The problem of heteronormativity in family-based health promotion: centring gender transformation in Ontario, Canada.

OBJECTIVES: Social scientists have demonstrated that family health work is interlinked with heteronormative gender inequities. Yet family-based public health interventions rarely incorporate a gender transformative approach or address heteronormativity as a potential health barrier in North America. Instead, attention to gender surfaces primarily in family health interventions conducted in low- to middle-income countries with majority Black and racialized populations. The objective of this article is to establish the importance of designing health interventions that account for heteronormative relations in Ontarian families by drawing on empirical data from the Guelph Family Health Study (GFHS). METHODS: We draw on data (February-October 2019) from (1) semi-structured interviews with 20 families and with 4 health educators facilitating the GFHS home visits and (2) observational data of 11 GFHS home visits and 1 health educator training day. Informed by gender transformation theory, data were analyzed and coded to understand the impact of gender, sexuality, and place in family health interventions. RESULTS: Pre-existing heteronormative parenting relations were reinforced through GFHS participation: the GFHS was mother-led, increasing some mothers' stress levels. Fathers tended to consider paid work a justification for disengaging from the GFHS, and their detachment sometimes obstructed mothers' intervention efforts. Health educators (all women) were caught in these relations, feeling like because of their gender, they were viewed by parents as confidants and marriage counsellors. CONCLUSION: Findings emphasize the need for expanding the epistemic and methodological approaches to family-based health interventions, changing the demographic and geographic emphasis within the field, and designing interventions that focus on societal-level changes. Heterosexuality has not been analyzed as a risk factor within the public health field, but our findings indicate the need for further study.

RéSUMé: OBJECTIFS: Les spécialistes des sciences sociales ont démontré que le travail en santé familiale est indissociable des inégalités hétéronormatives entre les sexes. Il est pourtant rare que les interventions sanitaires axées sur la famille intègrent une approche transformatrice du genre ou abordent l'hétéronormativité en tant qu'obstacle possible à la santé en Amérique du Nord. Au lieu de cela, l'attention au genre fait principalement surface dans les interventions en santé familiale menées dans des pays à faible revenu et à revenu intermédiaire dont les populations sont majoritairement noires et racisées. Notre article vise à souligner l'importance de concevoir des interventions sanitaires qui tiennent compte des relations hétéronormatives dans les familles ontariennes en puisant dans les données empiriques de l'étude Guelph Family Health Study (GFHS). MéTHODE: Nous avons fait appel aux données (février­octobre 2019) : 1) d'entretiens semi-directifs avec 20 familles et avec 4 éducatrices sanitaires ayant facilité des visites à domicile dans le cadre de la GFHS; et 2) d'observation de 11 visites à domicile menées dans le cadre de la GFHS et d'une journée de formation des éducatrices sanitaires. Éclairées par la théorie de la transformation de genre, les données ont été analysées et codées pour nous aider à comprendre les effets du sexe, de la sexualité et du lieu dans les interventions en santé familiale. RéSULTATS: Les relations parentales hétéronormatives préexistantes ont été renforcées par la participation à l'étude GFHS : ce sont surtout des mères qui y ont participé, ce qui a accru les niveaux de stress chez certaines. Les pères ont eu tendance à considérer leur travail rémunéré comme une raison de se retirer de l'étude, et leur détachement a parfois fait obstacle aux efforts d'intervention des mères. Les éducatrices sanitaires (toutes des femmes) ont été prises en étau dans ces relations et ont senti qu'en raison de leur sexe, elles étaient vues par les parents comme des confidentes et des conseillères conjugales. CONCLUSION: Nos constatations soulignent le besoin d'élargir les approches épistémiques et méthodologiques des interventions en santé familiale, de changer l'accent sur les données démographiques et géographiques dans le domaine et de concevoir des interventions axées sur les changements sociétaux. L'hétérosexualité n'est pas analysée en tant que facteur de risque dans le domaine de la santé publique, mais nos constatations indiquent le besoin de pousser la recherche en ce sens.

The Game of Queer Family Life: Exploring 2SLGBTQI+ Parents' Experiences of Cisheteronormativity, Racism, and Colonialism Through Digital Storytelling in Ontario, Canada.

In this article we describe and analyze five videos created through an arts-informed research project, Precarious Inclusion: Studying Ontarian 2SLGBTQI+ parents' experiences childrearing in a post-legal parity framework. Precarious Inclusion used interviews and digital storytelling to investigate Ontario 2SLGBTQI+ parents' current experiences of inclusion and exclusion when navigating institutional and social interactions in everyday life in a post-legal parity context. The study centrally explored how intersecting identities with regards to sexuality, gender, geography, disability, class, race, Indigeneity, and ethnicity intersect with structural forces to influence 2SLGBTQI+ parents' inclusion and exclusion experiences. We examine research creation activities that supported 2SLGBTQI+ parents in making short videos about their experiences of parenting. Our analysis of the five videos created by Indigenous, racialized, trans, nonbinary, Two-Spirit, and disabled parents show how consistent experiences of exclusion mark 2SLGBTQI+ parents' everyday lives. We deepen theorizations of the material and psychological impacts of exclusion for 2SLGBTQI+ families through foregrounding three themes: 1) the operations of racism, white supremacy, and colonialism in makers' lives; 2) misrecognition and its psychic effects of bifurcation and disjuncture; and 3) love, joy, and multi-species kinship as powerful sites of healing and belonging. We further demonstrate how parents used their videos as self-advocacy for resisting precarious inclusion.

Dishing on dinner: a life course approach to understanding the family meal context among families with preschoolers.

OBJECTIVE: Family meals promote healthful dietary intake and well-being among children. Despite these benefits, family meal participation typically declines as children age. This study utilises life course theory to explore parents' perceptions of family meals in order to understand how parents' past experiences with family meals (in childhood and earlier in adulthood) influence their current beliefs and practices regarding mealtimes with their own children. DESIGN: Semi-structured qualitative interviews. SETTING: In-person interviews were conducted in participants' homes. PARTICIPANTS: Twenty families (twenty-one mothers and fifteen fathers) with a child aged between 18 months and 5 years. RESULTS: Thematic analysis revealed that families seemed to primarily approach mealtimes from one of three overarching orientations: meals for (1) Togetherness, (2) Nutrition Messaging or (3) Necessity. These orientations were informed by parents' own mealtime experiences and significant life transitions (e.g. parenthood). The current family meal context, including the messages parents shared with their children during mealtimes and the challenges experienced with mealtimes, characterised the orientations and families' approaches to mealtimes. CONCLUSIONS: Parents' own early life experiences and significant life transitions influence why families eat meals together and have important implications for the intergenerational transmission of mealtime practices. Results may help to inform the content and timing of intervention strategies to support the continuation of frequent family meals beyond the preschool years.