AbstractObjectivesThis study investigates how lifecourse, immigrant status and acculturation, and neighbourhood of residence influence food purchasing and preparation among low-income women with children, living in the USA. This research sought to understand physical and economic access to food, from both ‘individual’ and ‘community’ perspectives.DesignThis study used qualitative methodology (focus groups) to examine the mechanisms and pathways of food preparation and purchasing within the context of daily life activity for US- and foreign-born women, living in the USA. The study methodology analysed notes and verbatim transcripts, summarised recurring responses and identified new themes in the discussions.Setting and subjectsA total of 44 women were purposively sampled from two metropolitan areas in Massachusetts, USA, based on (1) neighbourhood of residence and (2) primary language spoken. All focus groups were conducted in community health centres and community centres co-located with offices of the special supplemental nutritional programme for Women, Infants, and Children.ResultsAnalysis of key response themes suggested that scarcity of food and physical access to food purchasing points did not influence food purchasing and preparation as much as (1) limited time for food shopping, cooking and family activities; and (2) challenges in transportation to stores and childcare. The study results demonstrated differing attitudes toward food acquisition and preparation between immigrant and US-born women and between women who lived in two metropolitan areas in the western and eastern regions of the state of Massachusetts, USA.ConclusionsThe findings illustrate ‘hidden’ constraints that need to be captured in measures of physical and economic access and availability of food. US policies and programmes that aim to improve access, availability and diet quality would benefit from considering the social context of food preparation and purchasing, and the residential environments of low-income women and families.
Structural community factors and sub-optimal engagement in HIV care among low-income women in the Deep South of the USA