One of the key objectives of FEHNCY is to assess the health status of the children and youth in the communities relative to their food environment and food insecurity.

Food Environment: The availability, accessibility and affordability of food within a region or community; it directly influences what a person decides to consume on a daily basis.

Food Security: Household food security means that families have adequate financial resources to access sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life. Based on answers to 18 questions on a standardized questionnaire, households will be considered to be food secure or food insecure.

This component of the study will be divided according to the following three levels;

ASSESSMENT OF CHILD’S COMMUNITY AND SCHOOL’S FOOD ENVIRONMENT

Participatory mapping: children and youth will be invited to participate in group activities that will use participatory drawing to explore their perspectives about foods available in their community. Participatory mapping will give us access to the unique insights into children’s perspectives of their food environments via a visual representation.

Interviews: To assess traditional food yields, access to alternative food sources and enquire about food support groups, key informant interviews will be conducted with adult knowledge keepers from each community.

Observations of the food environment: To assess the nutritional quality, accessibility, and availability of food as well as determine how far people have to go to obtain food, observations of the consumer and community food environments will also be carried out. This includes obtaining the GPS points of key locations relevant to the food environment as well as an assessment of the food availability, cost and quality in local stores.

ASSESSMENT OF CHILD’S HOUSEHOLD ENVIRONMENT

Children, accompanied by their caregivers, will be interviewed to collect sociodemographic (such as age, gender and education), food security and food intake data (including traditional food).

A household inspection will be conducted to collect information on mould, dust, housing conditions and air quality. These data will be used to study possible links between children’s health and exposure to potential contaminants in their homes.

ASSESSMENT OF CHILD’S NUTRITION AND HEALTH

Children’s health status (how well they are growing as well as what contaminants they might be exposed to) will be examined by taking blood, urine and hair samples as well as measuring their height, weight and body fat. A health questionnaire will also ask questions about chronic illnesses as well as mental health.

HOUSEHOLD INSPECTION

• Parents/caregivers of participating children/youth will answer questions about the home
• Household inspection using standardized tool
• Installation of air quality monitors
• Installation of radon detectors

INDOOR AIR QUALITY

01. Collection of settled dust

Household dust will be collected and analyzed for endotoxin, dust-mite allergens and fungal glucan. These substances are harmful to lung/respiratory health and are linked to bronchitis, asthma and allergies.

02. Monitoring of indoor air quality

A monitor will be set up in each participating household to measure and record the levels of:

• carbon dioxide (from breathing),
• carbon monoxide and nitrogen dioxide (both released from the burning of fuel),
• PM2.5 or atmospheric particulate matter (from power plants, cars, burning wood, etc) and
• formaldehyde (from smoking, cars, burning wood, etc).

High levels of these chemicals can affect lung/respiratory health. The monitor will also record the relative humidity and the temperature in the home.

03. Measurement of Volatile Organic Compounds (VOCs)

Volatile Organic Compounds (VOCs) are released as gases from many household products such as paint, varnishes, wax, cleansers and disinfectants, air fresheners, dry-cleaned clothing and pesticides. Exposure to high levels of VOCs can result in symptoms ranging from irritation of the eyes, nose and throat to damage to the liver and kidney or even cancer. To date, little information is available regarding VOCs in First Nations communities.

04. Radon

Radon is an invisible, odourless and tasteless gas that comes from the breakdown of uranium in soil and rock. When radon is released in enclosed spaces, like homes, it can accumulate to high levels and become a health risk. Monitors will be left in participants’ homes for 90 days to record the level of this radioactive gas.

To measure the child’s exposure to environmental contaminants, their health and nutritional status, the community researchers will set up appointments for the children to visit the mobile clinic. In the FEHNCY mobile clinic, the following measurements, biological sample collection and tests will be conducted:

BIOLOGICAL SAMPLE COLLECTION

• Hair samples from each participant will be collected from each participant to measure total and inorganic mercury levels for the past three months. High exposure to mercury can affect the nervous, digestive and immune systems as well as brain function in children.
• Blood samples will be collected using standard protocols and a complete blood formula will be performed to evaluate the hemoglobin, corpuscular hemoglobin average, corpuscular hemoglobin average concentration, platelets, etc. These measurements will indicate how well each child is growing. Blood glucose level (to test for diabetes) will also be determined for each child.
• Urine samples will be collected to measure for exposure to contaminants such as arsenic and cadmium.

All the results obtained from the various analysis will be recorded on the FEHNCY clinical form and participant portfolio. Many analyses will be performed immediately after the sample collection to provide the participants with their results while the FEHNCY mobile clinic team is still in the community whenever possible. On-site clinical follow-up will be set up with designated local health professionals with the consent of the participant in case of abnormal test results.

COMMUNITY MOBILIZATION

FEHNCY is designed to encourage and emphasize the involvement of the local communities by motivating them in determining and advocating for improving the health of their next and future generations. Community mobilization is an important aspect of this study and will be applied by providing information to the communities and using the results obtained for advocacy. Presentations and workshops in community schools will be held to promote the engagement of youth leaders and other members in the early stage of the study. Results workshop will be organized to train the First Nations communities on how to analyze their data and to promote regional and national programs and policy changes to benefit the health of their children and youth. Likewise, the study will proceed by fully acknowledging the contributions made by the various partners in producing the results, giving rise to the knowledge and finally, in deciding the actions to be taken.

INTEGRATED KNOWLEDGE TRANSLATION (IKT)

An alliance between researchers and knowledge users is widely believed to be proven beneficial in improving the application of the research results and alteration of policies. This relationship between the involved parties in order to produce the best outcome is known as Integrated knowledge translation(IKT). In our project, we highly encourage the exercise of IKT and our primary knowledge users are the participating communities, Assembly of First Nations (AFN), and the First Nations and Inuit Health Branch. We will administer IKT in our project by holding two regular community presentations during the quantitative data collection phase and one presentation after the quantitative phase to discuss the report cards. A closing celebration will be arranged in each community to present the findings from the qualitative phase and to discuss priorities and recommendations for proposed actions. Towards the end of the entire project, an exhaustive report including all the significant data will be given to the identified band office and other community stakeholders.

INTERGENERATIONAL CAPACITY BUILDING

One of the key objectives of FEHNCY is implement intergenerational capacity building by exercising participatory mapping methods, key informant interviews and observations. This will help to assist the children, youth and the local community members to maximize their understanding, awareness and activity towards the health concerns present in their community.