AbstractType 2 diabetes, cardiovascular and renal disease contribute significantly to the lower life expectancy and disproportionately high rates of morbidity of Indigenous Australians1. Diet plays a key role in protecting against these conditions. The people of Galiwin’ku, an Aboriginal community in North-East Arnhem Land, are striving to improve their health and well-being by addressing the nutritional quality of the food supply and encouraging healthy eating practices. Through a series of studies, this thesis investigates the problem of poor nutrition and the factors influencing eating behaviour in Galiwin’ku community. Guided by the social-ecological perspective of the PRECEDE-PROCEED model, this thesis comprises four assessment phases: 1) an epidemiological assessment (screening study) of the extent of type 2 diabetes and related conditions; 2) a behavioural and environmental assessment of dietary intake, food affordability and availability (quantitative assessment of community level food supply); 3) an educational and ecological assessment of historical and contemporary factors impacting on diet and nutrition improvement (archival, observational and structured and unstructured interview methods); and 4) an administration and policy assessment of facilitators and barriers to improving the nutritional quality of food available through the community store (case study using observational and structured and unstructured interview methods). The epidemiological assessment identified excess weight gain among young people as a modifiable risk factor to prevent type 2 diabetes. The behavioural and environmental assessment identified access to healthy food and poverty as key determinants of food choice. The educational and ecological assessment suggests that nutrition improvement efforts need to consider broader-based determinants such as employment, housing, the availability and cost of food, and illicit substance use. The administration and policy assessment found the community store a critical intervention point for increasing the availability of healthy food choices. To achieve this, a framework is proposed based on a collaborative “whole-of-store” approach that integrates feed-back into a cyclic improvement model.
|Date of Award||2007|
Enough for rations and a little bit extra: challenges of nutrition improvement in an Aboriginal community in North East Arnhem Land
Brimblecombe, J. (Author). 2007
Student thesis: Doctor of Philosophy (PhD) - CDU