Dietary Practices during Pregnancy in a Marshallese Community: A Mixed Methods Analysis
Abstract
:1. Introduction
2. Methods
2.1. Recruitment and Sampling
2.2. Research Design
2.3. Data Collection
2.4. Data Analysis
3. Quantitative Results
4. Qualitative Results
4.1. Traditional Beliefs about a Healthy Diet during Pregnancy
4.1.1. Should Eat
4.1.2. Should Not Eat
“My mom told me not to eat Hot Cheetos because it causes rashes. It can cause rashes for the baby. And I don’t drink a lot of soda. She tells me not to eat a lot of sweets because it will cause something to the baby. Sometimes I don’t understand.”(PID 39)
“And they say not to eat limes and things like that. As for my mom, when she was pregnant with me she had too much lime and I got sick from it. My whole body was stiff and stomach as well, so those are the ones that they don’t want me to eat.”(PID 12)
4.1.3. Challenges to Traditional Diet
4.1.4. Spiritual Dietary Customs during Pregnancy
“In our customs we cannot eat at other places or eat other people’s food, especially here. They may do magic on us without knowing who did it. Other people usually warn other pregnant women and say things like ‘don’t go eating at other people’s houses because you don’t know what they will do to you.’”(PID 12)
4.2. Dietary Change during Pregnancy
4.2.1. A Healthy Diet for My Baby
“Before I didn’t care what I ate because I was working a lot and I usually never had time to fix food for myself. That is what all the weight gain was about. Then when I found out I had anemia and low iron, which is what caused me to change because I want my baby to have a lot of blood for oxygen for his blood.”(PID 39)
4.2.2. Autonomy and Diet
4.2.3. Sugar-Sweetened Beverages
5. Discussion
Limitations and Strengths
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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N | Percent of Sample (%) | |
---|---|---|
Age | 28.1 | |
Marital Status | ||
Single | 5 | 15.2 |
Married | 15 | 45.5 |
Divorced/separated | 0 | 0 |
Widowed | 0 | 0 |
A member of an unmarried couple | 13 | 39.4 |
Education | ||
Never attended school or only attended kindergarten | 0 | 0 |
Grades 1 through 8 (elementary) | 4 | 12.1 |
Grades 9 through 11 (some high school) | 9 | 27.3 |
Grade 12 or GED (high school graduate) | 11 | 33.3 |
College 1 year to 3 years (some college or technical school) | 9 | 27.3 |
College 4 years or more (college graduate) | 0 | 0 |
Household Size | 7.2 | |
Employment | ||
Employed for wages | 7 | 21.2 |
Self-employed | 0 | 0 |
Out of work for 1 year or more | 10 | 30.3 |
Out of work for less than 1 year | 11 | 33.3 |
Taking care of your family and home | 4 | 12.1 |
Student | 1 | 3 |
Retired/unable to work | 0 | 0 |
Health Insurance Status | ||
No | 20 | 60.6 |
Yes | 13 | 39.4 |
Birthplace | ||
United States | 5 | 15.2 |
Marshall Islands | 28 | 84.8 |
Other | 0 | 0 |
WIC Status | ||
No | 21 | 63.6 |
Yes | 12 | 36.4 |
Number of Total Pregnancies | 3.8 | |
Number of Miscarriages | 0.4 | |
0 miscarriages | 24 | 72.7 |
1 miscarriage | 6 | 18.2 |
2 miscarriages | 3 | 9.1 |
N | Percent of Sample (%) | ||
---|---|---|---|
How much weight I gain is entirely up to me | |||
Yes/Agree | 32 | 97 | |
Maybe/Not sure | 1 | 3 | |
No/Disagree | 0 | 0 | |
If I eat properly and get enough exercise and rest, I can control my weight in the way I desire | |||
Yes/Agree | 32 | 97 | |
Maybe/Not sure | 1 | 3 | |
No/Disagree | 0 | 0 | |
I can control eating when I am watching TV | |||
Yes/Completely sure | 18 | 54.5 | |
Maybe/Not sure | 2 | 6.1 | |
No/Not sure at all | 13 | 39.4 | |
I can control eating when there are many different kinds of foods available | |||
Yes/Completely sure | 23 | 69.7 | |
Maybe/Not sure | 2 | 6.1 | |
No/Not sure at all | 8 | 24.2 | |
I can control eating even when I am at a party | |||
Yes/Completely sure | 19 | 57.6 | |
Maybe/Not sure | 7 | 21.2 | |
No/Not sure at all | 7 | 21.2 | |
I can resist eating even when high-fat foods are available (n = 32) | |||
Yes/Completely sure | 21 | 65.6 | |
Maybe/Not sure | 6 | 18.8 | |
No/Not sure at all | 5 | 15.6 | |
I can resist eating even when I feel it’s impolite to refuse a second helping | |||
Yes/Completely sure | 16 | 48.5 | |
Maybe/Not sure | 8 | 24.2 | |
No/Not sure at all | 9 | 27.3 | |
I can resist eating even when others are pressuring me to eat | |||
Yes/Completely sure | 21 | 63.6 | |
Maybe/Not sure | 5 | 15.2 | |
No/Not sure at all | 7 | 21.2 | |
I can control eating when I feel stressed out or tired | |||
Yes/Completely sure | 23 | 69.7 | |
Maybe/Not sure | 2 | 6.1 | |
No/Not sure at all | 8 | 24.2 | |
How often do you attend church or other religious meetings? | |||
Never | 0 | 0 | |
Less than once a month | 4 | 12.1 | |
1–2 times a month | 5 | 15.2 | |
More than 2 times a month | 23 | 69.7 | |
Don’t know/Not sure | 1 | 3 | |
In an average month, how often does your church include any message encouraging healthy eating? | |||
Never | 14 | 42.4 | |
Less than once a month | 4 | 12.1 | |
1–2 times a month | 4 | 12.1 | |
More than 2 times a month | 10 | 30.3 | |
Don’t know/Not sure | 1 | 3 | |
During the past three months, how often did you … eat fruit for breakfast? (n = 32) | |||
Often | 6 | 18.8 | |
Sometimes | 22 | 68.8 | |
Never | 4 | 12.5 | |
During the past three months, how often did you … eat a vegetable at lunch? | |||
Often | 7 | 21.2 | |
Sometimes | 21 | 63.6 | |
Never | 5 | 15.2 | |
During the past three months, how often did you … eat two or more vegetables at dinner? (n = 32) | |||
Often | 9 | 28.1 | |
Sometimes | 18 | 56.3 | |
Never | 5 | 15.6 | |
Sodas consumed per day | |||
0 | 3 | 9.4 | |
More than 0 but less than 1 | 15 | 46.9 | |
1 or more | 15 | 46.9 | |
Sugary drinks consumed per day (n = 32) | |||
0 | 2 | 6.3 | |
More than 0 but less than 1 | 6 | 18.8 | |
1 or more | 24 | 75 | |
Height (in inches) (n = 32) | 60.0 | ||
Weight (in pounds) (n = 32) | 149.8 |
N | Percent of Sample (%) | ||
---|---|---|---|
How hard is it for you to pay for necessities like food, housing, medical care, and electricity? | |||
Very hard | 10 | 30.3 | |
Somewhat hard | 17 | 51.5 | |
Not hard at all | 6 | 18.2 | |
Which of the following describes the amount of food your household has to eat? | |||
Enough to eat | 18 | 54.5 | |
Sometimes not enough to eat | 10 | 30.3 | |
Often not enough to eat | 5 | 15.2 | |
In the last 12 months, did you or any member of your household ever get emergency food from a church, a food pantry, or a food bank, or eat in a soup kitchen? | |||
Yes | 16 | 48.5 | |
No | 16 | 48.5 | |
Don’t know/Not sure | 1 | 3 |
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Ayers, B.L.; Bogulski, C.A.; Bennett-Milburn, A.; Fisher, A.; Netwon, M.; McElfish, P.A. Dietary Practices during Pregnancy in a Marshallese Community: A Mixed Methods Analysis. Int. J. Environ. Res. Public Health 2022, 19, 6360. https://doi.org/10.3390/ijerph19116360
Ayers BL, Bogulski CA, Bennett-Milburn A, Fisher A, Netwon M, McElfish PA. Dietary Practices during Pregnancy in a Marshallese Community: A Mixed Methods Analysis. International Journal of Environmental Research and Public Health. 2022; 19(11):6360. https://doi.org/10.3390/ijerph19116360
Chicago/Turabian StyleAyers, Britni L., Cari A. Bogulski, Ashlea Bennett-Milburn, Anna Fisher, Morda Netwon, and Pearl A. McElfish. 2022. "Dietary Practices during Pregnancy in a Marshallese Community: A Mixed Methods Analysis" International Journal of Environmental Research and Public Health 19, no. 11: 6360. https://doi.org/10.3390/ijerph19116360