Skip to main content

Table 2 Summary of themes developed among participants

From: Incorporating Aboriginal women’s voices in improving care and reducing risk for women with diabetes in pregnancy - A phenomenological study

Main theme

Subtheme

Sample quotes

A. Structural barriers to lifestyle change:

1. Food insecurity and availability

• Availability (junk food more available)

• Access (enough money, other people eating food)

• Utilisation (overcrowding, limited facilities, fridges, easier to buy fast-food)

• Stability (weather dependent)

• Sugary drinks and food are addictive

• Harder to eat well

Availability

• W11: can’t keep eating good food, sometimes we get low of veggies and stuff…Yes sometimes when we get money, we get veggies… just eat what we got in the house, like plain noodles or just sandwich, butter and bread.

Access

• HP5: women try and buy healthy foods, put it in the cupboard, it’s eaten, and it’s gone. So, you basically eat for now. So, take away food is easy. I get my meal now, I eat it, it’s mine. Whereas if you buy for the future, there’s no guarantee you’re going to eat it.

Utilisation

• W1: if you’ve got three or four different families living in one house, what are you …? That other family’s going to go in and get your food while you’re not there, unless you’ve got a lock on your fridge, and most people don’t have fridges in their house.

Stability

• HP4: keeping food fresh and also by the time it’s travelled out here, it’s already three or four days old and frozen food would be better because the nutrient balance is probably better, but they don’t have freezers to freeze their food.

Other

• HP7: if you’re under such a barrage of sales I think the actual resisting it, especially in poorer areas is much more difficult.

• C1: quick feed, I’m hungry, I’ll just buy anything, Yeah, they just grab anything in the shop they will eat

2. Cultural appropriateness of facilities and previous programs

• Previous failed programs

• Western concepts of exercise

• W2: it’s too hot to exercise here.

• W10: the basketball court they closed it so some of them are not going there.

• W1: [people jogging and swimming] They’re only the white people. You never see an Aboriginal person jogging.

• W1: they used to have yoga, years ago, but it was only the nurses and the teachers that used to turn up; no locals.

What sort of exercise might work?

• W6: just women. And make it strict.

3. Competing priorities

• Other life stressors take priority

• Not motivated

Related to cooking and diet

• HP1: I think the depression and the despair is getting worse and worse and this is probably one of the worst communities I’ve seen: the hopelessness is really quite overwhelming here.

Related to sport and exercise

• W5: they got other problems, or they not interested.

B. Enablers to lifestyle change:

1. Culture and connection with Country

• Going on Country

• Eating bush-tucker

• Look after each other’s children

• W2: most people love their bush food. I know I do.

• W8: because Mum always … take me hunting and make me eat healthy food. She always cook … and make me food.

• HP1: I think it needs to get back into the community. This is something that needs to come from the community

Would it be hard to exercise because you have to look after your kids?

• W2: no. They can come with me

C. Solutions

1. Structural changes

• Banning soft drink

• Subsidising healthy food

• W1: stop selling sugary stuff in the shop.

• HP2: maybe if you ban soft drinks, I don’t know. But again, even as I say that I know you’ve got to make the decision yourself.

What do you think if you made junk food and soft drink expensive/ subsided fruit and vegetable?

• W4: they’ll keep it. They don’t care if it’s expensive they still buy it.

2. Cooking classes and community kitchen

• Culturally appropriate

• W6: to teach our people to cook, to better cooking healthy food. Need to have healthy food.

• W7: maybe they’ll get all the womens together and sit and talk about what sort of food that we want to, you know, eat, some better food. And bush tuckers.