive. http://www.cdc.gov/nchs/hdi.htm. Updated February 3, 2014. Accessed November 4, 2016.

        • Delisle H.
        Programming of Chronic Disease by Impaired Fetal Nutrition: Evidence and Implications for Policy and Intervention Strategies.
        World Health Organization, Geneva, Switzerland2002
        • Gunderson E.
        Childbearing and obesity in women: Weight before, during, and after pregnancy.
        Obstet Gynecol Clin North Am. 2009; 36: 317-ix
        • Gunderson E.
        • Abrams B.
        Epidemiology of gestational weight gain and body weight changes after pregnancy.
        Epidemiol Rev. 2000; 22: 261-274
        • Rooney B.
        • Schauberger C.
        Excess pregnancy weight gain and long-term obesity: One decade later.
        Obstet Gynecol. 2002; 100: 245-252
        • Williamson C.
        Nutrition in pregnancy.
        Br Nutr Found Bull. 2006; 31: 28-59
        • Barker D.
        Fetal origins of coronary heart disease.
        Br Med J. 1995; 311: 171-174
        • Barker D.J.
        • Gluckman P.D.
        • Godfrey K.M.
        • Harding J.E.
        • Owens J.A.
        • Robinson J.S.
        Fetal nutrition and cardiovascular disease in adult life.
        Lancet. 1993; 341: 938-941
        • Barker D.J.
        Maternal nutrition, fetal nutrition, and disease in later life.
        Nutrition. 1997; 13: 807-813
        • Smylie J.
        • Crengle S.
        • Freemantle J.
        • Taualii M.
        Indigenous birth outcomes in Australia, Canada, New Zealand and the United States—An overview.
        Open Womens Health J. 2010; 4: 7-17
        • Laws P.
        • Sullivan E.
        Australia’s Mothers and Babies 2007.
        Australian Institute of Health and Welfare National Perinatal Statistics Unit, Sydney2009
        • Back L.
        • Hui A.
        • Redi A.
        • et al.
        Comparison of physical activity and nutritional intake in First Nations pregnant women in remote communities and urban-living pregnant women.
        Can J Diabetes. 2012; 36: 64-67
      6. Australian Institute of Health and Welfare. Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report: Detailed Analyses. Cat. no. IHW 167. Canberra: Australian Institute of Health and Welfare; 2015.

        • Brimblecombe J.
        • van den Boogaard C.
        • Wood B.
        • et al.
        Development of the good food planning tool: A food system approach to food security in Indigenous Australian remote communities.
        Health Place. 2015; 34: 54-62
        • Lee A.
        • Leonard D.
        • Moloney A.
        • Minniecon D.
        Improving Aboriginal and Torres Strait Islander nutrition and health.
        Med J Aust. 2009; 190: 547-548
        • National Health and Medical Research Council, Department of Health and Ageing
        Eat For Health: Infant Feeding Guidelines Information for Health Workers.
        Australian Government, Canberra2012
      7. Exclusive Breastfeeding for Six Months Best for Babies Everywhere: Statement [press release]. Geneva, Switzerland: World Health Organization; 2011.

        • Cromie E.A.
        • Shepherd C.C.
        • Zubrick S.R.
        • Oddy W.H.
        Breastfeeding duration and residential isolation amid aboriginal children in Western Australia.
        Nutrients. 2012; 4: 2020-2034
      8. Health Canada. Breastfeeding Initiation in Canada: Key statistics and graphics (2009-2010). Food and Nutrition 2012; http://www.hc-sc.gc.ca/fn-an/surveill/nutrition/commun/prenatal/initiation-eng.php#a2Duration: http://www.hc-sc.gc.ca/fn-an/surveill/nutrition/commun/prenatal/exclusive-exclusif-eng.php#a2. Accessed February 7, 2016.

        • Dodgson J.E.
        • Codier E.
        • Kaiwi P.
        • Oneha M.F.M.
        • Pagano I.
        Breastfeeding patterns in a community of native Hawaiian mothers participating in WIC.
        Family Commun Health. 2007; 30: S46-S58
        • Academy of Nutrition and Dietetics
        Evidence Analysis Manual: Steps in the Academy Evidence Analysis Process.
        Academy of Nutrition and Dietetics, Chicago, IL2012
      9. The Organisation for Economic Co-operation and Development. List of OECD Member countries- Ratification of the Convention on the OECD. http://www.oecd.org/about/membersandpartners/list-oecd-member-countries.htm. Accessed September 1, 2014.

      10. Lowitja Institute LIt.search Autralian Government Department of Industry, Innovation and Science. Business Cooperative Research Centres Programme, 2013. http://www.lowitja.org.au/litsearch. Accessed October 3, 2016.

        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • Altman D.G.
        • PRISMA Group
        Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement.
        PLoS Med. 2009; 6: e1000097
        • Hermann J.
        • Williams G.
        • Hunt D.
        Effect of nutrition education by paraprofessionals on dietary intake, maternal weight gain, and infant birth weight in pregnant native American and Caucasian adolescents.
        J Extens. 2001; 39
        • Walkup J.T.
        • Barlow A.
        • Mullany B.C.
        • et al.
        Randomized controlled trial of a paraprofessional-delivered in-home intervention for young reservation-based American Indian mothers.
        J Am Acad Child Adolesc Psychiatry. 2009; 48: 591-601
        • Barlow A.
        • Mullany B.
        • Neault N.
        • et al.
        Effect of a paraprofessional home-visiting intervention on American Indian teen mothers' and infants' behavioral risks: A randomized controlled trial.
        Am J Psychiatry. 2013; 170: 83-93
        • Gray-Donald K.
        • Robinson E.
        • Collier A.
        • David K.
        • Renaud L.
        • Rodrigues S.
        Intervening to reduce weight gain in pregnancy and gestational diabetes mellitus in Cree communities: An evaluation.
        CMAJ. 2000; 163: 1247-1251
        • Long D.G.
        • Funk-Archuleta M.A.
        • Geiger C.J.
        • Mozar A.J.
        • Heins J.N.
        Peer counselor program increases breastfeeding rates in Utah Native American WIC population.
        J Human Lactat. 1995; 11: 279-284
        • Wright A.
        • Naylor A.
        • Wester R.
        • Bauer M.
        • Sutcliffe E.
        Using cultural knowledge in health promotion: Breastfeeding among the Navajo.
        Health Educ Behav. 1997; 24: 625-639
        • Wright A.
        • Bauer M.
        • Naylor A.
        • Sutcliffe E.
        • Clark L.
        increasing breastfeeding rates to reduce infant illness at the community level.
        Pediatrics. 1998; 101: 837-844
        • Muhajarine N.
        • Ng J.
        • Bowen A.
        • Cushon J.
        • Johnson S.
        Understanding the impact of the Canada Prenatal Nutrition Program: A quantitative evaluation.
        Can J Public Health. 2012; 103: eS26-eS31
        • Hoffhines H.
        • Whaley K.D.
        • Blackett P.R.
        • et al.
        Early childhood nutrition in an American Indian community: Educational strategy for obesity prevention.
        J Okla State Med Assoc. 2014; 107: 55-59
        • Lawrence H.P.
        • Romanetz M.
        • Rutherford L.
        • Cappel L.
        • Binguis D.
        • Rogers J.B.
        Effects of a community-based prenatal nutrition program on the oral health of Aboriginal preschool children in northern Ontario.
        Probe. 2004; 38: 172-190
        • Martens P.J.
        Increasing breastfeeding initiation and duration at a community level: An evaluation of Sagkeeng First Nation's community health nurse and peer counselor programs.
        J Human Lactat. 2002; 18: 236-246
        • Wilhelm S.
        • Rodehorst-Weber K.
        • Aguirre T.
        • et al.
        Lessons learned conducting breastfeeding intervention research in two northern plains tribal communities.
        Breastfeed Med. 2012; 7: 167-172
        • Karanja N.
        • Lutz T.
        • Ritenbaugh C.
        • et al.
        The TOTS community intervention to prevent overweight in American Indian toddlers beginning at birth: A feasibility and efficacy study.
        J Commun Health. 2010; 35: 667-675
        • Murphy E.
        • Best E.
        The Aboriginal Maternal and Infant Health Service: A decade of achievement in the health of women and babies in NSW.
        NSW Public Health Bull. 2012; 23: 68-72
        • D'Espaignet E.T.
        • Measey M.L.
        • Carnegie M.A.
        • Mackerras D.
        Monitoring the 'Strong Women, Strong Babies, Strong Culture Program': The first eight years.
        J Paediatr Child Health. 2003; 39: 668-672
        • Panaretto K.S.
        • Lee H.M.
        • Mitchell M.R.
        • et al.
        Impact of a collaborative shared antenatal care program for urban Indigenous women: A prospective cohort study.
        Med J Aust. 2005; 182: 514-519
        • Panaretto K.S.
        • Mitchell M.R.
        • Anderson L.
        • et al.
        Sustainable antenatal care services in an urban Indigenous community: The Townsville experience.
        Med J Aust. 2007; 187: 18-22
        • Bertilone C.
        • McEvoy S.
        Success in closing the gap: Favourable neonatal outcomes in a metropolitan Aboriginal Maternity Group Practice Program.
        Med J Aust. 2015; 203: 262
        • Glor E.
        Impacts of a prenatal program for native women.
        Can J Public Health. 1987; 78: 249-254
        • Coughlin R.L.
        • Kushman E.K.
        • Copeland G.E.
        • Wilson M.L.
        Pregnancy and birth outcome improvements for American Indians in the healthy start project of the inter-tribal council of Michigan, 1998-2008.
        Matern Child Health J. 2013; 17: 1005-1015
      11. McCalman J, Searles A, Edmunds K, et al. Evaluating the Baby Basket Program in North Queensland: As Delivered by Apunipima Cape York Health Council, 2009 to 2013. Hunter Medical Research Institute. South Carolton, Australia: The Lowitja Institute, James Cook University; 2014.

        • Barlow A.
        • Mullany B.
        • Neault N.
        • et al.
        paraprofessional-delivered home-visiting intervention for American Indian teen mothers and children: 3-Year outcomes from a randomized controlled trial.
        Am J Psychiatry. 2015; 172: 154-162
        • May P.A.
        • Hymbaugh K.J.
        A macro-level fetal alcohol syndrome prevention program for native Americans and Alaska natives: Description and evaluation.
        J Stud Alcohol. 1989; 50: 508-518
        • May P.A.
        • Miller J.
        • Goodhart K.
        • et al.
        Enhanced case management to prevent fetal alcohol spectrum disorders in Northern Plains communities.
        Matern Child Health J. 2008; 12: 747-759
        • Mehl-Madrona L.E.
        Psychosocial prenatal intervention to reduce alcohol, smoking and stress and improve birth outcome among minority women.
        J Prenat Perinat Psychol Health. 2000; 14: 257-278
        • Wennberg A.L.
        • Lundqvist A.
        • Hogberg U.
        • Sandstrom H.
        • Hamberg K.
        Women's experiences of dietary advice and dietary changes during pregnancy.
        Midwifery. 2013; 29: 1027-1034
        • Bookari K.
        • Yeatman H.
        • Williamson M.
        Exploring Australian women's level of nutrition knowledge during pregnancy: A cross-sectional study.
        Int J Womens Health. 2016; 8: 405-419
        • Rae K.
        • Weatherall L.
        • Hollebone K.
        • et al.
        Developing research in partnership with Aboriginal communities—Strategies for improving recruitment and retention.
        Rural Remote Health. 2013; 13
        • McLennan V.
        • Khavarpour F.
        Culturally appropriate health promotion: Its meaning and application in Aboriginal communities.
        Health Promot J Australia. 2004; 15: 237-239
        • National Health and Medical Research Council, Australian Health Ethics Committee
        Keeping Research on Track: A Guide for Aboriginal and Torres Strait Islander Peoples About Health Research Ethics.
        Australian Government, Canberra, Australia2005
      12. National Health and Medical Research Council. The NHMRC Road Map II: A Strategic Framework for Improving the Health of Aboriginal and Torres Strait Islander People Through Research. Canberra, Australia: Commonwealth of Australia; 2010.

        • Mackerras D.
        Birthweight changes in the pilot phase of the Strong Women Strong Babies Strong Culture Program in the Northern Territory.
        Aust N Z J Public Health. 2001; 25: 34-40
        • Smith R.M.
        • Smith P.A.
        • McKinnon M.
        • et al.
        Birthweights and growth of infants in five Aboriginal communities.
        Aust N Z J Public Health. 2000; 24: 124-135
      13. World Health Organization. e-Library of Evidence for Nutrition Actions (eLENA): Nutrition counselling during pregnancy http://www.who.int/elena/titles/nutrition_counselling_pregnancy/en/. Accessed February 12, 2016.

      Biography

      A. M. Ashman is a PhD candidate with the Gomeroi gaaynggal Centre, Faculty of Health and Medicine, University of Newcastle, Tamworth, New South Wales, Australia; the School of Health Sciences, Faculty of Health and Medicine; and the Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia.

      Biography

      L. J. Brown is academic team leader, Department of Rural Health, Faculty of Health and Medicine, University of Newcastle, Tamworth, New South Wales, Australia.

      Biography

      C. E. Collins is director of research, School of Health Sciences, Faculty of Health and Medicine, and acting director, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia.

      Biography

      M. E. Rollo is a postdoctoral research fellow, School of Health Sciences, Faculty of Health and Medicine, and a postdoctoral research fellow, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia.

      Biography

      K. M. Rae is Gomeroi gaaynggal program director, Gomeroi gaaynggal Centre, Faculty of Health and Medicine, and associate professor, Department of Rural Health, Faculty of Health and Medicine, University of Newcastle, Tamworth, New South Wales, Australia; Priority Research Centre in Reproduction, University of Newcastle, Callaghan, New South Wales, Australia; and Mothers and Babies Research Centre, Faculty of Health and Medicine, University of Newcastle, New Lambton, New South Wales, Australia.