FAR FROM IDEAL: TALKING ABOUT WEIGBT WITH MOTHERS AND DAUGaTERS FROM WINNIPEG, SOUTHERN MANITOBA AND A FIRST NATIONS COMMUNITY A Thesis Submitted to the Faculty of Graduate Studies in Partial Fulfilment of the Requirements for the Degree of DOCTOR OF PHILOSOPHY Department of Comrnunity Health Sciences Faculty of Medicine University of Manitoba Winnipeg, Manitoba Canada (c) 2001 National Library Bibliothèque nationale 1+1 of Canada du Canada Acquisitions and Acquisitions et Bibliographie Services services bibliographiques 395 Wellington Street 395. rue Weüingtocr Oîtawa ON K1A ON4 Ottawa ON K1A Canada Canads The author has granted a non- L'auteur a accordé une licence non exclusive licence allowïng the exclusive permettant a la National Lhrary of Canada to Bibliothèqge nationale du Canada de reproduce, loan, distribute or sell reproduire, prêter, distribuer ou copies of this thesis in microform, vendre des copies de cette thèse sous paper or electronic formats. la forme de microfiche/film, de reproduction sur papier ou sur format électronique. The author retains ownership of the L'auteur conserve la propriété du copyright in this thesis. Neither the droit d'auteur qui protège cette thèse. thesis nor substantial extracts fiom it Ni la thèse ni des extraits substantiels may be printed or otherwise de celle-ci ne doivent être imprimés reproduced without the author's ou autrement reproduits sans son permission . autorisation. THE UNWERSïN OF MANITOBA FACULTY OF GRADUATE STUDIES ***** COPYRIGHT PERMISSION PAGE Far From Ideai: Talkiag abatWeight with Mothers and Daughters hmWinnipeg, Southern Manitoba and a First Nations Community A Thesis/Practicum submitted ta the Facnlty of Graduate Studies of The University of Manitoba in partial falflllment of the reqairements of the degree of GAIL DM. MARCHESSAULT 02001 Permission has been granted ta the Library of The University of Manitoba to lend or seU copies of this thesidpmcticum, to the National Wrary of Cam& to microfilm tbis thdsand to lend or sell copies of the mm, and to Dissertations Abstncts Internitiod to pubosh an abstract of this thesis/practlcum. The author reserves other pubiiution rights, and ncither this thesidptllcticum nor extensive extracts from it may be printed or otherwise reproduced without the author's written permission. 1dedicate this thesis to Morley and Lexi who encouraged me to begin it and encouraged me to finish it. ABSTRACT This research compared body weight perceptions of Aboriginal and non-Aboriginal girls and their mothers. Three interview formats were used: in-depth qualitative interviews; a stnictured questionnaire analysed with cultural consensus theory; and three standardized questionnaires. Families were randomly selected based on the class lists of Grade 8 students from two urban and two rural schools. The sample consisted of 80 mother- daughter pairs, interviewed separately. The response rate was 71.3%. The non-Aboriginal women almost unanimously discussed strong societal pressures that made weight more important to women than to men. Most of the Aboriginal women, especially in the First Nations community (FNC),emphasized physiology and health, speaking in a way that suggested weight was not central to female identity. Despite this, some Aboriginal women related a history of risky eating behaviours. Analysis of the 24 weight-related values statements indicated consensus, except in the FNC women. Both agreement and disagreement were highlighted. Across locations, approximately half of the girls accuratety repeated their mothers' advice to them regarding weight. There were no significant associations between mother-daughter pairs in the analysis of the consensus statements, reports of dieting, general advice to others, the Restraint Scale, the Eating Attitudes Test (EAT-26), or body dissatisfaction as measured by the Body Shape Drawings Questionnaire. A pst-hoc analysis of 21 participants who most supported accepting one's body size was the only mother-daughter association that achieved statistical significance (kappa =û.51). Body dissatisfaction was higher in Aboriginal than non-Aboriginal women (83% and 62%) and girls (66% and 36%). Responses on the Restraint Scale suggested more dieting in the FNC. More Aboriginal (17.5%)than non- Aboriginal (2.5%) girls had EAT-26 scores suggestive of risk for an eating disorder. These results suggest that (a) girls are not necessady emulating their mothers' weight concems but may leam to challenge weight obsession fiom hem; (b) both weight and weight preoccupation need to be considered in health messages to Aboriginal girls and women living in or close to an wban centre. ACKNOWLEDGEMENTS Thank you to the mothers and daughters who shared the perspectives and experiences that fom the basis fur this sturty. To Dr. Linda Garro, Dr. Pat Kaufert, Dr. Sharon Macdonald and Dr. Manly Spigelman, a heartfelt thank you for an informative, chdenging and worthwhile graduate education. 1 feel both lucky and honoured to have studied with such an exceptional team of dedicated scholars and able teachers. 1 am especially grateful to my advisor, Dr. Linda Garro, for her expert guidance and consistently excellent advice given generously, fmt here and then from the University of California, Los Angeles. 1 thank the professors and staff of the Department of Community Health Sciences for a rich and supportive learning environment. 1especially thank Drs. Tom Hassard, Pat Martens and Bob Tate for statistical guidance rendered in plain English, Dawn Stewart for helpful cornputer advice, Joe Kaufert for filling the hallways with enthusiastic encouragement, and Camille Guenette and Theresa Kennedy for talcing care of my needs as a graduate student. 1 could not have completed this process without fiends and family. 1 thmk Morley and Lexi, my family and my husband's family for their enduring love, understanding, tolerance and assistance. A special thank you to my sister Tina, for her many hundreds of hours devoted to transcription. 1thank my friends, fellow graduate students and colleagues for many different kinds of support: Pat Allen, Frances Berg, Jocelyn Bruyere, Joan Butcher, Marian Campbell, Ruth Diamant, Chris Egan, Lyn Ferguson, Marcy Finlayson, Brian and Cathy Hallamore, Derek Lucian and Lillian Smith, Kathleen Harrison, Nancy Hughes and Gerry Kaplan, Pat Martens, Catherine McNeil, Donna Rodgers, Ted Rosenberg and Liza Zacharias, David Rosner, Sheelagh Smith, Moneca Sinclaire, Jan Sprout, Bob Tate, and Bev Watts. And, although 1 cannot name her, a special thanks to my host in the First Nations community, whose fiiendship 1value, and whose help was invaluable. Thanks also to the Winnipeg School Board Division No. 1, the ndschool boards and the Chief and Council of the First Nations community for granting permission to conduct the research in their district schools. 1appreciate the efforts of the principals and school personnel who kindly helped with the implementation of the project. This research was made possible in part by Health Canada through a National Health Research and Development Program (NHRDP)Research Training Award. I also acknowledge with gratitude financial assistance from the Manitoba Health Research Council, the Children's Hospital Research Foundation, the Canadian Home Economics Association, the Women's Health Research Foundation of Canada, and the Dietitians of Canada. And 1 thank the Department of Foods and Nutrition in the Faculty of Human Ecology for allowing the first few months of my position at the University of Manitoba to be the last few months of polishing the thesis. Table of Contents Abstract ............................................................... i ... Acknowledgements ..................................................... 111 List of Figures ......................................................... ix Chapter0ne:Introduction ................................................. 1 Statement of the Problem ............................................ 1 Objectives and Research Questions ................................... -5 Rationale for Group Identification ..................................... 6 Reflections on the Evolution of the Research ........................... 10 Title and Outline of the Thesis ....................................... 16 Chapter Two: Far from Ideal .............................................. 19 Aboriginal People's Weight Status. Perceptions and Behaviours ............ 24 BodyIrnage ..................................................... 33 Sociocultural Context for Perceptions of Weight ........................35 Family ................................................... 39 Mothers and Daughters ...................................... 42 Chapter Three: The Research Process ....................................... 50 Research Design and Analysis ...................................... -50 Serni-Stnictured Interviews .................................. -52 Fixed-Response Interviews ..................................-54 Questionnaires .............................................56 Background Information .................................... -63 Triangulating Methods ............................................. 65 Ethical Considerations ............................................. 67 The Research Sites ............................................... -68 Implementation .................................................. 70 Sample Selection .......................................... -75 The Research Participants .......................................... 76 Demographic Characteristics